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On-Demand | Updates in Hypothyroidism Treatment – ...
Recording_Updates in Hypothyroidism Treatment – Ne ...
Recording_Updates in Hypothyroidism Treatment – New Evidence for T3 Combination Therapy
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Video Transcription
Video Summary
Dr. Thanh Hoang, an endocrinology expert, provides a comprehensive overview of hypothyroidism, focusing on diagnosis, treatment, and recent evidence regarding T3 combination therapy. Primary hypothyroidism, often caused by autoimmune Hashimoto's thyroiditis, is common and primarily treated with levothyroxine (synthetic T4). However, some patients experience persistent symptoms despite normal TSH levels, prompting exploration of combination therapies including desiccated thyroid extract (DTE) which contains both T3 and T4.<br /><br />Historically, DTE was widely used but was largely replaced by synthetic T4 due to dosing consistency concerns; however, modern standardized formulations have revived interest. Clinical trials suggest some patients, particularly those with higher symptom scores, prefer and benefit from combination T3/T4 therapy or DTE, showing improvements in mood, cognition, and symptom relief without adverse effects. Guidelines recommend starting with levothyroxine but allow trials of combination therapy for symptomatic patients with normal TSH.<br /><br />Dr. Hoang emphasizes careful dosing, patient monitoring mainly via TSH, symptom evaluation using the thyroid symptom questionnaire (TSQ-36), and individualized treatment. Future research aims to identify patients best suited for combination therapy, optimize T3/T4 ratios, and develop slow-release formulations. He advocates for larger randomized trials to refine hypothyroidism management while underscoring the importance of addressing underlying causes and patient preferences.
Keywords
hypothyroidism
Hashimoto's thyroiditis
levothyroxine
T3 combination therapy
desiccated thyroid extract
thyroid symptom questionnaire
TSH monitoring
combination T3/T4 therapy
endocrinology
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