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Josephina G Kuiper PHARMO Institute for Drug Outcomes Research, AE Utrecht, Netherlands
Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands

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Aline C Fenneman Department of Clinical and Experimental Vascular Medicine, Amsterdam Cardiovascular Sciences (ACS), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

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Anne H van der Spek Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

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Elena Rampanelli Department of Clinical and Experimental Vascular Medicine, Amsterdam Cardiovascular Sciences (ACS), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

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Max Nieuwdorp Department of Clinical and Experimental Vascular Medicine, Amsterdam Cardiovascular Sciences (ACS), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

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Myrthe P P van Herk-Sukel Department of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, Netherlands

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Valery E P P Lemmens Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands

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Ernst J Kuipers Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands

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Ron M C Herings PHARMO Institute for Drug Outcomes Research, AE Utrecht, Netherlands
Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, Netherlands

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Eric Fliers Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

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.nivel.nl/nl/nivel-zorgregistraties-eerste-lijn/jaarcijfers-aandoeningen-incidenties-en-prevalenties ). Treatment of primary hypothyroidism consists of hormone substitution therapy with daily oral administration of the synthetic thyroid hormone levothyroxine. The majority of levothyroxine is absorbed in the upper gastrointestinal tract, ranging from 40 to 80

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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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Salman Razvi Translational and Clinical Research Institute, University of Newcastle, Newcastle-upon-Tyne, UK

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Sanaa Mrabeti Medical Affairs EMEA, Merck Serono Middle East FZ-LLC, Dubai, United Arab Emirates

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Markus Luster Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany

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Introduction Current management guidelines for the management of hypothyroidism focus on the administration of levothyroxine (LT4), with doses titrated to bring thyroid-stimulating hormone (thyrotropin, TSH) within a locally-derived reference

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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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Nella Augusta Greggio Endocrinology and Adolescence Unit, Department of Woman and Child Health, University of Padova, Padova, Italy

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Elisa Rossi CINECA – Interuniversity Consortium (Health Service), Bologna, Italy

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Silvia Calabria CORE srl – Collaborative Outcome Research, Bologna, Italy

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Alice Meneghin Endocrinology and Adolescence Unit, Department of Woman and Child Health, University of Padova, Padova, Italy

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Joaquin Gutierrez de Rubalcava Endocrinology and Adolescence Unit, Department of Woman and Child Health, University of Padova, Padova, Italy

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Carlo Piccinni CORE srl – Collaborative Outcome Research, Bologna, Italy

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Antonella Pedrini CORE srl – Collaborative Outcome Research, Bologna, Italy

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, 12 , 13 , 14 , 15 , 16 , 17 ). For this reason, the available European guidelines are not definitive on treatment of this population: it generally recommends a treatment with levothyroxine in children aged <3 years, in order to support the

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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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Nikolina Zdraveska University Children’s Hospital Skopje, Faculty of Medicine, Skopje, Republic of Macedonia

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Maja Zdravkovska Institute of Patophysiology and Nuclear Medicine, Faculty of Medicine, Skopje, Republic of Macedonia

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Violeta Anastasovska University Children’s Hospital Skopje, Faculty of Medicine, Skopje, Republic of Macedonia

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Elena Sukarova-Angelovska University Children’s Hospital Skopje, Faculty of Medicine, Skopje, Republic of Macedonia

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Mirjana Kocova University Children’s Hospital Skopje, Faculty of Medicine, Skopje, Republic of Macedonia

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initiated on levothyroxine (LT 4 ) treatment. The patients underwent regular thyroid function tests (TFT), as well as assessment of growth and development, mainly at 3-month intervals. Children aged ≥3 years underwent trial off therapy for period of 4 weeks

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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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Ningning Gong Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China

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Cuixia Gao Department of Ultrasonic Diagnosis, Gansu Provincial Hospital, Lanzhou, China

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Xuedi Chen Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China

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Yu Wang Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China

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Limin Tian Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China

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-α levels with endothelial function and the development of sHT with different TSH levels have not yet been investigated. Moreover, the effect of levothyroxine (LT 4 ) treatment on adipokine levels and endothelial function is not yet clear. Our study aims to

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