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Desiccated thyroid: Difference between revisions

From Pharmacopedia
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home-claude punt-list stub, Top 300 #141
 
B3 citation patch (home-claude, PM-approved): clear [citation needed] with verified ref
 
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| halflife          = T4 ~7 days; T3 ~1 day<ref name="armour-label" />
| halflife          = T4 ~7 days; T3 ~1 day<ref name="armour-label" />
| bioavailability  = Variable; reduced by food, calcium, iron, PPIs<ref name="armour-label" />
| bioavailability  = Variable; reduced by food, calcium, iron, PPIs<ref name="armour-label" />
| pregnancy        = Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied{{citation needed}}
| pregnancy        = Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied.<ref name="ata2017-preg">Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017;27(3):315-389. PMID 28056690.</ref>
| legal            = [[USLegal:Prescription only|Rx-only]] in US
| legal            = [[USLegal:Prescription only|Rx-only]] in US
| mechanism        = <vote slug="desiccated-thyroid-mech-claim">Desiccated thyroid supplies both T4 and T3 in a roughly 4:1 ratio; T4 is peripherally deiodinated to T3, but exogenous T3 supplementation produces faster onset and supraphysiologic post-dose peaks that synthetic T4 monotherapy avoids.</vote> Brand-to-brand and lot-to-lot variability in T3:T4 ratio is greater than with synthetic levothyroxine, which is why endocrine guidelines prefer the synthetic<ref name="armour-label" />.
| mechanism        = <vote slug="desiccated-thyroid-mech-claim">Desiccated thyroid supplies both T4 and T3 in a roughly 4:1 ratio; T4 is peripherally deiodinated to T3, but exogenous T3 supplementation produces faster onset and supraphysiologic post-dose peaks that synthetic T4 monotherapy avoids.</vote> Brand-to-brand and lot-to-lot variability in T3:T4 ratio is greater than with synthetic levothyroxine, which is why endocrine guidelines prefer the synthetic<ref name="armour-label" />.