Publications by authors named "L D Premawardhana"

Universal salt iodisation (USI) plays an essential role in the provision of iodine (I) to populations worldwide. Countries adopting USI programmes, adhering to strict criteria laid down by expert organisations such as the Iodine Global Network, are estimated to have reduced the prevalence of I deficiency by 75% (protecting 720 million individuals worldwide). Despite this success, doubts have been raised as to the desirability of continuing such programmes because of (a) the need to reduce salt intake for cardiovascular prevention and (b) the induction of thyroid autoimmunity.

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Introduction: There continues to be much discussion around optimisation of thyroid hormone status in hypothyroid individuals. We here looked the way that free T4(FT4) and thyroid-stimulating hormone (TSH) related to each other in a large laboratory sample of people who underwent a thyroid function test (TFT), split between those on levothyroxine replacement (monitoring test) and those who underwent a test to check for thyroid hormone imbalance (diagnostic test; not on levothyroxine).

Methods: TFT test (FT4/TSH) results were extracted from the Salford Royal Hospital Laboratory Information Management System during 2009-2012.

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Primary hypothyroidism affects about 3% of the general population in Europe. Early treatments in the late 19 Century involved subcutaneous as well as oral administration of thyroid extract. Until the early 1970s, the majority of people across the world with hypothyroidism were treated with natural desiccated thyroid (NDT) (derived from pig thyroid glands) in various formulations, with the majority of people since then being treated with levothyroxine (L-thyroxine).

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Article Synopsis
  • - Around 10%-15% of hypothyroid patients taking L-thyroxine (LT4) still report ongoing symptoms that negatively impact their quality of life, potentially due to insufficient tissue levels of T3.
  • - Although combining liothyronine (LT3) with LT4 seemed beneficial, randomized controlled trials did not show significant improvement over LT4 alone, which might be due to trial design flaws and inadequate measures.
  • - Future studies should focus on better subject selection, utilize appropriate assessment tools for thyroid-related symptoms, employ long-acting LT3 formulations, and consider crossover designs to improve the reliability and efficiency of the trials.
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