Abstract：
It is estimated that hypothyroidism treatment may be either suboptimal or excessive in about 32-45% patients treated with L-thyroxine (LT4). There are multiple possible causes of poor control of hypothyroidism, including narrow LT4 therapeutic index, food and drug interactions, comorbidities, and patient non-adherence. Some of these obstacles could possibly be overcome with the novel liquid LT4 formulation. Liquid LT4 reaches maximum blood concentration about 30 minutes faster than the tablet form. Faster pharmacokinetics might lead to more efficient LT4 absorption, as suggested by a recent real-world study in patients with primary and central hypothyroidism. Liquid LT4 treatment led to increased free thyroxine (FT4) and sex hormone binding globulin (SHBG) with decreased low-density lipoprotein (LDL) cholesterol concentration and substantially improved quality of life for the patients. Herein we present a series of 31 patients with hypothyroidism of different aetiologies treated with the novel liquid LT4 formulation in standard clinical care in light of the latest scientific publications on liquid LT4 formula. We observed normalization of thyroid function tests shortly after introduction of liquid LT4, irrespective of concurrent diseases or concomitant medications that could diminish LT4 absorption. In more detail, the treatment with liquid LT4 managed to normalize thyroid-stimulating hormone (TSH) concentrations in patients without any known causes of LT4 absorption disturbances, as well as in those with malabsorption: with gastric bypass, partial small and large intestine resection, scleroderma, gluten intolerance, celiac disease, atrophic gastritis, and polytherapy. In conclusion, considering many factors disturbing LT4 absorption, hypothyroidism therapy with liquid LT4 seems to be a particularly effective option.
摘要：
据估计，在使用L-甲状腺素（LT4）治疗的约32-45％的患者中，甲状腺功能减退的治疗可能不够理想或过度。甲状腺功能减退症控制不佳的可能原因有多种，包括狭窄的LT4治疗指数，食物和药物的相互作用，合并症,和患者不坚持。这些障碍中的一些可以用新型液体LT4制剂克服。液体LT4比片剂形式快约30分钟达到最大血液浓度。更快的药代动力学可能导致更有效的LT4吸收，正如最近在原发性和中枢甲状腺功能减退症患者中进行的一项现实研究所暗示的那样。液体LT4治疗导致游离甲状腺素（FT4）和性激素结合球蛋白（SHBG）增加，低密度脂蛋白（LDL）胆固醇浓度降低，并显着改善患者的生活质量。在此，我们介绍了一系列31例不同病因的甲状腺功能减退症患者，根据有关液体LT4配方的最新科学出版物，在标准临床护理中使用新型液体LT4配方进行治疗。我们观察到，在引入液体LT4后不久，甲状腺功能检查恢复正常，而与可能减少LT4吸收的并发疾病或伴随药物无关。更详细地说,用液体LT4治疗可以使患者的促甲状腺激素（TSH）浓度正常化，而没有任何已知的LT4吸收障碍的原因。以及那些吸收不良的人:胃旁路术，部分小肠和大肠切除，硬皮病,麸质不耐受,乳糜泻,萎缩性胃炎,和综合疗法。总之,考虑到许多因素干扰LT4吸收，液体LT4治疗甲状腺功能减退似乎是一个特别有效的选择.
