Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036, Graz, Austria.
General Internal Medicine Practice, Dr. Theodor Körnerstrasse 19b, A-8600, Bruck, Austria.
Endocrine. 2024 Oct;86(1):233-238. doi: 10.1007/s12020-024-03829-w. Epub 2024 Apr 18.
Recommended pharmacotherapy for hypothyroidism in Hashimoto's thyroiditis (HT) is oral supplementation with levothyroxine (LT-4). However, serum thyrotropin (TSH) levels within normal range are not consistently achieved with LT-4 medication.
We report on 35 HT patients with LT-4 therapy in this retrospective evaluation. In general, we recommend that a maximum of two sips of water, which would then amount to < 50 mL, be ingested at the same time as LT-4. We report on follow up examinations measuring TSH and antibodies against thyroid peroxidase (TPOAb) after 6 months to five years.
After median time of 643 days (range 98-1825) we found in 35 HT patients a statistical significant reduction of serum TSH (p < 0.001) and TPOAb (p = 0.006). The patients median body weight was 71 kg (range 48-98) and a daily LT-4 dosage was used with median 69.1 µg (range 25-150). This results in a daily LT-4 dose of median 1.01 µg/kg bodyweight (range 0.3-2.3).
The reduction of water ingestion to a maximum of two sips, which is <50 mL, combined with LT-4 supplementation helps to achieve euthyroidism in HT. In addition, it reduces the L-T4 medication dosage needed to lower TSH serum levels and decreases TPO antibodies in HT.
桥本甲状腺炎（HT）患者的甲状腺功能减退症推荐使用左甲状腺素（LT-4）进行药物治疗。然而，通过 LT-4 药物治疗通常无法使血清促甲状腺激素（TSH）水平保持在正常范围内。
我们对 35 名接受 LT-4 治疗的 HT 患者进行了回顾性评估。一般来说，我们建议 LT-4 同时最多饮用两口（<50ml）水。我们报告了经过 6 个月至 5 年的随访检查，测量 TSH 和甲状腺过氧化物酶抗体（TPOAb）的结果。
在中位时间 643 天（范围 98-1825）后，我们发现 35 名 HT 患者的血清 TSH（p<0.001）和 TPOAb（p=0.006）显著降低。患者的中位体重为 71kg（范围 48-98），LT-4 的日剂量中位数为 69.1μg（范围 25-150）。这相当于中位 1.01μg/kg 体重的 LT-4 日剂量（范围 0.3-2.3）。
将饮水量减少到最多两口（<50ml），同时补充 LT-4，有助于 HT 患者实现甲状腺功能正常。此外，它还降低了降低 TSH 血清水平所需的 LT-4 药物剂量，并降低了 HT 中的 TPO 抗体。
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