Part 3- Treating T3 Deficiency, The Evidence You Need
Objectives
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.
Instructor
Neal Rouzier, MD
Faculty Chairman
Accreditation
In support of improving patient care, this activity has been planned and implemented by The Foundation for Care Management (FCM) and Worldlink Medical. FCM is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
This program is approved for 1.0 AMA Category 1 Credits.
This program is approved for 1.0 Nursing Contact hour of Education.
Enrollment Options
Enroll today with a Premium Membership for $495/year, for access to THIS course and:
- All 1 Hour Accredited Courses (28+ more added monthly)
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- All upcoming Journal Clubs AND Journal Club Library
- EBSCOhost – research articles for the BHRT Workshop Series and to support your own evidence based studies!
