Rangan S, Tahrani A A, Macleod A F, Moulik P K
Department of Diabetes and Endocrinology, Royal Shrewsbury Hospital, Shrewsbury, UK.
Postgrad Med J. 2007 Oct;83(984):e3. doi: 10.1136/pgmj.2007.060244.
Hypothyroidism is a common disorder, which is mainly treated in primary rather than secondary care. Once daily thyroxine replacement restores euthyroidism in most patients; some patients, however, remain hypothyroid despite adequate thyroxine replacement. Non-compliance is the most common cause of lack of response to thyroxine treatment. We describe two cases of primary hypothyroidism in which daily thyroxine treatment did not restore biochemical euthyroidism but once weekly thyroxine treatment was successful. In addition we review the evidence and discuss the differential diagnosis of lack of response to thyroxine treatment. Once weekly thyroxine treatment can be a safe, well-tolerated, and effective therapy for patients with non-compliance.
甲状腺功能减退症是一种常见疾病，主要在初级医疗而非二级医疗中进行治疗。大多数患者每日服用甲状腺素替代药物可恢复甲状腺功能正常；然而，一些患者尽管服用了足够的甲状腺素，仍处于甲状腺功能减退状态。治疗依从性差是对甲状腺素治疗无反应的最常见原因。我们描述了两例原发性甲状腺功能减退症患者，每日服用甲状腺素治疗未能恢复生化指标正常，但每周服用一次甲状腺素治疗取得了成功。此外，我们回顾了相关证据并讨论了对甲状腺素治疗无反应的鉴别诊断。对于治疗依从性差的患者，每周服用一次甲状腺素治疗可能是一种安全、耐受性良好且有效的治疗方法。
