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Endocrine Abstracts (2022) 81 P492 | DOI: 10.1530/endoabs.81.P492

ECE2022 Poster Presentations Thyroid (136 abstracts)

Simulation of the plasma level of thyroid hormones for a total thyroidectomized virtual-patient treated by BMI and BSA-based LT4 monotherapy dose regimen

Hadi Tabesh 1 , Mostafa Hemmati 1 & Hamid Bazrafshan 2


1Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran; 2LMU Klinikum, Ludwig Maximilian University of Munich, Munich, Germany


Introduction: Several levothyroxine (LT4) monotherapy dose regimen have been already proposed by different medical scientists which may result in various daily LT4 doses. Comparing the consequences of such dose regimen are rather difficult since they have to be applied on either the same patient or a large study groups. Therefore, a straight forward method would be to simulate the plasma level of thyroid hormones of virtual-patients treated by various dose regimen.

Method: In this study, the resulting plasma levels of thyroid hormones were compared for a total thyroidectomized virtual-patient treated by BMI and BSA-based LT4 monotherapy dose regimen adopted from Elfenbein et al., 2016 and Al-Dhahri et al., 2019 respectively. Our virtual-patient was considered as a 37 years old male with 72 kg weight and 170 cm height. The BMI of this patient would be 24.9 kg/m^2 while the calculated BSA based on DuBois & DuBois method is 1.83 m^2. In order to evaluate patient responses to LT4 monotherapy dose regimen, we simulated our total thyroidectomized virtual-patient by setting T3 and T4 secretion parameters at 1% using THYROSIM 3.0 while receiving static oral LT4 dosages post-surgery. In addition, with an assumption that no supplement was administrated, the absorption rate of oral LT4 was set to 88%.

Results: Considering the proposed dose regimen by BMI and BSA our virtual-patient should receive static LT4 dose of 1.9 and 1.4 μ g/kg respectively. Parameters to compare these two dose regimen for a period of 30-days are presented in the following table.

ParameterBMIBSA
Time to reach normal TSH level (days)1530
Time to reach normal T3 level (days)34
Time to reach normal T4 level (days)45
TSH out of normal range (days)1430
T3 out of normal range (days)23
T4 out of normal range (days)34
Discrepancy between TSH at day 30 and normal TSH (=1.93)1.937.11
Discrepancy between T3 at day 30 and normal T3 (=1.35)-0.51-0.59
Discrepancy between T4 at day 30 and normal T4 (=78.21)8.35-9.95

Conclusion: the BMI dose regime shows some superiority over BSA method especially in terms of lower time to reach normal TSH level and the discrepancy between TSH at day 30 and normal TSH. At the end of 30-days treatment period our virtual patient experiences a plasma T4 level of 86.56 and 68.26 μg/l if administering LT4 doses based on BMI and BSA methods.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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