scholarly journals Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5233
Author(s):  
Katarzyna Bornikowska ◽  
Małgorzata Gietka-Czernel ◽  
Dorota Raczkiewicz ◽  
Piotr Glinicki ◽  
Wojciech Zgliczyński
Keyword(s):  
Quality Of Life ◽  
Thyroid Hormone ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Therapeutic Effects ◽  
Central Hypothyroidism ◽  
Tablet Form ◽  
Hormone Levels ◽  
Hypothyroid Patients

Levothyroxine (LT4) is a standard therapy in hypothyroidism; however, its bioavailability and therapeutic effects might be affected by many factors. Data shows that therapy with liquid LT4 characterized by quicker pharmacokinetics provides better thyroid hormones control than tablet LT4. We addressed the quality of life (QoL) and efficacy of the new ethanol-free formula of liquid LT4 (Tirosint®SOL) treatment in 76 euthyroid patients with primary (PH, n = 46) and central hypothyroidism (CH, n = 30), and compared the results to retrospective data on equivalent doses of tablet L-T4 therapy. After 8 weeks of liquid LT4 therapy, we found a significant improvement in QoL in both PH and CH patients. TSH levels were unaltered in PH patients. Free hormone levels (fT4 and fT3) increased in all the patients, with the exception of fT3 in the CH group. SHBG and low-density lipoprotein (LDL) also improved. Liquid LT4 therapy provided a better thyroid hormone profile and improvement in patients’ QoL than the tablet form, which was possibly due to the more favorable pharmacokinetics profile resulting in better absorption, as suggested by the increased free thyroid hormone levels. In summary, this is the first study addressing the QoL in hypothyroid patients, including primary and central hypothyroidism, treated with liquid LT4 formula in everyday practice.

Implementation of Pharmaceutical Care Services for Patients with Hyperlipidemias by Independent Community Pharmacy Practitioners

1997 ◽  
Vol 31 (6) ◽  
pp. 713-719 ◽  
Author(s):  
Michelle CH Shibley ◽  
Carol B Pugh
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Community Pharmacy ◽  
Pharmaceutical Care ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Therapeutic Goals ◽  
Care Services ◽  
A Prospective Study

OBJECTIVE: To implement and evaluate pharmaceutical care services for patients with hyperlipidemias in the community pharmacy setting, to evaluate the results of a pharmaceutical care training process for pharmacists by using an assessment quiz, and to measure patient outcomes resulting from provision of pharmaceutical care to patients with hyperlipidemia. DESIGN: A prospective study was conducted over a 1 -year period. Patients served as their own controls. SETTING: Two independent community pharmacies in Richmond, Virginia. PARTICIPANTS: Twenty-five adult patients with confirmed dyslipidemias completed the study. INTERVENTIONS: Study pharmacists assessed each patient and assisted in setting therapeutic goals; patients also completed a visit with a registered dietitian. Drug therapy recommendations were made to physicians by the pharmacist when appropriate. Follow-up was scheduled with the pharmacist to ensure positive outcomes and reduce adverse effects. MAIN OUTCOME MEASURES: Fasting lipoprotein profiles were measured initially and at 6 and 12 months. The SF-36 survey, the MacKeigan-Larson satisfaction survey, and a patient opinion survey were administered initially and at the conclusion of the study. RESULTS: Total cholesterol and low-density lipoprotein cholesterol values were significantly decreased at 12 months compared with either the baseline or 6-month values (p < 0.02). Significant improvement was found in several domains of the surveys; quality of life, patient satisfaction with pharmacy services, and patient opinions on the role of the pharmacist improved after the intervention. CONCLUSIONS: Pharmaceutical care may positively affect lipid values, quality of life, and patient satisfaction.

scholarly journals Combination Treatment with T4 and T3: Toward Personalized Replacement Therapy in Hypothyroidism?

2012 ◽  
Vol 97 (7) ◽  
pp. 2256-2271 ◽  
Author(s):  
Bernadette Biondi ◽  
Leonard Wartofsky
Keyword(s):  
Quality Of Life ◽  
Thyroid Hormone ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Hormone Action ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Action ◽  
Thyroid Hormone Replacement Therapy ◽  
Hypothyroid Patients

Abstract Context: Levothyroxine therapy is the traditional lifelong replacement therapy for hypothyroid patients. Over the last several years, new evidence has led clinicians to evaluate the option of combined T3 and T4 treatment to improve the quality of life, cognition, and peripheral parameters of thyroid hormone action in hypothyroidism. The aim of this review is to assess the physiological basis and the results of current studies on this topic. Evidence Acquisition: We searched Medline for reports published with the following search terms: hypothyroidism, levothyroxine, triiodothyronine, thyroid, guidelines, treatment, deiodinases, clinical symptoms, quality of life, cognition, mood, depression, body weight, heart rate, cholesterol, bone markers, SHBG, and patient preference for combined therapy. The search was restricted to reports published in English since 1970, but some reports published before 1970 were also incorporated. We supplemented the search with records from personal files and references of relevant articles and textbooks. Parameters analyzed included the rationale for combination treatment, the type of patients to be selected, the optimal T4/T3 ratio, and the potential benefits of this therapy on symptoms of hypothyroidism, quality of life, mood, cognition, and peripheral parameters of thyroid hormone action. Evidence Synthesis: The outcome of our analysis suggests that it may be time to consider a personalized regimen of thyroid hormone replacement therapy in hypothyroid patients. Conclusions: Further prospective randomized controlled studies are needed to clarify this important issue. Innovative formulations of the thyroid hormones will be required to mimic a more perfect thyroid hormone replacement therapy than is currently available.

scholarly journals Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults

2003 ◽  
pp. 499-509 ◽  
Author(s):  
S Ezzat ◽  
S Fear ◽  
RC Gaillard ◽  
C Gayle ◽  
S Marcovitz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Composition ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Long Term Effects ◽  
Gh Treatment ◽  
Igf I ◽  
Total Fat

OBJECTIVE: To investigate the effects of long-term GH in GH-deficient adults, as predicted by IGF-I levels. METHODS: Patients received GH, 5 microg/kg per day for 1 Month and 10 microg/kg per day for another 12-30 Months. Changes in body composition, cardiac structure/function, serum lipids and quality of life were measured. RESULTS: There was a significant increase in lean body mass (LBM) (2.21 kg; P<0.0001) after 6 Months, which was sustained throughout treatment. A larger increase occurred in males than females (2.97 vs 1.19 kg; P<0.0001). Total fat mass was reduced (2.56 kg; P<0.0001 (3.26 kg males, 1.63 kg females)). Responsiveness to GH varied greatly, but LBM changes correlated with IGF-I changes (P<0.004). Furthermore, thinner patients experienced greater and progressive LBM increases. There was an increase in ejection fraction (3.85+/-9.95%; P=0.0002) after 6 Months, sustained to 18 Months. These cardiac effects were equal for males and females, and did not correlate with IGF-I levels. Serum low-density lipoprotein/high-density lipoprotein ratios decreased within 6 Months, and were sustained thereafter. Quality of life improved significantly after 6 Months, an effect that was sustained/enhanced as treatment continued. No major adverse events were identified. CONCLUSIONS: Improved body composition is both reflected by IGF-I changes and predicted inversely by baseline adiposity. Other effects of GH replacement on cardiac function, dyslipidaemia and quality of life, however, do not correlate with circulating IGF-I concentrations. Our findings validate the importance of sustained GH therapy, but caution on the interpretation of IGF-I levels in monitoring the long-term effects of GH treatment.

scholarly journals GH replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

2008 ◽  
Vol 159 (6) ◽  
pp. 825-832 ◽  
Author(s):  
Pascale Abrams ◽  
Hugo Boquete ◽  
Hugo Fideleff ◽  
Ulla Feldt-Rasmussen ◽  
Peter J Jönsson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lipid Profile ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Gh Treatment ◽  
Gh Replacement ◽  
Design And Methods

ObjectiveGH deficiency (GHD) in adults is characterized by elevated body mass index (BMI), increased waist girth (WG) and increased fat mass (FM). Information about how these indicators of obesity affect the lipid profile and quality of life (QoL) of GHD subjects is scarce. It is also unclear how changes in these indicators brought about by GH replacement influence lipids and QoL.Design and methodsAdult GHD subjects from the Pfizer International Metabolic Database were grouped according to BMI (n=291 with BMI <25 kg/m2, n=372 with BMI 25–30 kg/m2, n=279 with BMI >30 kg/m2), WG (n=508 with normal WG, n=434 with increased WG) and FM (n=357) and according to changes in these variables after 1 year of GH replacement. Serum IGF-I concentrations, lipid concentrations and QoL using the QoL Assessment of GHD in Adults questionnaire were assessed at baseline and after 1 year of treatment.ResultsAt baseline, total and low-density lipoprotein (LDL) cholesterol were similarly elevated in the BMI and WG groups, but high-density lipoprotein (HDL) cholesterol decreased and triglycerides increased with increasing BMI and WG. QoL was progressively poorer with increasing BMI and WG. After 1 year of GH replacement, total and LDL cholesterol and QoL improved in all BMI, WG and FM groups.ConclusionsVariables of obesity adversely affect the already unfavourable lipid profile in GHD subjects by decreasing HDL cholesterol, but do not counteract the positive effect of GH replacement on LDL cholesterol. Similarly, QoL is influenced by obesity, but responds equally well to GH treatment independent of BMI, WG and FM.

Glycation and HMG-CoA Reductase Inhibitors: Implication in Diabetes and Associated Complications

2019 ◽  
Vol 15 (3) ◽  
pp. 213-223 ◽  
Author(s):  
Rabia Nabi ◽  
Sahir Sultan Alvi ◽  
Mohd. Saeed ◽  
Saheem Ahmad ◽  
Mohammad Salman Khan
Keyword(s):  
Oxidized Ldl ◽  
Advanced Glycation Endproducts ◽  
Low Density Lipoprotein ◽  
Ldl Receptor ◽  
Density Lipoprotein ◽  
Protective Role ◽  
Therapeutic Effects ◽  
Hmg Coa Reductase ◽  
Toxicological Effects ◽  
Coa Reductase

Introduction: Diabetes Mellitus (DM) acts as an absolute mediator of cardiovascular risk, prompting the prolonged occurrence, size and intricacy of atherosclerotic plaques via enhanced Advanced Glycation Endproducts (AGEs) formation. Moreover, hyperglycemia is associated with enhanced glyco-oxidized and oxidized Low-Density Lipoprotein (LDL) possessing greater atherogenicity and decreased the ability to regulate HMG-CoA reductase (HMG-R). Although aminoguanidine (AG) prevents the AGE-induced protein cross-linking due to its anti-glycation potential, it exerts several unusual pharmaco-toxicological effects thus restraining its desirable therapeutic effects. HMG-R inhibitors/statins exhibit a variety of beneficial impacts in addition to the cholesterol-lowering effects. Objective: Inhibition of AGEs interaction with receptor for AGEs (RAGE) and glyco-oxidized-LDL by HMG-R inhibitors could decrease LDL uptake by LDL-receptor (LDL-R), regulate cholesterol synthesis via HMG-R, decrease oxidative and inflammatory stress to improve the diabetes-associated complications. Conclusion: Current article appraises the pathological AGE-RAGE concerns in diabetes and its associated complications, mainly focusing on the phenomenon of both circulatory AGEs and those accumulating in tissues in diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy, discussing the potential protective role of HMG-R inhibitors against diabetic complications.

Formulating biossay data of chemicals and environmental water

2000 ◽  
Vol 42 (3-4) ◽  
pp. 115-123 ◽  
Author(s):  
R. Shoji ◽  
A. Sakoda ◽  
Y. Sakai ◽  
M. Suzuki
Keyword(s):  
Water Quality ◽  
Low Density Lipoprotein ◽  
Water Environment ◽  
Density Lipoprotein ◽  
Environmental Water ◽  
Toxicity Data ◽  
Human Beings ◽  
Environmental Waters ◽  
Bodies Of Water

The quality of environmental waters such as rivers is often deteriorated by various kinds of trace and unidentified chemicals despite the recent development of sewage systems and wastewater treatment technologies. In addition to contamination by particular toxicants, complex toxicity due to multi-component chemicals could be much more serious. The environmental situation in bodies of water in Japan led us to apply bioassays for monitoring the water quality of environmental waters in order to express the direct and potential toxicity to human beings and ecosystems rather than determinating concentrations of particular chemicals. However, problems arose from the fact that bioassays for pharmaceutical purposes generally required complicated, time-consuming, expert procedures. Also, a methodology for feedback of the resultant toxicity data to water environment management has not been established yet. To this end, we developed a novel bioassay based on the low-density lipoprotein (LDL) uptake activity of human hepatoblastoma cells. The assay enabled us to directly detect the toxicity of environmental waters within 4 hours of exposure. This is a significantly quick and easy procedure as compared to that of conventional bioassays. The toxicity data for 255 selected chemicals and environmental waters obtained by this method were organized by a mathematical equation in order to make those data much more effectively and practically useful to the management of environmental waters. Our methodology represents a promising example of applying bioassays to monitor environmental water quality and generating potential solutions to the toxicity problems encountered.

scholarly journals Comparisons of Thyroid Hormone, Intelligence, Attention, and Quality of Life in Children with Obstructive Sleep Apnea Hypopnea Syndrome before and after Endoscopic Adenoidectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hui-Wei Feng ◽  
Tao Jiang ◽  
Hong-Ping Zhang ◽  
Zhe Wang ◽  
Hai-Ling Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Thyroid Hormone ◽  
Intelligence Quotient ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
Hypopnea Syndrome

Objective. The aim of this study was to compare the differences in thyroid hormone, intelligence, attention, and quality of life (QoL) of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after endoscopic adenoidectomy.Method. A total of 35 OSAHS children (21 males and 14 females with a mean age of6.81±1.08years) were included in this study for analyzing the levels of thyroid hormone, intelligence, attention, and QoL. There were 22 children underwent endoscopic adenoidectomy with bilateral tonsillectomy (BT), while the other 13 children who underwent endoscopic adenoidectomy without bilateral tonsillectomy without BT.Results. Our results revealed no significant difference in serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels in OSAHS children before and after endoscopic adenoidectomy (allP>0.05). However, there were significant differences in full-scale intelligence quotient (FIQ) (92.45±5.88versus106.23±7.39,P<0.001), verbal intelligence quotient (VIQ) (94.17±15.01versus103.91±9.74,P=0.006), and performance intelligence quotient (PIQ) (94.12±11.04versus104.31±10.05,P=0.001), attention (98.48±8.74versus106.87±8.58,P<0.001), and total OSA-18 scores (87.62±17.15versus46.61±10.15,P<0.001) between before and after endoscopic adenoidectomy in OSAHS children.Conclusion. Our findings provided evidence that the intelligence, attention, and QoL of OSAHS children may be significantly improved after endoscopic adenoidectomy.

The Effect of Long-Term Metabolic Control on Free Thyroid Hormone Levels in Diabetics during Insulin Treatment

1987 ◽  
Vol 24 (5) ◽  
pp. 466-469 ◽  
Author(s):  
J H Parr
Keyword(s):  
Thyroid Hormone ◽  
Metabolic Control ◽  
Insulin Treatment ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Hormone Levels ◽  
Free Thyroid Hormone ◽  
The Mean ◽  
Thyroid Hormone Levels

Serum concentration of free T3 and, in female patients, FT4, were found to be lower in 20 asymptomatic, moderately-poor or well controlled, diabetics treated with insulin than in a group of non-diabetic subjects. Over a mean 3-month period of the study a significant fall occurred in HbA1 concentration in both groups of diabetics without change in free thyroid hormone levels. The mean capillary blood glucose, fasting free insulin and fasting lipid concentrations, other than high density lipoprotein (HDL) cholesterol, did not change. No correlations were found between the changes in HbA1 and free thyroid hormone concentrations. Improvement in long term metabolic control did not influence free thyroid hormone levels in well controlled and moderately-poor controlled diabetics, taking insulin.

Sign in / Sign up

Export Citation Format

Share Document