Levothyroxine Use in the United States, 2008-2018
Open accessAbstract
This cross-sectional study assesses national data for commercially insured and Medicare Advantage enrollees to analyze the use of levothyroxine in the US over time.
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Studies from the United States and across Europe have shown that up to 30% of people prescribed levothyroxine may have had normal thyroid function tests beforehand.
“Studies from the United States and across Europe have shown that up to 30% of people prescribed levothyroxine may have had normal thyroid function tests beforehand, 21”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
The Results (page not specified) report that 30.5% of the US patients with both thyrotropin and thyroxine results available had normal thyroid levels before starting levothyroxine. The Methods describe a US cohort of commercially insured and Medicare Advantage enrollees; this paper does not provide evidence from Europe. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMost LT4 users are treated based on a single, mildly elevated serum TSH or even when it is within reference intervals, often inappropriately.
“In addition, most LT4 users are treated based on a single, mildly elevated serum TSH or even when it is within the reference intervals, often in an inappropriate way (10).”
From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [10]
The Results and Table report that most new levothyroxine users had a mildly elevated TSH (59.6%) or a TSH within the stated reference range (28.4%) before initiation. The Discussion suggests substantial overuse, but the Methods require only a TSH measurement within three months; they do not establish that treatment was based on a single test. The authors also say they could not assess symptoms or other compelling reasons for treatment, so they could not determine whether individual prescriptions were inappropriate. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMany patients are labelled as having hypothyroidism and started on levothyroxine inappropriately.
“This has led to many patients being labelled as having hypothyroidism and started on levothyroxine inappropriately. 20,21”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
The Results report that 30.5% of patients with full thyroid-test results had normal thyroid levels when levothyroxine was initiated, and the Discussion concludes that the findings suggest substantial overuse. The paper does not establish that these patients were labelled as having hypothyroidism; it also notes that symptoms or other compelling reasons for treatment could not be assessed. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBoth levothyroxine and liothyronine are currently overprescribed.
“Both levothyroxine and liothyronine are currently overprescribed, 20,21,27 including to people with a transient elevation in TSH”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
The Discussion (page not specified) concludes that the 2008–2018 results suggest substantial overuse of levothyroxine. The Methods (page not specified) describe a cohort of people starting levothyroxine, not liothyronine; this paper therefore does not support the claim about liothyronine or establish that both drugs are currently overprescribed. (LLM, conf=0.90)
Experimental — accuracy not yet measuredLevothyroxine and liothyronine are overprescribed to those with persistent subclinical hypothyroidism.
“or to those with persistent subclinical hypothyroidism, where trials do not show a benefit from thyroid hormone replacement. 12,15,16,44 -46”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
The Discussion reports frequent levothyroxine initiation for subclinical hypothyroidism, mostly mild cases, and concludes that the findings suggest substantial overuse. It also cites evidence of no significant benefit on several patient outcomes. The Methods assess thyroid function before treatment initiation, not whether hypothyroidism persisted; the paper does not assess liothyronine prescribing. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Levothyroxine and liothyronine are overprescribed to people with a transient elevation in TSH.
“Both levothyroxine and liothyronine are currently overprescribed, 20,21,27 including to people with a transient elevation in TSH”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
The Discussion (page not provided) concludes that the findings suggest substantial overuse of levothyroxine, including frequent initiation for mildly elevated TSH. The Methods and Results (pages not provided) concern levothyroxine prescriptions and thyroid levels before treatment; they do not establish that elevations were transient or address liothyronine overprescribing. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMany patients with subclinical hypothyroidism (TSH: 5-10 mU/L) are now treated with levothyroxine, fuelling a rise in its use, such that it is now the third most frequently prescribed medication in the United Kingdom.
“many patients with subclinical hypothyroidism (TSH: 5 -10 mU/L) are now treated with levothyroxine, 20,21 fuelling a rise in its use, such that it is now the third most frequently prescribed medication in the United Kingdom. 22”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [21]
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Cites
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
Trends in Prescription Drug Use Among Adults in the United States From 1999-2012
Kantor, E. D., Rehm, C. D., Haas, J. S., Chan, A. T., & Giovannucci, E. L. (2015) · JAMA · doi:10.1001/jama.2015.13766 · Cited by 1,219 · see citing works
Optum Labs: Building A Novel Node In The Learning Health Care System
Wallace, P. J., Shah, N. D., Dennen, T., Bleicher, P. A., & Crown, W. H. (2014) · Health Affairs · doi:10.1377/hlthaff.2014.0038 · Cited by 449 · see citing works
Self-citationFeller, M., Snel, M., Moutzouri, E., Bauer, D. C., de Montmollin, M., Aujesky, D., Ford, I., Gussekloo, J., Kearney, P. M., Mooijaart, S., et al. (2018) · JAMA · doi:10.1001/jama.2018.13770 · Cited by 266 · see citing works
Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline
Bekkering, G. E., Agoritsas, T., Lytvyn, L., Heen, A. F., Feller, M., Moutzouri, E., Abdulazeem, H., Aertgeerts, B., Beecher, D., Brito, J. P., et al. (2019) · BMJ · doi:10.1136/bmj.l2006 · Cited by 240 · see citing works
Self-citationRoss, J. S., Rohde, S. C., Sangaralingham, L. R., Brito, J. P., Choi, L. H., Dutcher, S. K., Graham, D. J., Jenkins, M., Lipska, K. J., Mendoza, M., et al. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02197 · Cited by 29 · see citing works
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Chaker, L., Razvi, S., Bensenor, I. M., Azizi, F., Pearce, E. N., & Peeters, R. P. (2022) · Nature Reviews Disease Primers · doi:10.1038/s41572-022-00357-7 · Cited by 330 · see citing works
Taylor, P. N., Medici, M. M., Hubalewska-Dydejczyk, A., & Boelaert, K. (2024) · The Lancet · doi:10.1016/s0140-6736(24)01614-3 · Cited by 128 · see citing works
Optimal thyroid hormone replacement
Jonklaas, J. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab031 · Cited by 89 · see citing works
Hypothyroidism: The difficulty in attributing symptoms to their underlying cause
Jansen, H. I., Boelen, A., Heijboer, A. C., Bruinstroop, E., & Fliers, E. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1130661 · Cited by 74 · see citing works
Xu, Y., Derakhshan, A., Hysaj, O., Wildisen, L., Ittermann, T., Pingitore, A., Abolhassani, N., Medici, M., Kiemeney, L. A. L. M., Riksen, N. P., et al. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00227-9 · Cited by 61 · see citing works
Chaker, L., & Papaleontiou, M. (2025) · JAMA · doi:10.1001/jama.2025.13559 · Cited by 63 · see citing works
Ross, D. S. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13410 · Cited by 42 · see citing works
Ahluwalia, R., Baldeweg, S. E., Boelaert, K., Chatterjee, K., Dayan, C., Okosieme, O., Priestley, J., Taylor, P., Vaidya, B., Zammitt, N., et al. (2023) · Clinical Endocrinology · doi:10.1111/cen.14935 · Cited by 34 · see citing works
Centanni, M., Duntas, L., Feldt-Rasmussen, U., Koehrle, J., Peeters, R. P., Razvi, S., Trimboli, P., & Virili, C. (2025) · European Thyroid Journal · doi:10.1530/etj-25-0123 · Cited by 38 · see citing works
“In addition, most LT4 users are treated based on a single, mildly elevated serum TSH or even when it is within the reference intervals, often in an inappropriate way (10).”
Perros, P., Nagy, E. V., Papini, E., Van Der Feltz-Cornelis, C. M., Weetman, A. P., Hay, H. A., Abad-Madroñero, J., Tallett, A. J., Bilas, M., Lakwijk, P., et al. (2023) · Thyroid · doi:10.1089/thy.2022.0641 · Cited by 27 · see citing works
Wang, Y., Liang, S., Ren, J.-J., Wang, Z., Deng, X., Liu, W.-D., Yan, Y.-L., Song, G.-H., & Li, X. (2023) · Nutrients · doi:10.3390/nu15143194 · Cited by 25 · see citing works
Perros, P., Hegedűs, L. D., Nagy, E. V., Papini, E., Hay, H. A., Abad-Madroñero, J., Tallett, A. J., Bilas, M., Lakwijk, P., & Poots, A. J. (2022) · Thyroid · doi:10.1089/thy.2022.0324 · Cited by 24 · see citing works
Evaluating health outcomes in the treatment of hypothyroidism
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Casula, S., Ettleson, M. D., & Bianco, A. C. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.04.003 · Cited by 18 · see citing works
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Bindel, L. J., & Seifert, R. (2025) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-025-03930-5 · Cited by 12 · see citing works
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Attanasio, R., Žarković, M., Papini, E., Nagy, E. V., Negro, R., Perros, P., Akarsu, E., Alevizaki, M., Ayvaz, G., Bednarczuk, T., et al. (2024) · Thyroid® · doi:10.1089/thy.2023.0580 · Cited by 11 · see citing works
Kuś, A., Sterenborg, R. B. T. M., Haug, E. B., Galesloot, T. E., Visser, W. E., Smit, J. W. A., Bednarczuk, T., Peeters, R. P., Åsvold, B. O., Teumer, A., et al. (2024) · Thyroid · doi:10.1089/thy.2024.0045 · Cited by 12 · see citing works
Mustafa, M., Ali, E., McGowan, A., McCabe, L., Hegedűs, L. D., Attanasio, R., Nagy, E. V., Papini, E., Perros, P., & Moran, C. (2022) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-022-03235-z · Cited by 11 · see citing works
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Toloza, F. J. K., Kawkgi, O. M. E., Spencer, H. J., Mathews, S. E., García, A. S., Gamboa-Alonso, A., Mirza, N., Mohan, S., Vallejo, S., Bogojevic, M., et al. (2023) · Thyroid · doi:10.1089/thy.2023.0062 · Cited by 9 · see citing works
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Díaz-Soto, G., Fernández-Velasco, P., Torres, B., Gómez, J. J. L., Calvo, S. G., & de Luis, D. A. (2022) · Endocrinología Diabetes y Nutrición (English ed ) · doi:10.1016/j.endien.2022.11.031 · Cited by 8 · see citing works
Ravensberg, A. J., Poortvliet, R. K. E., Puy, R. S. D., Dekkers, O. M., Mooijaart, S. P., & Gussekloo, J. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-070741 · Cited by 7 · see citing works
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Díaz-Soto, G., Fernández-Velasco, P., Torres, B., Gómez, J. J. L., Calvo, S. G., & Román, D. D. L. (2022) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2021.11.008
Schlaht, K. M., Sas, D. J., Davis, D. M. R., & Hand, J. L. (2022) · Pediatric Dermatology · doi:10.1111/pde.15022
Considerations for Generic-to-Generic Levothyroxine Switching
Hennessey, J. V. (2022) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2022.1984
Tessnow, A. H. (2022) · Clinical Thyroidology · doi:10.1089/ct.2022;34.385-388
Jiang, C., Wolf, K., Kaakati, R. N., Oh, J., Yip, A. T., Jonklaas, J., Bianco, A. C., Laiteerapong, N., & Ettleson, M. D. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.07.031
Is it time to re-assess the development of thyroid function reference ranges?
Pearce, E. N. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00257-7
张, 强. (2024) · Traditional Chinese Medicine · doi:10.12677/tcm.2024.131021
Варіативність показників тиреотропного гормону в клінічній практиці
Bolgov, М. Y., Omelchuk, О. V., & Komisarenko, І. І. (2023) · Endokrynologia · doi:10.31793/1680-1466.2023.28-3.222
Stijgend gebruik van levothyroxine in België
Boets, L., den Bruel, A. V., haecht, C. V., Cornelis, K., Debbaut, B., Ntahonganyira, R.-M., Flamaing, J., Stokx, J., & Decallonne, B. (2024) · Tijdschrift voor Geneeskunde · doi:10.47671/tvg.79.23.122
Replacement Therapy for Hypothyroidism: Purpose and Indication for Correction
Степановна, М. Н., Алексеевич, Т. А., Matveyeva, Y. О., Олеговна, Щ. А., Кузина, И. А., Валерьевна, Г. Е., Эдуардовна, Т. М., & Petunina, N. A. (2024) · Effective Pharmacotherapy · doi:10.33978/2307-3586-2024-20-8-64-69
Jang, H., Calder, L., Choi, J. W., Kwon, B., Pearce, E. N., & Shin, H. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4901997
Perros, P. (2024) · Copernicus books · doi:10.1007/978-3-031-58287-5_5
L-Thyroxin bei Hypothyreose – absetzen oder nicht?
Kramer, M. R., Bleckwenn, M., Deutsch, T., Voigt, K., & Schübel, J. (2024) · Zeitschrift für Allgemeinmedizin · doi:10.1007/s44266-024-00291-9
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Brenta, G. (2025) · Clinical Thyroidology · doi:10.1089/ct.2025;37.204-207
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Selinger, S. (2025) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.92c.07001
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Bednarczuk, T., Sugier, A., Attanasio, R., Nagy, E. V., Negro, R., Papini, E., Žarković, M., Akarsu, E., Alevizaki, M. K., Ayvaz, G., et al. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1713814
Mohajer, B., Moradi, K., Guermazi, A., Mammen, J. S. R., Hunter, D. J., Roemer, F. W., & Demehri, S. (2023) · Figshare · doi:10.6084/m9.figshare.22618594
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Almutlaq Ahlam Mohammed, T., ALSAADI, M. H., ALRUWAILI, M. M. A., Alanazı, K. N. K., Alenezı, A. A. N., ALRUWAILI, F. T. A., ALRUWAILI, M. N. J., ALENEZI, M. M. K., ALSALEEM, A. T., Alanazi, A. R. S., et al. (2024) · International Journal of Computational and Experimental Science and Engineering · doi:10.22399/ijcesen.3947
Piao, L., Ma, J. F., Zhao, N., Liu, C., Hou, Y., & Wang, T. (2026) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s581042
Murphy, T. L., Till, V., Merritt, C. R., Cunningham, K. A., & Golovko, G. (2026) · Substance Use Research and Treatment · doi:10.1177/29768357261418824
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Pearce, E. N. (2026) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(26)00031-8
Ettleson, M. D., Wan, W., Laiteerapong, N., Kim, B. W., & Bianco, A. C. (2026) · Thyroid · doi:10.1177/10507256261462468
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Galofré, J. C. (2026) · Medicina Clínica · doi:10.1016/j.medcli.2026.107492
Zheng, W., Tang, Y., Chen, X., Wang, Y., Yu, J., Sun, Y., Zhang, B., Wu, G., Jipeng, Z., Wang, Y., et al. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1852620
Ghotbi, E., McGready, J., Hadidchi, R., Ibad, H. A., Simonsick, E. M., Xue, Q., Demehri, S., & Mammen, J. S. (2026) · Bone · doi:10.1016/j.bone.2026.118100
Limitations in the interpretation of thyroid function tests
Galofré, J. C. (2026) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2026.107492
- Authors
- Brito, J. P., Ross, J. S., El Kawkgi, O. M., Maraka, S., Deng, Y., Shah, N. D., & Lipska, K. J.
- Affiliations
- Mayo Clinic (US)
- Yale New Haven Hospital (US)
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
- Central Arkansas Veterans Healthcare System (US)
- Corresponding author
- Brito, Juan P.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2021-10-01
- Volume
- 181
- Issue
- 10
- Pages
- 1402
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC8218227
- OpenAlex
- W3175268859
- Cited by
- 94
- References
- 6
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 24 · 2023: 25 · 2022: 13 · 2021: 5
- FWCI
- 12.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1TR001863)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- levothyroxine, thyroid hormone replacement, drug use trends, Medicare Advantage enrollees, hypothyroidism, United States
- MeSH terms
- Medical Overuse, Adult, Cross-Sectional Studies, Drug Utilization, Female, Medicare, Humans, Hypothyroidism, Insurance Claim Review, Male, Thyroid Function Tests, Thyroid Hormones, Thyrotropin, Thyroxine, United States, Prescription Drugs, Asymptomatic Diseases
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