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Objective To identify the attitudes of German thyroid specialists towards the clinical treatment of hypothyroidism using thyroid hormones TH. Methods All members of the thyroid section of the German Endocrine Society DGE were e-mailed an invitation to participate in a web-based survey about substitution with TH. Of responding members, Of all respondents, In conditions that could interfere with LT4 absorption, most respondents still preferred tablets and did not expect a significant difference when switching from one LT4 formulation to another.
Conclusion For German thyroid specialists, LT4 is the treatment of choice for hypothyroidism. Even in conditions that could affect bioavailability, German thyroid specialists prefer LT4 tablets rather than other LT4 formulations, such as liquid or soft-gel capsules.
The widespread use of thyroid hormone for non-hypothyroid conditions is not consistent with current evidence and needs further study. Levothyroxine LT4 is the standard therapy for thyroid hormone TH substitution, and different types of LT4 formulations are available, including tablets, liquid solutions, and soft-gel capsules, in several European countries.
Liquid solutions and soft-gel capsules are relatively new LT4 formulations and were produced to overcome some of the bioavailability issues with tablets [ 2 ]. Oral LT4 bioavailability may be reduced when tablets are administered simultaneously with beverages, food, other types of medications e.
Although all available LT4 formulations are regarded as effective in treating hypothyroidism, pre-existing morbidity may be increased in hypothyroid individuals, and post-diagnosis co-morbidity due to psychiatric [ 4 ] and somatic [ 5 ] disorders is higher than in euthyroid controls. This is associated with a higher rate of disability pension, excess mortality from natural and unnatural causes [ 6 ] [ 7 ], and loss of labor market income compared to the background population [ 8 ].