Endocrine Abstracts

Introduction: Levothyroxine is the first choice treatment for patients with hypothyroidism However, some people would continue to have symptoms of thyroid disease despite biochemical control on levothyroxine. Others might be intolerant to levothyroxine.

Aim: The aim of this audit is to evaluate UHL endocrinology practice against local and national guidelines with regards to prescribing and monitoring of liothyronine treatment in 2019.

• Retrospective data collection

• Period from January 2019 to January 2020

• List of patients was provided by UHL pharmacy

• Electronic database search

• Improvement in symptoms of tiredness, dizziness and lack of sleep was reported by 17 of 21 patients after starting liothyronine.

• Well-being was assessed using Quality of Life (QoL) questionnaire in 13 of 21 patients using SF-36. Only 2 patients had their post-treatment outcome documented on subsequent clinic follow up.

• Bone health was assessed using Dual Energy X-ray Absorptiometry (DEXA) scan in 3 of 21 patients. Two had osteopenia and one had osteoporosis.

Conclusion: 1) There is a small cohort of patients with hypothyroidism in Leicestershire who clinically improve on liothyronine compared with conventional replacement.

2) No biochemical evidence of over-replacement in liothyronine-naïve patients started on treatment at UHL

3) There was biochemical evidence of over-replacement in patients established on liothyronine prior to UHL referral.

4) We need formal quantitative documentation of SF-36 scores after treatment.

5) We need to be more proactive at looking for evidence complications like osteoporosis/osteopenia and atrial fibrillation.