Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):467-77. doi: 10.1097/MED.0000000000000003.
In this article, we will consider the failure of thyroid hormone replacement therapy to normalize serum thyroid stimulating hormone concentrations. We will review circumstances and causes for failures, discuss pertinent unpublished personal cases of didactical value, and provide practical suggestions for providers encountering patients with similar presentations.
Recent data are available on the benefit of novel formulations of levothyroxine therapy on malabsorption.
Most frequently, reasons for ineffectiveness are noncompliance, inappropriate administration of levothyroxine, gastrointestinal disorders, and drug interactions. The diagnostic work-up should include careful history to elucidate the potential reasons for the ineffective therapy.
本文将讨论甲状腺激素替代治疗未能使血清促甲状腺激素浓度正常化的情况。我们将回顾失败的情况和原因，讨论具有教学价值的相关未发表的个人病例，并为遇到类似表现的患者的医务人员提供实用建议。
关于新型左甲状腺素治疗吸收不良的益处，目前有最新数据。
最常见的无效原因是不遵医嘱、左甲状腺素给药不当、胃肠道疾病和药物相互作用。诊断性检查应包括仔细的病史，以阐明治疗无效的潜在原因。
