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Bjarke R Medici Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Birte Nygaard Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jeppe L la Cour Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark

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Martin Krakauer Department of Clinical Physiology and Nuclear Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark

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Andreas Brønden Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark

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Mette P Sonne Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark

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Jens J Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens F Rehfeld Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Herlev, Denmark

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Jens Faber Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Filip K Knop Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Herlev, Denmark

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Introduction Hypothyroidism is a common endocrine disease, affecting about 3% of the general population ( 1 ), with levothyroxine substitution therapy being the standard treatment ( 2 , 3 ). Hypothyroidism is associated with increased body

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Bogumila Urgatz Merck Healthcare KGaA, Darmstadt, Germany

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Kris G Poppe University Hospital CHU Saint Pierre, Free University of Brussels, Brussels, Belgium

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recommend measuring TSH in women with TAB at the time of confirmation of pregnancy and monthly during mid-pregnancy ( 8 ). Effects of levothyroxine during pregnancy A large database study of 1013 pregnancies in the UK, where LT4 was started at least

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Heleen I Jansen Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Marijn M Bult Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Peter H Bisschop Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands

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Anita Boelen Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Annemieke C Heijboer Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Jacquelien J Hillebrand Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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samples with fT4 > ULN and a slightly suppressed TSH and 72% of the samples with fT4 > ULN and a TSH within the reference interval belonged to levothyroxine (L-T4) users, as shown in Fig. 1 . Furthermore, we noticed that, respectively, 4.7 and 8.2% of the

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Carmen Sydlik Division of Pediatric Endocrinology, Center for Pediatric and Adolescent Medicine Inn-Salzach-Rott, Altoetting, Germany

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Ilja Dubinski Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Susanne Bechtold Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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Heinrich Schmidt Division of Pediatric Endocrinology, Dr. von Hauner Children's Hospital, University Hospital Munich, LMU Munich, Munich, Germany

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hypothyroidism. Therefore, thyroxine/free thyroxine (T4/fT4) levels are used as an additional parameter for therapy adjustment in patients treated with levothyroxine (LT4). However, peripheral euthyroidism cannot be reliably assessed even with both parameters

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Ning Yuan Department of Endocrinology, Peking University International Hospital, Beijing, China

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Jianbin Sun Department of Endocrinology, Peking University International Hospital, Beijing, China

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Xin Zhao Department of Endocrinology, Peking University International Hospital, Beijing, China

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Jing Du Department of Endocrinology, Peking University International Hospital, Beijing, China

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Min Nan Department of Endocrinology, Peking University International Hospital, Beijing, China

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Qiaoling Zhang Department of Endocrinology, Peking University International Hospital, Beijing, China

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Xiaomei Zhang Department of Endocrinology, Peking University International Hospital, Beijing, China

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(GDM), and placental abruption ( 1 , 2 , 3 ). A previous study ( 4 ) about thyroid disease and pregnancy outcomes showed that SCH increased the odds of adverse pregnancy outcomes and that levothyroxine (LT4) administration improved pregnancy outcomes

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G Amiyangoda Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Sri Lanka
Diabetes and Endocrine Unit, National Hospital, Kandy, Sri Lanka

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C N Antonypillai Diabetes and Endocrine Unit, National Hospital, Kandy, Sri Lanka

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S S C Gunatilake Diabetes and Endocrine Unit, National Hospital, Kandy, Sri Lanka

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T T Weerathunge Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka

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D Ediriweera Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Sri Lanka

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S G P D Kosgallana Diabetes and Endocrine Unit, National Hospital, Kandy, Sri Lanka

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R D P Jayawardana Department of Biochemistry, National Hospital, Kandy, Sri Lanka

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H A N D Thissera Department of Biochemistry, National Hospital, Kandy, Sri Lanka

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W J Emalka Faculty of medicine, University of Peradeniya, Sri Lanka

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H U Daraniyagala Faculty of medicine, University of Peradeniya, Sri Lanka

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Introduction Refractory hypothyroidism is characterized by an inadequate response to the standard dose of levothyroxine, resulting in persistent biochemical or clinical hypothyroidism ( 1 ). The recommended average daily dose of levothyroxine

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Sílvia Santos Monteiro Division of Endocrinology, Diabetes and Metabolism. Department of Medicine, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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Tiago Silva Santos Division of Endocrinology, Diabetes and Metabolism. Department of Medicine, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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Ana Martins Lopes Division of Endocrinology, Diabetes and Metabolism. Department of Medicine, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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José Carlos Oliveira Department of Clinical Pathology, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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Cláudia Freitas Division of Endocrinology, Diabetes and Metabolism. Department of Medicine, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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André Couto Carvalho Division of Endocrinology, Diabetes and Metabolism. Department of Medicine, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar Porto, Portugal

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Introduction Oral levothyroxine (LT4) is the mainstay therapy for hypothyroidism. Absorption of oral LT4 occurs primarily in the small intestine within the first 3 h of ingestion, with an absorption rate of 60–80% ( 1 ). Initial LT4 dosing is

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Qing Zhou Department of Endocrinology, Fujian Maternity and Child Health Hospital, Fujian Children’s Hospital, Fuzhou, China

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Li Yong Zhang Department of Thyroid Surgery, Minimal Invasive Center, Fujian Medical University Union Hospital, Fuzhou, China

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Mei Feng Dai Department of Clinical Lab, Fujian Maternity and Child Health Hospital, Fuzhou, China

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Zhen Li Department of Endocrinology, Fujian Maternity and Child Health Hospital, Fujian Children’s Hospital, Fuzhou, China

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Chao Chun Zou Department of Endocrinology, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

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Hui Liu Department of Endocrinology, Fujian Maternity and Child Health Hospital, Fujian Children’s Hospital, Fuzhou, China

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exhibited elevated serum TSH levels but maintained normal thyroid hormone levels compared to control mouse. To normalize TSH levels, mice with subclinical hypothyroidism were provided with levothyroxine in their drinking water for 2 weeks. Levothyroxine (5

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Yukari Maki Department of Pediatric Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Kiyomi Horiuchi Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Takahiro Okamoto Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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, including fatigue or tiredness, of levothyroxine-treated patients were significantly related to a low concentration of fT3 ( 17 ). The objectives of the present study were to determine the prevalence of fatigue among postoperative patients with PTC and to

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Hanneke J C M Wouters Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Bruce H R Wolffenbuttel Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Anneke C Muller Kobold Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands

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Thera P Links Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Gerwin Huls Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Melanie M van der Klauw Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Introduction Hypothyroidism is a common endocrine disorder. Treatment with levothyroxine has been considered the standard of care for patients with established primary hypothyroidism, and its use has been enforced in all international

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