Compliance problems in therapy with levothyroxine

: In order to evaluate problems with long-term levothyroxine therapy, the course of treatment in 185 patients of an endocrinological outpatient ward (88 with euthyroid goiter, 41 with overt or latent hypothyroidism, ten with Hashimoto's thyroiditis, 46 after resection of goiter) was analyzed retrospectively. Duration of therapy ranged from one to 28 years. Suppressive therapy of euthyroid goiter was stopped by the treating physician in eleven patients (11%), in five permanently. To the contrary, 30 patients (34%) stopped medication by themselves 31 times, 29 times, however, levothyroxine was restarted again. Observations in the group with latent hypothyroidism were similar. After operation levothyroxine therapy was stopped by the physician eight times, six times only for a limited time period. Eight patients (17%) decided to stop therapy without knowledge of the treating physician, but in all it was restarted later. The presented results show that the success of levothyroxine therapy of euthyroid goiter as well as of prophylaxis of goiter relapse after operation is threatened by dyscompliance of the patients. In goiter suppression therapy compliance is further challenged by a lack of consequence in therapy planning and guidance.