From the Guidelines
Liothyronine is not commonly used in children, but it may be considered in specific situations such as severe hypothyroidism or thyroid insufficiency with catecholamine-resistant shock, as noted in a study published in Critical Care Medicine 1. When considering the use of liothyronine in children, it's essential to weigh the potential benefits against the risks, particularly in pediatric patients with underlying medical conditions.
- The study highlights the importance of thyroid replacement therapy in children with thyroid insufficiency and catecholamine-resistant shock, but it does not provide specific guidance on the use of liothyronine in this population 1.
- However, it does mention that infusion therapy with triiodothyronine (T3) has been beneficial in postoperative congenital heart disease patients, suggesting potential applications in pediatric care 1.
- It's crucial to note that children with hypothyroidism are typically treated with levothyroxine (T4) as the primary therapy, and liothyronine (T3) may only be considered in specific situations requiring rapid correction or in cases of myxedema coma.
- Close monitoring and careful dosing adjustments are necessary when using liothyronine in children, as they are more sensitive to thyroid hormone fluctuations, and overtreatment can have significant consequences on growth, development, and cardiac function.
- Ultimately, treatment decisions should be made by pediatric endocrinologists who can provide personalized care and monitoring protocols for each child's unique needs.
From the Research
Use of Liothyronine in Children
- Liothyronine is used in children with congenital hypothyroidism and central resistance to thyroid hormone, as it helps normalize serum thyrotropin (TSH) and thyroxine (T4) concentrations 2.
- A study found that adding liothyronine to levothyroxine monotherapy improved biochemical control of congenital hypothyroidism in children with central resistance to thyroid hormone 2.
- The use of liothyronine in children is also mentioned in a review of pediatric hypothyroidism, which highlights the importance of prompt diagnosis and appropriate treatment of hypothyroidism in infants and children 3.
Liothyronine Treatment in Hypothyroidism
- Liothyronine is used in combination with levothyroxine to treat hypothyroidism, particularly in patients who remain symptomatic despite achieving target TSH levels 4, 5, 6.
- The goals of combination therapy include achieving a physiological ratio of free triiodothyronine/free thyroxine (FT3/FT4) and non-suppression of TSH 4.
- However, the use of liothyronine in hypothyroidism is still a topic of debate, and more clinical studies are needed to identify patients who may benefit from its use 4, 5, 6.