Navigation Links
Combination of Thyroid Medicines Not Necessary

One medication can do the job of both after thyroid removal surgery, study finds,,,,

TUESDAY, Feb. 19 (HealthDay News) -- Two treatments aren't always better than one, suggests new research comparing thyroid hormone levels before and after thyroid removal surgery.

The study, published in the Feb. 20 issue of the Journal of the American Medical Association, found that when people are only given synthetic levothyroxine (T4) after thyroid removal surgery, their levels of another hormone, triiodothyronine (T3), stay about the same as they were before surgery, suggesting that treatment with additional T3 isn't necessary.

"Basically, each patient's T3 levels remained the same after surgery as it was before," said study author Dr. Jacqueline Jonklaas, an assistant professor of medicine in the division of endocrinology at Georgetown University Hospital in Washington, D.C.

As many as 27 million Americans have some type of thyroid disease, according to the American Association of Clinical Endocrinologists; about half of these people are undiagnosed.

Normally, the thyroid makes two hormones -- T3 and T4. As much as 20 percent of T3 in the blood is directly produced by the thyroid, but the rest is made in tissues outside of the thyroid that convert T4 into T3, according to Jonklaas. Most people who've had their thyroids removed or who have had thyroid tissue destroyed as a result of treatment with radioactive iodine take supplemental T4 produce adequate levels of both hormones and feel fine.

But, said Jonklaas, in a small group of people taking just T4, cognitive problems occur, and experts thought maybe it was because these people were missing the extra dose of T3 normally produced in the thyroid, rather than converted from T4.

To try to alleviate these symptoms, some physicians have prescribed combination therapy that included T4 and T3. Jonklaas said that many clinical studies have been done on the combination and that no clear benefit has been shown to prescribing T3 in addition to T4.

The addition of T3 also makes treatment and monitoring more complex. Treatment with T4 provides steady levels of both T3 and T4 hormones. However, when synthetic T3 is given, it builds up and then dissipates quickly, according to Jonklaas, who added that if patients on combination therapy aren't carefully monitored, they can develop symptoms of thyroid overactivity, such as heart palpitations and trouble sleeping.

In an attempt to put this debate to rest, Jonklaas and her colleagues followed 50 people between the ages of 18 and 65 who needed to have their thyroid removed due to thyroid nodules, cancer or a goiter. None of the volunteers had symptoms of underactive (hypo) or overactive (hyper) thyroid glands at the start of the study.

All of the study participants were treated with T4 alone after surgery.

The researchers measured T4 and T3 levels both before and after surgery and essentially found no change.

"This is further evidence that combination therapy is unlikely to be of use to people who've had thyroid surgery," said Dr. David Cooper, director of the division of endocrinology at Sinai Hospital of Baltimore and director of Johns Hopkins University's thyroid clinic. He wrote an editorial that accompanied the study.

Cooper did point out that there were some people who had slightly lower levels of T3 after surgery and that these people may be the ones who are candidates for combination therapy.

Both Jonklaas and Cooper said the findings are likely applicable to people who have improperly functioning thyroid glands as well, particularly for people with overactive thyroids that either have their thyroids removed or destroyed with radioactive iodine.

More information

To learn more about thyroid medications, read this from the U.S. Food and Drug Administration.

SOURCES: Jacqueline Jonklaas, M.D., Ph.D., assistant professor, medicine, division of endocrinology, Georgetown University Hospital, Washington, D.C.; David S. Cooper, M.D., director, division of endocrinology, Sinai Hospital of Baltimore, professor, medicine, Johns Hopkins University School of Medicine, director, Johns Hopkins thyroid clinic, Baltimore, and contributing editor, Journal of the American Medical Association; Feb. 20, 2008, Journal of the American Medical Association

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Promising drug combination may help those with ocular melanoma that has spread
2. Combination therapy reverses effects of portal hypertension in rats
3. Combination vaccines okay for infants, study shows
4. Antidepressants and painkillers - a dangerous combination
5. Intra-arterial combination chemotherapy induces long-term survival for hepatocellular carcinoma
6. U.S. Oncology Initiates Complete Phase Ib Trial of Brostallicin Combination Therapy in Advanced Solid Tumors
7. Drug combination might offer hope for patients deadly brain tumors
8. EpiCept to Present Preclinical Studies of EPC2407 in Combination With Anti-Angiogenic and Chemotherpeutic Agents at the AACR-NCI-EORTC International Conference
9. Combination targets: some drugs may work best when they work together
10. MAP Pharmaceuticals Initiates Phase 2a Clinical Trial of Combination Therapy in Adult Patients with Asthma
11. Quality Control: Nissan Quest to Feature micronAir(R) Combination Cabin Air Filters
Post Your Comments:
Related Image:
Combination of Thyroid Medicines Not Necessary
(Date:11/25/2015)... ... November 25, 2015 , ... "When I underwent ... bras were incredibly uncomfortable," said an inventor from Bronx, N.Y. "In order to ... the patent-pending RECOVERY BRA for added comfort and support. The bra is easier ...
(Date:11/25/2015)... ... November 25, 2015 , ... Bcureful—a non-profit organization devoted to ... raising public awareness of the disorder while helping to bring expert medical care ... to bolster progress at the Tuberous Sclerosis Complex Center at Ann & Robert ...
(Date:11/24/2015)... Florida (PRWEB) , ... November 25, 2015 , ... ... planning and monitoring. Their Care Plan software creates an agreement between the ... patient care plan, including financial, scheduling, monitoring, notification, and projections. Click ...
(Date:11/24/2015)... ... November 24, 2015 , ... Young patients with a ... Dr. Angela Wolfman and Dr. Kedar S. Lele, who are pediatric dentists in ... and fillings, the WaterLase iPlus 2.0™ system causes minimal discomfort and bleeding to the ...
(Date:11/24/2015)... ... November 25, 2015 , ... ... solutions for drugs, biologics, consumer health and global clinical supply services, today announced ... upcoming Clinical Trial Supply East Asia Conference, to be held at the InterContinental ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... Nov. 24, 2015  Thanks to a donor with ... Mary,s Medical Center,s Sister Diane Grassilli Center for Women,s ... in San Francisco . ... stepped forward with a gift of $617,320 that allowed ... Mammography with Tomosynthesis and Whole Breast Ultrasound. Tomosynthesis, three-dimensional ...
(Date:11/24/2015)... 24, 2015  Array BioPharma Inc. (Nasdaq: ... Officer, Ron Squarer , will present at ... York.  The public is welcome to participate in ... BioPharma website.Event:Piper Jaffray Annual Healthcare ConferencePresenter:  , Ron ... 2015Time:1:30 p.m. Eastern Time Webcast: , ...
(Date:11/24/2015)... and VANCOUVER, Nov. 24, 2015 /PRNewswire/ - ESSA ... EPIX ) announced today that the first patient ... of EPI-506 as a treatment for metastatic castration-resistant prostate ... and Canada.  --> the ... In the Phase 1/2 clinical trial, ESSA intends ...
Breaking Medicine Technology: