L-Thyroxin bei Hypothyreose – absetzen oder nicht?

L‑thyroxine is one of the most frequently prescribed drugs in Germany. It is mainly used for the treatment of hypothyroidism. Based on prescription data, it can be assumed that L‑thyroxine is prescribed more frequently than is medically indicated.

Are family doctors willing to reduce the dose or try to discontinue L‑thyroxine?

At the annual conference of the Saxon Society of General Practice, a cross-sectional survey was carried out using a questionnaire. The questionnaire contained three constructed cases of patients whose L‑thyroxine therapy was to be assessed for the potential for change. Descriptive analysis of the quantitative data and qualitative content analysis were performed.

A total of 33 family doctors took part in the survey. Maintaining or even increasing the dose was most frequently favored. This was justified on the grounds of good adjustment to the current treatment, the presumed lack of disadvantages of a low-dose regimen, or the avoidance of complications of discontinuation. Reduction or discontinuation was rarely suggested and if so, it was advocated with reference to the lack of a medical indication.

Even in the absence of a medical indication, participants were reluctant to change an existing therapy. This is consistent with findings from the existing literature. The assumption of avoiding subsequent illnesses, limited time for counseling sessions, and a lack of communication between prescribers have been identified as causes in other studies. However, there is evidence for benefits of deprescribing. More research is needed in this area in the German primary care sector.