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Name
Levothyroxine Sodium
Alternate Names
Alti-Thyroxine
Eltroxin
Euthroid
Euthyrox
L-Thyroxine
L-Tyrosine
Levo-T
Levotabs
Levothroid
Levothyroxine
Levoxine
Levoxyl
Proloid
Sodium Levothyroxine
Synthroid
Synthrox
Thyroid USP
Thyrolar
Thyroxine
Thysin
Tirosint
Unithroid
Abbreviations
T4
Category
Hormones and hormonal mechanisms
Subcategory
NSC Number
None
Primary Site
Thyroid
Histology
None
Remarks
Code Levothyroxine as hormonal in papillary, follicular or oncocytic thyroid carcinoma. Do not code if it is medullary or anaplastic thyroid carcinoma.
Rationale:
In papillary, follicular and oncocytic carcinoma levothyroxine has a dual role: 1. Suppression of TSH: This would be considered cancer directed therapy since the tumor cells of the above mentioned morphologies express TSH receptor. TSH is a trophic hormone that can promote tumor growth. 2. Hormonal replacement therapy to treat post-surgical or post-radiation hypothyroidism.
C-cells in medullary carcinoma do not express TSH receptor, thus, TSH suppression would not be indicated. However, replacement hormonal therapy with levothyroxine post surgery is given to treat the post-surgical hypothyroidism. In operable thyroid anaplastic carcinoma the goal of levothyroxine therapy is hormone replacement.
Rationale:
In papillary, follicular and oncocytic carcinoma levothyroxine has a dual role: 1. Suppression of TSH: This would be considered cancer directed therapy since the tumor cells of the above mentioned morphologies express TSH receptor. TSH is a trophic hormone that can promote tumor growth. 2. Hormonal replacement therapy to treat post-surgical or post-radiation hypothyroidism.
C-cells in medullary carcinoma do not express TSH receptor, thus, TSH suppression would not be indicated. However, replacement hormonal therapy with levothyroxine post surgery is given to treat the post-surgical hypothyroidism. In operable thyroid anaplastic carcinoma the goal of levothyroxine therapy is hormone replacement.
Coding
Please see remarks for additional information
