Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine

Escobar-Morreale, Héctor F.; Botella-Carretero, José I.; Morreale de Escobar, Gabriella

doi:10.1016/j.beem.2014.10.004

Cited by 30Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine

Escobar-Morreale, Héctor F., Botella-Carretero, José I., Morreale de Escobar, Gabriella·2015·Best Practice & Research Clinical Endocrinology & Metabolism

DOI 10.1016/j.beem.2014.10.004

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Abstract

At present, the drug of choice for the treatment of hypothyroidism is levothyroxine sodium, even though the thyroid gland secretes both thyroxine and 3',3,5-triiodothyronine; the latter is the more active of the two at the cellular level because of its higher affinity for the nuclear thyroid hormone receptors. To date, combined levothyroxine plus liothyronine treatment for hypothyroidism has been evaluated in 15 clinical trials in humans. In two studies, combined therapy seemed to have beneficial effects on mood, quality of life, and psychometric performance of patients, compared with levothyroxine alone; in some of these studies, the patients preferred levothyroxine plus liothyronine combinations. This preference should be balanced against the possibility of adverse events resulting from the addition of liothyronine to levothyroxine. Until clear advantages of levothyroxine plus liothyronine are demonstrated, the administration of levothyroxine alone should remain the treatment of choice for replacement therapy of hypothyroidism.

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Four systematic reviews and meta-analyses based on RCTs failed to show any advantages in quality of life, mood states, or psychometric performance for patients receiving combination therapy.
“Four systematic reviews and meta-analyses based on RCTs failed to show any advantages in quality of life, mood states, or psychometric performance for patients receiving combination therapy (160–163).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [160]

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Treatment of Hypothyroidism with Combinations of Levothyroxine plus Liothyronine
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Authors: Escobar-Morreale, H. F., Botella-Carretero, J. I., & Morreale de Escobar, G.
Affiliations: Universidad de Alcalá (ES)
Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES)
Corresponding author: Escobar-Morreale, Héctor F.
ORCID: Escobar-Morreale, Héctor F.
Botella-Carretero, José I.
Venue: Best Practice & Research Clinical Endocrinology & Metabolism
Publisher: Elsevier BV
Published: 2015-01
Volume: 29
Issue: 1
Pages: 57-75
ISSN: 1521-690X (ISSN-L)
DOI: 10.1016/j.beem.2014.10.004
OpenAlex: W2141229125
Cited by: 30
References: 72
Citations by year: 2026: 2 · 2025: 2 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 6 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 1
FWCI: 0.26
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Best Practice & Research Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
DIGITAL.CSIC (Spanish National Research Council (CSIC)) (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, liothyronine, triiodothyronine, combination thyroid hormone therapy, thyroid hormone replacement, thyroid hormone receptor, mood, quality of life, adverse events, patient preferences
MeSH terms: Drug Therapy, Combination, Humans, Hypothyroidism, Thyroxine, Triiodothyronine, Treatment Outcome, Hormone Replacement Therapy

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Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine

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