https://doi.org/10.4081/ejtm.2023.11582
Efficacy and safety of postoperative levothyroxine sodium tablets for improving serum thyroid hormone levels and tumor marker levels in patients with thyroid tumors
Submitted: 11 July 2023
Accepted: 15 July 2023
Published: 5 September 2023
Accepted: 15 July 2023
Abstract Views: 909
PDF: 386
HTML: 48
HTML: 48
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Levothyroxine tablet has been used for improving serum thyroid hormones. Despite its efficacy, there has been a persistent recurrence. We aimed to evaluate the efficacy of levothyroxine regimen (administered as sodium tablets or liquid) therapy, including the regime in combination with other thyroxine hormones, to determine its effectiveness and safety regarding thyroid tumor patient outcomes. An electronic search of the online databases (PubMed, EMBASE, and Web of Science) was performed in duplicate independently by two authors (SSK and LPY) to identify any potential studies published in the English language from January 2002 to October 2022. The records were retrieved using keywords and MeSH terms. The Cochrane risk of bias tool in the Review Manager (RevMan software version 5.4.) was used to evaluate the risk of bias in the included studies. A total of 18 quality studies were reported on levothyroxine tablets. Results showed that liquid levothyroxine was more efficient than tablet levothyroxine. Further results showed that levothyroxine in combination with L-T3 or I-131 was more effective than L-T4 tablet monotherapy for improving thyroid cancer hormones. Levothyroxine tablet monotherapy is less efficient than liquid levothyroxine and/or levothyroxine combined therapy. This research recommends future research using larger randomized controlled studies.
Schneider DF, Chen H. New developments in the diagnosis and treatment of thyroid cancer. CA Cancer J Clin. 2013 Nov-Dec;63(6):374-94. Epub 2013 Jun 24. PMID: 23797834; PMCID: PMC3800231.
DOI: https://doi.org/10.3322/caac.21195
Botta L, Gatta G, Trama A, Bernasconi A, Sharon E, Capocaccia R, Mariotto AB; RARECAREnet working group. Incidence and survival of rare cancers in the US and Europe. Cancer Med. 2020 Aug;9(15):5632-5642. Epub 2020 May 21. PMID: 32436657; PMCID: PMC7402819.
DOI: https://doi.org/10.1002/cam4.3137
Haigh PI, Urbach DR. The treatment and prognosis of Hürthle cell follicular thyroid carcinoma compared with its non-Hürthle cell counterpart. Surgery. 2005 Dec;138(6):1152-7; discussion 1157-8. PMID: 16360403.
DOI: https://doi.org/10.1016/j.surg.2005.08.034
Verburg FA, Mäder U, Tanase K, Thies ED, Diessl S, Buck AK, Luster M, Reiners C. Life expectancy is reduced in differentiated thyroid cancer patients ≥ 45 years old with extensive local tumor invasion, lateral lymph node, or distant metastases at diagnosis and normal in all other DTC patients. J Clin Endocrinol Metab. 2013 Jan;98(1):172-80. Epub 2012 Nov 12. PMID: 23150687.
DOI: https://doi.org/10.1210/jc.2012-2458
Yoo WS, Chung HK. Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape. Endocrinol Metab (Seoul). 2021 Jun;36(3):500-513. Epub 2021 Jun 18. PMID: 34139799; PMCID: PMC8258336.
Wiersinga WM. Adult Hypothyroidism. 2014 Mar 28. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905416.7. Wilkes S, Pearce S, Ryan V, Rapley T, Ingoe L, Razvi S. Study of Optimal Replacement of Thyroxine in the ElDerly (SORTED): protocol for a mixed methods feasibility study to assess the clinical utility of lower dose thyroxine in elderly hypothyroid patients: study protocol for a randomized controlled trial. Trials. 2013 Mar 22;14:83. PMID: 23522096; PMCID: PMC3617081.
Flux G, Leek F, Gape P, Gear J, Taprogge J. Iodine-131 and Iodine-131-Meta-iodobenzylguanidine Dosimetry in Cancer Therapy. Semin Nucl Med. 2022;52(2):167-177.
DOI: https://doi.org/10.1053/j.semnuclmed.2021.11.002
Lan H, Wen J, Mao Y, Huang H, Chen G, Lin W. Combined T4 + T3 therapy versus T4 monotherapy effect on psychological health in hypothyroidism: A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2022 Jul;97(1):13-25. Epub 2022 Apr 27. PMID: 35445422.
DOI: https://doi.org/10.1111/cen.14742
T Tariq A, Wert Y, Cheriyath P, Joshi R. Effects of Long-Term Combination LT4 and LT3 Therapy for Improving Hypothyroidism and Overall Quality of Life. South Med J. 2018 Jun;111(6):363-369. PMID: 29863229; PMCID: PMC5965938.
DOI: https://doi.org/10.14423/SMJ.0000000000000823
Ito M, Takahashi S, Okazaki-Hada M, Minakata M, Kohsaka K, Nakamura T, Kasahara T, Kudo T, Nishihara E, Fukata S, Nishikawa M, Akamiuzu T, Miyauchi A. Proportion of serum thyroid hormone concentrations within the reference ranges in athyreotic patients on levothyroxine monotherapy: a retrospective study. Thyroid Res. 2022 May 10;15(1):9. PMID: 35534833; PMCID: PMC9087916.
DOI: https://doi.org/10.1186/s13044-022-00127-3
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. PMID: 33782057; PMCID: PMC8005924.
DOI: https://doi.org/10.1136/bmj.n71
Cappelli C, Pirola I, Gandossi E, Casella C, Lombardi D, Agosti B, Marini F, Delbarba A, Castellano M. TSH Variability of Patients Affected by Differentiated Thyroid Cancer Treated with Levothyroxine Liquid Solution or Tablet Form. Int J Endocrinol. 2017;2017:7053959. Epub 2017 May 9. PMID: 28572820; PMCID: PMC5441121.
DOI: https://doi.org/10.1155/2017/7053959
Peroni E, Vigone MC, Mora S, Bassi LA, Pozzi C, Passoni A, Weber G. Congenital hypothyroidism treatment in infants: a comparative study between liquid and tablet formulations of levothyroxine. Horm Res Paediatr. 2014;81(1):50-4. Epub 2013 Nov 12. PMID: 24247169.
DOI: https://doi.org/10.1159/000356047
Bai Y, Jin J, Liu Y, Zhang B, Zhang B, Li J. Effectiveness and Safety of Levothyroxine Tablets Combined with Iodine-131 in the Treatment of Thyroid Cancer. J Oncol. 2022 Jun 2;2022:3676886. PMID: 35693983; PMCID: PMC9184223.
DOI: https://doi.org/10.1155/2022/3676886
Pang YL, Wang YP, Cheng K. Clinical Efficacy of Levothyroxine Sodium plus I 131 in the Treatment of Patients with Thyroidectomy and Its Effect on the Levels of Thyroglobulin and Thyrotropin. Evid Based Complement Alternat Med. 2022 Aug 2;2022:9557061. PMID: 35958920; PMCID: PMC9363160.
DOI: https://doi.org/10.1155/2022/9557061
Fallahi P, Ferrari SM, Materazzi G, Ragusa F, Ruffilli I, Patrizio A, Miccoli P, Antonelli A. Oral L-thyroxine liquid versus tablet in patients submitted to total thyroidectomy for thyroid cancer (without malabsorption): A prospective study. Laryngoscope Investig Otolaryngol. 2018 Oct 3;3(5):405-408. PMID: 30410995; PMCID: PMC6209618.
DOI: https://doi.org/10.1002/lio2.186
Fallahi P, Ferrari SM, Camastra S, Politti U, Ruffilli I, Vita R, Navarra G, Benvenga S, Antonelli A. TSH Normalization in Bariatric Surgery Patients After the Switch from L-Thyroxine in Tablet to an Oral Liquid Formulation. Obes Surg. 2017 Jan;27(1):78-82. PMID: 27272506.
DOI: https://doi.org/10.1007/s11695-016-2247-4
Lombardi CP, Bocale R, Barini A, Barini A, D'Amore A, Boscherini M, Bellantone R. Comparative study between the effects of replacement therapy with liquid and tablet formulations of levothyroxine on mood states, self-perceived psychological well-being and thyroid hormone profile in recently thyroidectomized patients. Endocrine. 2017 Jan;55(1):51-59. Epub 2016 Jul 7. PMID: 27388589.
DOI: https://doi.org/10.1007/s12020-016-1003-9
Vita R, Di Bari F, Benvenga S. Oral liquid levothyroxine solves the problem of tablet levothyroxine malabsorption due to concomitant intake of multiple drugs. Expert Opin Drug Deliv. 2017 Apr;14(4):467-472. Epub 2017 Feb 13. PMID: 28151692.
DOI: https://doi.org/10.1080/17425247.2017.1290604
Benvenga S, Di Bari F, Vita R. Undertreated hypothyroidism due to calcium or iron supplementation corrected by oral liquid levothyroxine. Endocrine. 2017 Apr;56(1):138-145. Epub 2017 Feb 3. PMID: 28155174.
DOI: https://doi.org/10.1007/s12020-017-1244-2
Vita R, Saraceno G, Trimarchi F, Benvenga S. Switching levothyroxine from the tablet to the oral solution formulation corrects the impaired absorption of levothyroxine induced by proton-pump inhibitors. J Clin Endocrinol Metab. 2014 Dec;99(12):4481-6. PMID: 25259910.
DOI: https://doi.org/10.1210/jc.2014-2684
Giusti M, Mortara L, Machello N, Monti E, Pera G, Marenzana M. Utility of a Liquid Formulation of Levo-thyroxine in Differentiated Thyroid Cancer Patients. Drug Res (Stuttg). 2015 Jun;65(6):332-6. Epub 2014 Jul 14. PMID: 25020105.
DOI: https://doi.org/10.1055/s-0034-1384535
Pirola I, Daffini L, Gandossi E, Lombardi D, Formenti A, Castellano M, Cappelli C. Comparison between liquid and tablet levothyroxine formulations in patients treated through enteral feeding tube. J Endocrinol Invest. 2014 Jun;37(6):583-7. Epub 2014 May 1. PMID: 24789541.
DOI: https://doi.org/10.1007/s40618-014-0082-9
Ribichini D, Fiorini G, Repaci A, Castelli V, Gatta L, Vaira D, Pasquali R. Tablet and oral liquid L-thyroxine formulation in the treatment of naïve hypothyroid patients with Helicobacter pylori infection. Endocrine. 2017 Sep;57(3):394-401. Epub 2016 Nov 15. PMID: 27848196.
DOI: https://doi.org/10.1007/s12020-016-1167-3
Clyde PW, Harari AE, Getka EJ, Shakir KM. Combined levothyroxine plus liothyronine compared with levothyroxine alone in primary hypothyroidism: a randomized controlled trial. JAMA. 2003 Dec 10;290(22):2952-8. PMID: 14665656.
DOI: https://doi.org/10.1001/jama.290.22.2952
Escobar-Morreale HF, Botella-Carretero JI, Gómez-Bueno M, Galán JM, Barrios V, Sancho J. Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone. Ann Intern Med. 2005 Mar 15;142(6):412-24. PMID: 15767619.
DOI: https://doi.org/10.7326/0003-4819-142-6-200503150-00007
Kaminski J, Miasaki FY, Paz-Filho G, Graf H, Carvalho GA. Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study. Arch Endocrinol Metab. 2016 Nov-Dec;60(6):562-572. Epub 2016 Aug 25. PMID: 27982198.
DOI: https://doi.org/10.1590/2359-3997000000192
Walsh JP, Shiels L, Lim EM, Bhagat CI, Ward LC, Stuckey BG, Dhaliwal SS, Chew GT, Bhagat MC, Cussons AJ. Combined thyroxine/liothyronine treatment does not improve well-being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism. J Clin Endocrinol Metab. 2003 Oct;88(10):4543-50. PMID: 14557419.
DOI: https://doi.org/10.1210/jc.2003-030249
Fadeyev VV, Morgunova TB, Melnichenko GA, Dedov II. Combined therapy with L-thyroxine and L-triiodothyronine compared to L-thyroxine alone in the treatment of primary hypothyroidism. Hormones (Athens). 2010 Jul-Sep;9(3):245-52. PMID: 20688622.
DOI: https://doi.org/10.14310/horm.2002.1274
Bikas A, Burman KD. Epidemiology of Thyroid Cancer. In: Markus Luster, Leonidas H. Duntas, Leonard Wartofsky (Eds.), The Thyroid and Its Diseases, 541-547 - January 2019.
DOI: https://doi.org/10.1007/978-3-319-72102-6_35
Lundgren CI, Hall P, Dickman PW, Zedenius J. Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case-control study. Cancer. 2006 Feb 1;106(3):524-31. PMID: 16369995.
DOI: https://doi.org/10.1002/cncr.21653
Jonklaas J, Bianco AC, Cappola AR, Celi FS, Fliers E, Heuer H, McAninch EA, Moeller LC, Nygaard B, Sawka AM, Watt T, Dayan CM. Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document. Eur Thyroid J. 2021 Mar;10(1):10-38. Epub 2021 Feb 16. PMID: 33777817; PMCID: PMC7983670.
DOI: https://doi.org/10.1159/000512970
Kwiatek MA, Roman S, Fareeduddin A, Pandolfino JE, Kahrilas PJ. An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients. Aliment Pharmacol Ther. 2011 Jul;34(1):59-66. Epub 2011 May 3. PMID: 21535446; PMCID: PMC3612878.
DOI: https://doi.org/10.1111/j.1365-2036.2011.04678.x
Virili C, Brusca N, Capriello S, Centanni M. Levothyroxine Therapy in Gastric Malabsorptive Disorders. Front Endocrinol (Lausanne). 2021 Jan 28;11:621616. PMID: 33584549; PMCID: PMC7876372.
DOI: https://doi.org/10.3389/fendo.2020.621616
Nagy EV, Perros P, Papini E, Katko M, Hegedüs L. New Formulations of Levothyroxine in the Treatment of Hypothyroidism: Trick or Treat? Thyroid. 2021 Feb;31(2):193-201. Epub 2020 Nov 2. PMID: 33003978.
DOI: https://doi.org/10.1089/thy.2020.0515
Trimboli P, Mouly S. Pharmacokinetics and Clinical Implications of Two Non-Tablet Oral Formulations of L-Thyroxine in Patients with Hypothyroidism. J Clin Med. 2022 Jun 16;11(12):3479. PMID: 35743549; PMCID: PMC9224574.
DOI: https://doi.org/10.3390/jcm11123479
Morelli S, Reboldi G, Moretti S, Menicali E, Avenia N, Puxeddu E. Timing of breakfast does not influence therapeutic efficacy of liquid levothyroxine formulation. Endocrine. 2016 Jun;52(3):571-8. Epub 2015 Nov 4. PMID: 26537478.
DOI: https://doi.org/10.1007/s12020-015-0788-2
Morelli S, Reboldi G, Moretti S, Menicali E, Avenia N, Puxeddu E. Timing of breakfast does not influence therapeutic efficacy of liquid levothyroxine formulation. Endocrine. 2016 Jun;52(3):571-8. Epub 2015 Nov 4. PMID: 26537478.
DOI: https://doi.org/10.1007/s12020-015-0788-2
Fard-Esfahani A, Emami-Ardekani A, Fallahi B, Fard-Esfahani P, Beiki D, Hassanzadeh-Rad A, Eftekhari M. Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl Med Commun. 2014 Aug;35(8):808-17. PMID: 24751702.
DOI: https://doi.org/10.1097/MNM.0000000000000132
How to Cite
Hao, D., Tian, L., He, H., Zhu, C., Guo, L., Zhang, K., & Zhang, J. (2023). Efficacy and safety of postoperative levothyroxine sodium tablets for improving serum thyroid hormone levels and tumor marker levels in patients with thyroid tumors. European Journal of Translational Myology, 33(3). https://doi.org/10.4081/ejtm.2023.11582
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.