Drs Kaniksha Desai and Juan Brito discuss generic vs brand-name medication for thyroid hormone replacement.
www.medscape.c...
-- TRANSCRIPT --
Kaniksha Desai, MD: Welcome to the Thyroid Stimulating Podcast. This podcast was created in partnership with the American Thyroid Association to discuss up-to-date diagnosis and management of a wide array of thyroid diseases. Back in 2023, we embarked on this podcasting journey with the focus on the emerging topic of T3 use for hypothyroidism. This has since gained mainstream recognition with the release of the new joint British Thyroid Association guidelines.
As we step into 2024, we are excited to be kicking off this year with our first episode, taking a deep dive into the intriguing debate between generic levothyroxine and brand-name medication for thyroid hormone replacement. If you've ever wondered about the differences, the benefits, and the potential concerns when making this crucial choice, you've come to the right place.
Our journey begins today by delving into the science behind levothyroxine and tracing the historical development of brand-name thyroid medications. We'll then navigate through topics such as cost-effectiveness, availability, and potential variability in the medication quality between generic and brand-name levothyroxine.
Whether you're a healthcare professional, a patient managing thyroid-related diseases, or simply curious about the world of thyroid treatment, this episode is packed with valuable insights that you don't want to miss. Joining me today is Dr Brito, a world-renowned thyroidologist and a leading authority on the subject, with over 200 publications in the field.
Dr Brito completed his medical training at Memorial Sloan Kettering on the East Coast and is joining us today from the Mayo Clinic, where he's currently a professor of endocrinology in the Department of Internal Medicine. Thank you, Dr Brito. We're honored to have you as a guest on today's show.
Juan P. Brito: Thank you very much for having me. I really appreciate the invitation and the opportunity to talk about this very interesting topic.
Desai: Let's get started. I wanted to start today with a little background on how levothyroxine works. Could you provide that information for our listeners?
Brito: Levothyroxine is a medication used to treat thyroid problems, particularly an underactive thyroid gland problem, which is called hypothyroidism. Levothyroxine is the synthetic version of the hormone that we usually produce, which is called thyroxine. The hormone is very important for regulating your body metabolism.
When we take a levothyroxine pill, it enters the bloodstream and eventually reaches our cells. Inside the cells, it turns into an active type of form, called T3, or liothyronine. This T3, or active form, binds specific receptors in the cell, and by doing so, will stimulate the activation of specific genes. These genes control how the cell uses energy, processes nutrients, and performs vital functions.
As an end result, levothyroxine activates the metabolism. People produce more energy, generate more heat, and the cells become more efficient. Levothyroxine is really important to maintain the body's function.
Desai: Thank you so much. I wanted to talk a little bit about the medication itself, in that it's taken once a day but it can last in your system a relatively long period of time. Can you go over a little bit about the metabolism of levothyroxine?
Brito: Levothyroxine, I believe, has a very interesting way to be absorbed and metabolized. Once somebody takes the pill, it goes into the stomach. That is the part that is very crucial for the absorption of the pill because the majority of people take what is called tablet levothyroxine.
The acid production of the stomach will dissolve what is around the active component of the tablet. Our gastrointestinal system will finally have the active form. It will pass to the small intestine and it will be absorbed. Once it's absorbed, it will stay in your system at least 6-7 days on average.
This is exactly why sometimes when we talk to patients about levothyroxine, we tend to tell them it takes almost 4-6 weeks to actually see the effect of levothyroxine because by adding on this medicine every day, eventually you reach a steady point in which, finally, you have what is called a therapeutic level.
Transcript in its entirety can be found by clicking here:
www.medscape.c...
8 апр 2024
