Análise da dose de levotiroxina nos diversos tipos de hipotireoidismo atendidos no ambulatório de tireoide do Centro de Especialidades Médicas do CESUPA (CEMEC)

Abstract

Introduction: Hypothyroidism is an endocrinopathy with a prevalence of 0.3% to 4.6% in the population, and its treatment is hormone replacement with levothyroxine (LT4) at an initial dose of 1.6 to 1.8 mcg / kg / day, however, it is known that the type of hypothyroidism may influence the amount of LT4 to be administered to the patient. Objectives: To analyze the dose of levothyroxine (LT4) used in the various types of hypothyroidism. Material and Method: It was a cross-sectional, descriptive and quantitative study based on the data collection of medical records of patients with hypothyroidism, attended, in the period from 2015 to 2018, in the Thyroid Ambulatory of the Center of Medical Specialties of CESUPA (CEMEC). The variables analyzed were age, sex, weight, type of hypothyroidism, levothyroxine dose, TSH and free T4 value recorded at the last visit, symptoms, comorbidities and use of other medications. Results: 187 medical records of patients with hypothyroidism were analyzed, with a predominance of women (97.9%) between 21-44 years of age. The most prevalent cause of hypothyroidism was total thyroidectomy and the highest mean levothyroxine dose was in this group. Among men, the postoperative period was predominant in adult patients (2). In most patients, there was no record of cardiovascular and gastrointestinal related comorbidities that could affect LT4 dose. There was also no significant statistical difference (p = 0.5428) between the use of other drugs and the absence of comorbidities and the age groups of the patients. Disabsortive disease was the comorbidity found that altered LT-4 replacement by age range. The highest mean doses of levothyroxine were recorded in patients with total thyroidectomy hypothyroidism. No significant statistical difference was observed between the averages and medians of the levothyroxine doses and the age ranges of the patients. The medications that may change the dose of LT4 most encountered were calcium, metformin and estrogens. The most controlled patients (within the TSH target) were those with an autoimmune cause. Conclusion: No type influence of hypothyroidism was observed on the dose of levothyroxine.