{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:21:07Z","timestamp":1777875667873,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Therapy of hypothyroidism is based on the administration of appropriate doses of levothyroxine (LT4). A failure to achieve the thyrotropin (TSH) target may be due to poor compliance with the LT4 therapy in about 60% of cases or to malabsorption in about 40% of cases. No tools are available for detecting malabsorption disorders before the choice of the most appropriate therapy. The aim of this study was to validate the Evaluation of Malabsorption in PATients with HYpothyroidism (EMPATHY) questionnaire and to demonstrate its usefulness in indicating the most appropriate therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>EMPATHY consists of seven questions that allow the evaluation of several intolerances and allergies. Three hundred (100 males) newly diagnosed hypothyroid patients were enrolled and randomly assigned to complete an EMPATHY questionnaire (150 patients; group 1) or to a control group (150 patients; group 2). The choice of thyroxine formulation and dose for each group was made on the basis of the questionnaire answers or based on the history. Thyroid hormones and TSH were evaluated at enrollment and then every two months for six months; the number of the dose adjustments in the six months for each patient was recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 150 patients in each group, 21 (14%) in group 1 and 42 (28%) in group 2 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005) needed more than two dose adjustments within six months. After six months of replacement therapy, six (4%) patients in group 1 and 17 (11%) in group 2 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03) did not have appropriately controlled hypothyroidism (TSH \u22652.5 mIU\/L). A significantly higher LT4 final dose was found in group 2 (148\u2009\u00b1\u200933\u2009\u03bcg\/day) than in group 1 (136\u2009\u00b1\u200928\u2009\u03bcg\/day;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Validation of EMPATHY provides endocrinologists with a useful tool in clinical practice, permitting a better personalization of LT4 replacement therapy, a more rapid attainment of the target TSH levels, and a decreased need for dose adjustments after initiating therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2018.0493","type":"journal-article","created":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T07:50:23Z","timestamp":1554796223000},"page":"928-933","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["EMPATHY: A New Tool for Identifying the Most Suitable Thyroxine Formulation in Hypothyroid Patients"],"prefix":"10.1177","volume":"29","author":[{"given":"Giuseppe","family":"Bellastella","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariangela","family":"Caputo","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Ida","family":"Maiorino","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Longo","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Scappaticcio","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Giugliano","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Esposito","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Department of Advanced Medical and Surgical Sciences, University of Campania \u201cL. Vanvitelli,\u201d Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000356507"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30703-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0028"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP161308.OR"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP12280.GL"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1991.1.241"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198703263161302"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043903"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0222"},{"key":"e_1_3_2_11_2","first-page":"74","article-title":"Thyroid hormone replacement therapy","volume":"56","author":"Wiersinga WM","year":"2001","unstructured":"Wiersinga WM. 2001. 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