Upon completion of this workshop, the healthcare professional will be able to:
- Review the literature demonstrating that levothyroxine therapy (T4-alone) does not improve symptoms after thyroid gland removal.
- Evaluate thyroid hormone levels before and after surgery demonstrating the inability to raise Free T3 levels after surgery to pre-surgery levels using T4-alone therapy.
- Recall the serum levels of Free T3 were not achieved despite TSH suppression with T4 Levothyroxine.
- Critique the meta-analysis of T4/T3 trials that demonstrate the ineffectiveness of adding T3 to T4. However, the ratio used was 14/1 whereas studies demonstrate the need to use 3/1 ratio in order to achieve therapeutic equivalency.
- Discuss the inadequate achievement of therapeutic levels of Free T3 due to 1) decreased gland production of T3 and 2) downregulation of D2 deiodinase enzyme pathway to T4.
- Review that this accounts for many patients not achieving symptom improvement, patient satisfaction or serum lipids using T4 alone therapy. T4 also increased BMI.
- Identify why the T4/T3 trials were designed to fail.
- Describe the mechanism of inadequate tissue levels of T3 as being the cause of persistent symptoms on T4 alone. However, AACE recommends against testing for Free T3 levels.
- Discuss why levothyroxine remains the standard therapy for treating hypothyroidism and the many studies that support that opinion. Nevertheless, other studies support the superiority of DTE.
- Review the recent studies demonstrating that a combination therapy for T4/T3 is different than DTE. Use of DTE provides improved patient satisfaction over T4-alone as well as T4/T3 combinations.
Neal Rouzier, MD
Enroll today with a Premium Membership for $495/year, for access to THIS course and:
- All 1 Hour Accredited Courses (28+ more added monthly)
- All upcoming Accredited Monthly Webinars
- All upcoming Journal Clubs AND Journal Club Library
- EBSCOhost – research articles for the BHRT Workshop Series and to support your own evidence based studies!
Are we given the articles referenced?
Of course – we pride ourselves in offering evidence-based courses. You’ll find the articles under Course Materials once you have enrolled.
Who is this course recommended for?
Anyone who is interested in learning more about BHRT!