Centres of Excellence -> Endocrinology and Diabetes -> Hormonal treatment of thyroid disorders

Hormonal treatment of thyroid disorders

Thyroid hormones are essential for normal life. They have numerous functions, the most important of which are the regulation of metabolism (exchange of substances and processes) of all organs and cells, stimulation of growth, development and differentiation of cells, influence on the work of the heart and production of energy for muscles, they speed up digestive processes and improve bowel function, act on fat metabolism, stimulate mental functions and bone growth, influence the maintenance of pregnancy, normal growth and development of the child etc. In the case of various diseases manifested by reduced thyroid function, we resort to hormonal treatment.

The use of synthetic hormones in the treatment of thyroid disorders began in 1949, when the hormone levothyroxine (T4) was synthesized by laboratory procedures. Although animal thyroid hormones (cow, sheep, pig) obtained by drying (dehydrating) the thyroid (they have been in use since the end of the 19th century) were used to a significant extent over the next two decades, today synthetic hormones are the most widespread form of treatment for reduced thyroid function, regardless of its cause.

This primarily refers to the hormone levothyroxine (T4), which with its smaller part (about 10%) is transformed into the hormone triiodothyronine (T3) by various metabolic processes, which also achieves the main metabolic effect by affecting all organs. This conversion can sometimes be inadequate, creating a larger amount of the partially inactive form of the T3 hormone, the so-called inverted (reverse) T3. Also, the conversion of T4 to T3 is influenced by a number of other factors and conditions (impaired intestinal and liver function, psychological stress and inadequate secretion of the hormone cortisol, elevated levels of the hormone estrogen, disturbed nutrition and extreme diets with insufficient intake of zinc and selenium, etc.)

Therefore, sometimes in the treatment of hypothyroidism it is necessary to apply T3 in addition to T4. Today, we have at our disposal several types of synthetic pharmaceutical preparations that contain only one active substance (eg. pure T4 or pure T3) or a combination of two active substances (T4 and T3). When treating with thyroid hormones, it is important to emphasize that each patient should be approached strictly individually and create a private treatment plan, since each person is unique in their genetic, pharmacological, biochemical, nutritional and every other aspect. The decision to use thyroid hormone (when? which preparation? in which dose? for how long?) is based on the careful assessment of specialist doctors, taking into account the specific needs of each individual patient and the nature of his illness.

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