ArticleAACE endocrinology and diabetes
Daily Intramuscular Levothyroxine in Refractory Hypothyroidism and Malabsorption.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/Objective: In patients with hypothyroidism, levothyroxine (LT4) monotherapy is the standard treatment; however, when standard therapy is ineffective, alternative approaches including liquid LT4, desiccated thyroid extract, LT4/liothyronine combinations, or injectable LT4 can be considered. Case Report: A 55-year-old Caucasian woman with a history of Hashimoto thyroiditis, diagnosed during her first pregnancy in 1989, was controlled on 125 mcg of Synthroid daily until undergoing Roux-en-Y gastric bypass in 2004. Several years following gastric bypass surgery, she developed persistent hypothyroidism with increased serum thyroid-stimulating hormone (TSH) levels, low free thyroxine levels, and symptoms including fatigue, brain fog, constipation, cold intolerance, hair loss, dry skin, and delayed wound healing. Despite trials of various high-dose oral thyroid hormone regimens-including Tirosint (750 mcg daily), Synthroid (200 mcg daily), a combination of LT4 (175 mcg) and triiodothyronine (10 mcg), and Armour (150 mg daily)-her TSH level remained elevated. Thyroid hormone absorption tests revealed significant reduction in absorption: (1) 9% for Tirosint (1050 mcg), (2) 50% for Synthroid (1000 mcg), (3) 47% for Armour thyroid (600 mcg), and (4) 69% for sublingual LT4. Given her refractory hypothyroidism, intramuscular (IM) LT4 100 mcg daily was started, leading to normalization of TSH level and resolution of symptoms. Conclusion: Our manuscript highlights the importance of considering alternative therapies for hypothyroidism, including IM LT4 either daily or weekly, when the oral routes are not adequately bioavailable to normalize TSH levels and resolve symptoms. This is the first case report of successful treatment of uncontrolled hypothyroidism with daily IM LT4 in an outpatient setting. Further studies are needed.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.