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天然甲状腺干制剂治疗甲状腺功能减退症?

Natural desiccated thyroid for the treatment of hypothyroidism?

机构信息

The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom.

Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, United Kingdom.

出版信息

Front Endocrinol (Lausanne). 2024 Jan 8;14:1309159. doi: 10.3389/fendo.2023.1309159. eCollection 2023.

Abstract

Primary hypothyroidism affects about 3% of the general population in Europe. Early treatments in the late 19 Century involved subcutaneous as well as oral administration of thyroid extract. Until the early 1970s, the majority of people across the world with hypothyroidism were treated with natural desiccated thyroid (NDT) (derived from pig thyroid glands) in various formulations, with the majority of people since then being treated with levothyroxine (L-thyroxine). There is emerging evidence that may account for the efficacy of liothyronine (NDT contains a mixture of levothyroxine and liothyronine) in people who are symptomatically unresponsive to levothyroxine. While this is a highly selected group of people, the severity and chronicity of their symptoms and the fact that many patients have found their symptoms to be alleviated, can be viewed as valid evidence for the potential benefit of NDT when given after careful consideration of other differential diagnoses and other treatment options.

摘要

原发性甲状腺功能减退症影响欧洲一般人群的约 3%。19 世纪晚期的早期治疗涉及甲状腺提取物的皮下和口服给药。直到 20 世纪 70 年代初,世界上大多数甲状腺功能减退症患者都用天然干燥甲状腺素(NDT)(源自猪甲状腺)以各种制剂治疗,此后大多数人都用左甲状腺素(L-甲状腺素)治疗。越来越多的证据可能解释了三碘甲状腺原氨酸(NDT 含有左甲状腺素和三碘甲状腺原氨酸的混合物)在对左甲状腺素无反应的症状患者中的疗效。虽然这是一组高度选择的人群,但他们症状的严重程度和慢性程度,以及许多患者发现他们的症状得到缓解,这可以被视为在仔细考虑其他鉴别诊断和其他治疗选择后给予 NDT 的潜在益处的有效证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa61/10801060/f3aa2b85aa71/fendo-14-1309159-g001.jpg

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