70 Years of Levothyroxine.

• Author: Kahaly, George J.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2021.; ©2021.
• Year of Publication: 2021
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (141 pages)

Table of Contents

• Intro
• Preface
• Contents
• About the Editor and Contributors
• Editor
• Contributors
• Therapeutic Use of Levothyroxine: A Historical Perspective
• 1 Introduction
• 2 Early Beginnings: Growing Understanding of the Thyroid
• 2.1 Cretinism, Goitre, and the Recognition of the Importance of the Thyroid Gland
• 2.2 An Endocrine Function for the Thyroid Gland
• 3 Towards the Modern Era in the Management of Hypothyroidism
• 3.1 Introduction of Chemically Synthesised Thyroid Hormones
• 3.2 Monotherapy or Combination Therapy?
• 3.3 Technological Advances: Better Assays of Thyroid Function
• 3.4 Recent Developments in Levothyroxine Therapy
• 4 Where We Stand Today
• 4.1 A Fuller (But Incomplete) Understanding of Thyroid Hormone Homeostasis
• 4.2 Unresolved Issues and Current Research Questions
• 5 Conclusions
• References
• Administration and Pharmacokinetics of Levothyroxine
• 1 Introduction
• 2 Absorption, Distribution, Metabolism, and Elimination of Levothyroxine
• 2.1 Absorption and Distribution
• 2.2 Metabolism and Elimination
• 3 Factors That May Alter Exposure to an Oral Dose of Levothyroxine
• 3.1 Factors That May Reduce Exposure to Levothyroxine
• 3.1.1 Diurnal Variation
• 3.1.2 Malabsorption of, and Suboptimal Adherence to, Levothyroxine
• 3.2 Factors That May Alter the Measured Level of Thyrotropin
• 4 Levothyroxine Tablets in a Changing Regulatory Environment
• 5 Conclusions
• References
• Pharmacodynamic and Therapeutic Actions of Levothyroxine
• 1 Introduction
• 2 Thyroid Hormone Homeostasis
• 2.1 Conversion of T4 to T3
• 2.2 Regulation of Deiodinases and Individual "Set Points" for Thyroid Function
• 2.3 Thyroid Hormone Receptors (THRs)
• 2.4 Regulation of TSH Release
• 3 Clinical Pharmacodynamics of (Levo)Thyroxine
• 3.1 Which Thyroid Hormones Are Important?
• 3.2 Actions on Skeletal Muscle.
• 3.2.1 Mechanisms
• 3.2.2 Clinical Studies of Interest
• 3.3 Effects on Lipid Profiles
• 3.4 Actions in Adipose Tissue
• 3.5 Effects on Glucose Metabolism
• 3.6 Actions on Mood and Affect
• 3.7 Fatigue
• 3.8 Actions on Inflammation and Haemostasis
• 3.9 Effects in the Kidney
• 3.10 Effects on the Heart and in Bone
• 4 Evidence-Based Guidelines for the Management of Hypothyroidism
• 4.1 Current Status of Evidence-Based Guidelines
• 4.2 Levothyroxine Monotherapy, or Levothyroxine Plus Triiodothyronine, for Hypothyroidism
• 4.3 Barriers to Optimal Care of Patients with Hypothyroidism
• 4.3.1 The Impact of the Diagnosis Itself
• 4.3.2 Avoiding over Diagnosis
• 5 Conclusions
• References
• Levothyroxine in Pregnancy
• 1 Introduction
• 2 Changes in Thyroid Function During Pregnancy
• 3 Maternal and Foetal Outcomes in Women with Hypothyroidism
• 3.1 Effects of Hypothyroidism on Fertility and Preterm Delivery
• 3.2 LT4 Treatment and Pregnancy Outcomes: Importance of Thyroid Autoimmunity
• 3.3 LT4 Treatment of Euthyroid Women with Thyroid Autoimmunity
• 3.4 Thyroid Autoimmunity and Pregnancy Outcomes in Women Receiving Assisted Reproduction Technologies (ART)
• 3.5 Effects on Offspring
• 4 Summary of Current Major Guidelines
• 4.1 Guidelines Considered Here
• 4.2 Overt Hypothyroidism During Pregnancy and Postpartum
• 4.3 Subclinical Hypothyroidism During Pregnancy and Postpartum
• 5 Conclusions
• References
• Levothyroxine in Children
• 1 Introduction
• 2 Overview of Hypothyroidism in Children
• 2.1 Congenital Hypothyroidism
• 2.2 Subclinical Hypothyroidism
• 2.2.1 Prevalence and Clinical Course
• 2.2.2 Outcomes in Children with Subclinical Hypothyroidism
• 2.3 Other Causes of Hypothyroidism in Children
• 3 Effects of Levothyroxine in Children with Hypothyroidism
• 3.1 Congenital or Overt Hypothyroidism.
• 3.2 Subclinical Hypothyroidism
• 3.3 Biochemically Euthyroid Children
• 4 Conclusions
• References
• Levothyroxine in the Older Patient
• 1 Thyroid Homeostasis in Older Individuals
• 1.1 Thyroid Homeostasis
• 1.2 Thyroid Hormone Levels and Clinical Outcomes
• 2 Therapeutic Use of Levothyroxine in Older Patients with Hypothyroidism
• 2.1 Analyses from Randomised, Placebo-Controlled Trials
• 2.2 Observational Studies of Levothyroxine in Older Patients with Hypothyroidism
• 2.3 Managing Elderly Patients with Hypothyroidism: Implications of the SORTED 1 Trial
• 3 Conclusions
• References
• Levothyroxine and the Heart
• 1 Introduction
• 2 Overview of the Adverse Effects of Thyroid Dysfunction on the Heart
• 3 Effects of Levothyroxine Replacement Therapy on the Cardiovascular System
• 3.1 Effects on ECG Parameters
• 3.2 Effects of l-Thyroxine on Cardiovascular Structure and Function
• 3.3 Effects of LT4 on Major Adverse Cardiovascular Events
• 3.4 Effects of LT4 in Patients with Heart Failure
• 4 Conclusions
• References
• Levothyroxine and Bone
• 1 Overview of the Effects of Thyroid Hormones on the Skeleton
• 2 Bone Health in Patients Receiving Treatment with Levothyroxine
• 2.1 Patients with Congenital Hypothyroidism
• 2.2 Adult Patients with Hypothyroidism
• 2.2.1 Subclinical Hypothyroidism
• 2.2.2 Overt Hypothyroidism
• 2.3 Effects of Thyrotropin-Suppressive Doses of Levothyroxine
• 3 Clinical Perspectives
• References
• Levothyroxine and Cancer
• 1 Introduction
• 1.1 Overview of the Management of Differentiated Thyroid Cancer
• 1.2 Scope of This Chapter
• 2 Application of Thyrotropin-Suppressive Doses of Levothyroxine After Surgery and Radioactive Iodine for Well-Differentiated Thyroid Tumours
• 2.1 Need for Suppression of Thyrotropin in Thyroid Cancer Survivors.
• 2.2 Long-Term Consequences of Thyroidectomy and Thyrotropin Suppression
• 2.2.1 Bone
• 2.2.2 The Cardiovascular System
• 2.2.3 Patient-Reported Outcomes
• 3 Thyroid Hormones and Cancer Risk
• 4 Conclusions
• References
• Practical Application of Levothyroxine-Based Therapy
• 1 Introduction
• 2 Safety and Tolerability of Levothyroxine
• 2.1 Avoiding Symptoms of Thyroid Dysfunction
• 2.2 Adverse Reactions to the LT4 Tablet Itself
• 3 How to Prescribe and Take Levothyroxine
• 4 Overview of Guidelines on the Management of Hypothyroidism
• 5 Conclusions
• References.