Skip to main content
Log in

Optimizing the treatment of hypothyroidism

  • Comment
  • Published:

From Nature Reviews Endocrinology

View current issue Sign up to alerts

Daily levothyroxine (LT4) is the standard of care for the treatment of hypothyroidism; however, a small number of patients experience residual symptoms of hypothyroidism. Guidelines indicate that a trial with LT4 and liothyronine (LT3) could be attempted once other conditions have been addressed or excluded. Even so, currently, treatment of hypothyroidism can still be suboptimal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Bianco, A. C. Rethinking Hypothyroidism (Univ. Chicago Press, 2022).

  2. Penna, G. C., Bensenor, I. M., Bianco, A. C. & Ettleson, M. D. Thyroid hormone homeostasis in levothyroxine-treated patients: findings from ELSA-Brasil. J. Clin. Endocrinol. Metab.https://doi.org/10.1210/clinem/dgae139 (2024).

    Article  PubMed  Google Scholar 

  3. Idrees, T., Palmer, S., Maciel, R. M. B. & Bianco, A. C. Liothyronine and desiccated thyroid extract in the treatment of hypothyroidism. Thyroid 30, 1399–1413 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Jonklaas, J. et al. Evidence-based use of levothyroxine/liothyronine combinations in treating hypothyroidism: a consensus document. Thyroid 31, 156–182 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Shakir, M. K. M. et al. Comparative effectiveness of levothyroxine, desiccated thyroid extract, and levothyroxine+liothyronine in hypothyroidism. J. Clin. Endocrinol. Metab. 106, e4400–e4413 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dumitrescu, A. M. et al. Extended absorption of liothyronine from poly-zinc-liothyronine: results from a phase 1, double-blind, randomized, and controlled study in humans. Thyroid 32, 196–205 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Ettleson, M. D. et al. Demographic, healthcare access, and dietary factors associated with thyroid hormone treatments for hypothyroidism. J. Clin. Endocrinol. Metab. 108, e1614–e1623 (2023).

    Article  PubMed  Google Scholar 

  8. Taylor, P. N. et al. Falling threshold for treatment of borderline elevated thyrotropin levels-balancing benefits and risks: evidence from a large community-based study. JAMA Intern. Med. 174, 32–39 (2014).

    Article  CAS  PubMed  Google Scholar 

  9. Ahluwalia, R. et al. Use of liothyronine (T3) in hypothyroidism: joint British Thyroid Association/Society for Endocrinology consensus statement. Clin. Endocrinol. 99, 206–216 (2023).

    Article  CAS  Google Scholar 

  10. Taylor, P. N. et al. Liothyronine cost and prescriptions in England. Lancet Diabetes Endocrinol. 7, 11–12 (2019).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Antonio C. Bianco.

Ethics declarations

Competing interests

A.C.B. is a consultant for AbbVie, Acella, Synthonics. P.N.T. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bianco, A.C., Taylor, P.N. Optimizing the treatment of hypothyroidism. Nat Rev Endocrinol (2024). https://doi.org/10.1038/s41574-024-00989-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1038/s41574-024-00989-7

  • Springer Nature Limited

This article is cited by

Navigation