3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic.
Scientific Committee of Associazione Medici Endocrinologi, Milan, Italy.
BMC Endocr Disord. 2022 May 3;22(1):117. doi: 10.1186/s12902-022-01027-1.
Inconsistencies in the management of hypothyroidism have been reported among endocrinologists in different European countries. Aim of this study was to explore Czech endocrinologists' use of thyroid hormones in hypothyroid and euthyroid patients.
We used a web-based survey containing 32 questions regarding the use of thyroid hormones. Four-hundred thirty-two members of the Czech Society of Endocrinology received an e-mail invitation to participate in the survey.
We received and analysed 157 responses (112 females and 45 males) from the 432 members (36.3%). According to 99.4% of the respondents, levothyroxine (LT4) is the primary drug of choice for the treatment of hypothyroidism. Liothyronine (LT3) was used in clinical practice by 29.9% of responders. According to 90.5% of respondents, thyroid hormones may be indicated in biochemically euthyroid patients. Female physicians prescribe thyroid hormones in euthyroid infertile women with high antibody levels more frequently than male physicians (P = 0.003). Most Czech endocrinologists (76.4%) consider combined therapy with LT4 and LT3 in various clinical scenarios, but only 1 of 29 hypothyroid physicians (3.5%) would recommend it to their patients, and only 4 out of 128 respondents (3.1%) would consider LT3 or desiccated thyroid for themselves, if diagnosed with hypothyroidism.
LT4 is the primary thyroid hormone used in the Czech Republic for treatment of hypothyroidism. At variance with thyroid guideline recommendations, Czech endocrinologists are quite liberal when prescribing thyroid hormones to euthyroid patients and in the use of LT4/LT3 combination treatment for hypothyroid patients with persisting symptoms.
在不同的欧洲国家，内分泌学家在甲状腺功能减退症的管理方面存在不一致的情况。本研究旨在探讨捷克内分泌学家在甲状腺功能减退症和甲状腺功能正常患者中使用甲状腺激素的情况。
我们使用了一个包含 32 个问题的网络调查，内容涉及甲状腺激素的使用。捷克内分泌学会的 432 名成员收到了参加调查的电子邮件邀请。
我们收到并分析了 432 名成员中的 157 名（112 名女性和 45 名男性）的回复。根据 99.4%的受访者的说法，左甲状腺素（LT4）是治疗甲状腺功能减退症的首选药物。29.9%的应答者在临床实践中使用三碘甲状腺原氨酸（LT3）。根据 90.5%的受访者的说法，甲状腺激素可能对生化甲状腺功能正常的患者有指示作用。女性医生比男性医生更频繁地为甲状腺抗体水平高的甲状腺功能正常的不孕女性开甲状腺激素（P = 0.003）。大多数捷克内分泌学家（76.4%）认为在各种临床情况下联合使用 LT4 和 LT3，但只有 1 名甲状腺功能减退症医生（3.5%）会向患者推荐这种治疗方法，而在 128 名受访者中只有 4 人（3.1%）会考虑 LT3 或甲状腺片作为自己的甲状腺功能减退症的治疗方法。
LT4 是捷克共和国治疗甲状腺功能减退症的主要甲状腺激素。与甲状腺指南建议不同，捷克内分泌学家在为甲状腺功能正常的患者开甲状腺激素处方和在使用 LT4/LT3 联合治疗持续存在症状的甲状腺功能减退症患者方面非常宽松。
