143 - The Low Down on Hypothyroidism: The Essentials of What Healthcare Providers Need to Know

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 8 February 2022

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we review the diagnostic criteria and treatment strategy of hypothyroidism including the controversy surrounding brand versus generic levothyroxine and non-levothyroxine thyroid drugs.

Key Concepts

The most common cause of hypothyroidism is autoimmune thyroiditis - the body attacks the thyroid gland cells. Typically in hypothyroidism, TSH levels will be high and thyroid hormone levels (T3 and T4) will be normal or low.
Levothyroxine is the drug of choice to treat hypothyroidism. Doses should start low (to avoid cardiovascular side effects) and then be titrated up based on TSH levels.
All other thyroid hormone formulations (including Thyroid USP, Armour Thyroid, liothyronine, etc.) are NOT recommended for use in hypothyroidism. These are not FDA approved medications and there is no data showing these products are more effective than levothyroxine.
Generic formulations of levothyroxine are as effective and safe as brand-name Synthroid®. Although several levothyroxine formulations are AB compatible and can be interchanged by a pharmacist, patients should be maintained on the same formulation whenever possible.

References

Dong BJ, Hauck WW, Gambertoglio JG, et al. Bioequivalence of generic and brand-name levothyroxine products in the treatment of hypothyroidism. JAMA. 1997;277(15):1205-1213.
Rennie D. Thyroid storm. JAMA. 1997;277(15):1238-1243.
American Thyroid Association. https://www.thyroid.org/

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show.
0:31.2	Welcome to Helix Talk episode 143. I'm your co-host Dr. Kane. And I'm Dr. Patel. And the title of today's episode is The Lowdown on Hypothyroidism, The Essentials of
0:42.4	of What Healthcare Providers Need to Know.
0:44.5	So obviously we're talking about hypothyroidism today.
0:47.4	And what's interesting, Dr. Patel, is that this was actually a listener request, multiple
0:51.6	listener requests.
0:52.6	So we got questions from listeners asking about
0:55.8	hypothyroidism to do an episode on it, specifically about how to interpret some of those thyroid
1:00.6	panel numbers and also what the difference is between different thyroid medications like
1:06.1	Brandon versus generic cynthrate or levarythoroxin, armor thyroid, leo thyrotthyronin.
1:12.2	You know, when are we supposed to be using these non-lebo-thyroxine products?
1:16.3	And what is the difference between them?
1:18.5	And you know, I think over the years, this has become a little bit more clear.
1:23.5	However, there is still some controversy.
1:25.1	And we'll talk about why there is a controversy.
1:45.5	But all in all, Dr. Kane, I just love doing episodes that are requested by our listeners because it feels like we're giving back. Right. So I'm excited for this one. Yeah. And for listeners, if you do have a topic that you would like us to cover, you can reach out to us. So helix talk.com has our contact information or even on Twitter at Helix Talk.
1:47.6	So it seems like hypothyroidism is everywhere.
1:50.8	You know, I have a few family members who have it.
	...

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