George J. Kahaly - 70 Years of Levothyroxine

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Levothyroxine (LT4) is celebrating its 70th birthday, since its introduction to the management of hypothyroidism or primary thyroid failure.

This is a good opportunity to explore the history and the current state of the art with regard to the therapeutic use of LT4, now one of the most-prescribed treatments worldwide. In our book, we explore the early research that led to an understanding of the role of thyroid gland that led to the initial therapeutic use of LT4. We also describe the pharmacokinetics, pharmacodynamics and mechanism of action of LT4, its actions on key target organs (heart and bone), and its use and effects in important special populations (children, older persons, pregnancy, and survivors of thyroid cancer). A concluding chapter summarizes pragmatic recommendations for the practicing physician on the optimal clinical application of LT4 substitution.

As the Editor of this book, I am extremely grateful to the nine internationally respected physicians and clinical researchers in the field of thyroid research, based in three continents (Asia, Europe, and the Americas), who agreed to join me to make up our expert Faculty. They were Drs. Takashi Akamizu (Japan), Tomasz Bednarczuk (Poland), Bernadette Biondi (Italy), Gabriela Brenta (Argentina), James Hennessey (USA), Hans-Peter Lipp (Germany), Kris Poppe (Belgium), Salman Razvi (United Kingdom), and Weiping Teng (China). Their expertise, knowledge, and active participation greatly facilitated my task as book Editor. Their important contributions, well-taken points, constructive comments, and excellent proposals made this book possible. This book also benefited from independent peer review by two experts in the field of thyroidology, in addition to the experience and knowledge of our faculty.

I also thank our medical writer, Dr. Mike Gwilt. Mike provided effective editorial support to our Faculty, from the building of the first draft through successive revisions, to the final book you see here. His engagement with the authorsincluding myselfhelped greatly in bringing their knowledge and experience to the page. His engagement with me as Editor helped me to oversee the production of a book of ten coherent chapters that not only stand individually as expert reviews in our authors fields of expertise, but also work together tell us the full story of seven decades of therapeutic use of LT4.

The idea for this anniversary book, and logistical support, came from Merck Healthcare KGaA, Darmstadt, Germany. I am most grateful to Dr. Bogumila Urgatz (Medical Director) and Dr. Ulrike Hostalek (Executive Medical Director, GMA, GM & Endocrinology) from this company, for this productive and successful collaboration.

Enjoy the reading!

With all best wishes,