Recommendations for treatment of hypothyroidism with levothyroxine and levotriiodothyronine: a 2016 position statement of the Italian Society of Endocrinology and the Italian Thyroid Association
Abstract
Levothyroxine (L-T4) is recommended as lifelong replacement therapy for hypothyroidism. Recent clinical and experimental data support the addition of levotriiodothyronine (L-T3) treatment in some selected hypothyroid patients when their symptoms persist and their quality of life remains impaired despite adequate L-T4 monotherapy. An increase in L-T3 prescriptions has been recently observed in Italy due to availability of different L-T3 formulations, making it possible to clinicians to prescribe L-T3 alone or in combination with L-T4. The aim of the present position statement was to define the correct clinical indications, schedule, duration of treatment and contraindications of combined treatment with L-T4 and L-T3 in hypothyroid patients in an attempt to guide clinicians and to avoid potential adverse effects of overtreatment.
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The Italian Endocrine Society and the Italian Association of Clinical Endocrinologists suggested that combination therapy could be considered.
“Most recently, the Italian Endocrine Society and the Italian Association of Clinical Endocrinologists have also suggested that combination therapy could be considered (21,22).”
From Short-Term Time Trends in Prescribing Therapy for Hypothyroidism: Results of a Survey of American Thyroid Association Members (2019) · cites this paper as [21]
Levothyroxine is the first-line treatment for hypothyroidism.
“Since levothyroxine is the first-line treatment for hypothyroidism”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [19]
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“Most recently, the Italian Endocrine Society and the Italian Association of Clinical Endocrinologists have also suggested that combination therapy could be considered (21, 22).”
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- Authors
- Biondi, B., Bartalena, L., Chiovato, L., Lenzi, A., Mariotti, S., Pacini, F., Pontecorvi, A., Vitti, P., & Trimarchi, F.
- Affiliations
- Federico II University Hospital (IT)
- University of Insubria (IT)
- University of Pavia (IT)
- Sapienza University of Rome (IT)
- University of Cagliari (IT)
- University of Siena (IT)
- Università Cattolica del Sacro Cuore (IT)
- University of Pisa (IT)
- University of Messina (IT)
- Corresponding author
- Biondi, B.
- ORCID
- Venue
- Journal of Endocrinological Investigation
- Published
- 2016-07-29
- Volume
- 39
- Issue
- 12
- Pages
- 1465-1474
- ISSN
- 0391-4097 (ISSN-L)
- 1720-8386
- OpenAlex
- W2490875036
- Semantic Scholar
- 9d883eda36e2e96f6bc3523d8d22d5a02a10ef4a
- Cited by
- 44
- References
- 64
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 8 · 2018: 9 · 2017: 3 · 2016: 2
- FWCI
- 7.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Endocrinological Investigation (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- hypothyroidism, levothyroxine, overtreatment, treatment indications, treatment duration, contraindications, quality of life
- MeSH terms
- Humans, Hypothyroidism, Italy, Quality of Life, Thyroxine, Triiodothyronine, Practice Guidelines as Topic, Hormone Replacement Therapy
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