Thyroid clinic audit of patients on non-standard thyroid hormone replacement: review of practice at the university hospital of wales (UHW)

Ganti Sri Ramya; Suhani Bahl; Mike Stedman; Adrian Heald; Lakdasa Premawardhana; Onyebuchi Okosieme; Peter Taylor; Colin Dayan

doi:10.1530/endoabs.109.P277

P277

Prev Next

Section Contents Cite

Endocrine Abstracts (2025) 109 P277 | DOI: 10.1530/endoabs.109.P277

SFEBES2025 Poster Presentations Thyroid (41 abstracts)

Thyroid clinic audit of patients on non-standard thyroid hormone replacement: review of practice at the university hospital of wales (UHW)

Sri Ramya Ganti ¹ , Suhani Bahl ² , Mike Stedman ³ , Adrian Heald ³ , Lakdasa Premawardhana ² , Onyebuchi Okosieme ² , Peter Taylor ² & Colin Dayan ²

Author affiliations

¹University Hospital of Wales, Cardiff, United Kingdom; ²Cardiff University, Cardiff, United Kingdom; ³University of Manchester, Manchester, United Kingdom

Introduction: Levothyroxine is the drug of choice for treating patients with hypothyroidism. However, a certain subset of individuals continue to experience symptoms despite biochemical normalization of their thyroid function.

Objectives: To evaluate our clinical practice of individuals on non-standard treatment modalities for hypothyroidism.

Methods: Retrospective analysis of the Thyroid clinic electronic database of all patients on non-standard treatment for hypothyroidism between 2010-2024 at UHW.

Results: Data of 176 patients (158 women and 18 men) was available for analysis. Median age was 55 years, range was 22 to 91 years. 54% (n = 95) patients had previously trialed non-standard treatment before their first clinic appointment (either on their own or via private clinic consultation). Patients were screened for complications through clinical monitoring for atrial fibrillation (AF) and a DEXA bone density scan. 25% patients (n = 44) underwent day curves and 22.7% (n = 40) had answered a quality of life questionnaire. On their last clinic letter, 87.5% of them remained on non-standard treatment for hypothyroidism (T3 only = 29, Armour (dessicated thyroid) only = 39, T3+T4 = 82, Armour+T4 = 4) whereas 12% continued on T4 alone and 1 patient (0.5%) was not on any treatment due to intolerance to all forms of medication. Four patients were discharged from the clinic towards the end of the study period.

Table 1 Clinical response to treatment as perceived by patients:
TOTAL	176
Complete response	70.5% (n = 124)
Partial response	17% (n = 30)
No response	12.5% (n = 22)

Conclusion: In our cohort of 176 patients on non-standard thyroid hormone replacement we report high levels of satisfaction. Substantial adverse complications were not observed. However, a significant proportion remained on dessicated thyroid extract and T3 monotherapy. More work is needed to assess complications and formally assess quality of life.