Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study
Open accessAbstract
OBJECTIVE: To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. SUBJECTS AND METHODS: This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16. RESULTS: Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged. CONCLUSIONS: The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Further trials of liothyronine/levothyroxine combination therapy, as well as the use of thyroid extracts, have recently been published, again with negative results.
“further trials of liothyronine/levothyroxine combination therapy, as well as the use of thyroid extracts, have recently been published, again with negative results. 43,62”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [62]
Since the publication of the 2014 guidelines, one additional original research study, which did not identify an advantage of combination therapy, has been published.
“Since the publication of the 2014 guidelines, one additional original research study, which did not identify an advantage of combination therapy has been published (19).”
From Short-Term Time Trends in Prescribing Therapy for Hypothyroidism: Results of a Survey of American Thyroid Association Members (2019) · cites this paper as [19]
Of the 14 combination therapy trials that have been completed, 10 employed once-daily LT3 administration, 4 employed twice-daily LT3 therapy, and none used three times a day LT3 therapy.
“Of the 14 combination therapy trials that have been completed, 10 employed once-daily LT3 administration [23, 46, 47, 49, 51, 52, 59, 71, 78, 79], 4 employed twicedaily LT3 therapy [17, 48, 53, 60], and none used three times a day LT3 therapy.”
From Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document (2021) · cites this paper as [79]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
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
Hypothyroidism and Atherosclerosis
Cappola, A. R., & Ladenson, P. W. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030398 · Cited by 640 · see citing works
Bunevičius, R., Kažanavičius, G., Žalinkevičius, R., & Prange, A. J. (1999) · New England Journal of Medicine · doi:10.1056/nejm199902113400603 · Cited by 482 · cited 9× · see citing works
“Furthermore, no significant changes were detected in arterial blood pressure, in concordance with previous clinical trials (10-12,22-24,32).”
BackgroundResultInfluential2012 ETA Guidelines: The Use of L-T4 + L-T3 in the Treatment of Hypothyroidism
Wiersinga, W. M., Duntas, L., Fadeyev, V., Nygaard, B., & Vanderpump, M. P. J. (2012) · European Thyroid Journal · doi:10.1159/000339444 · Cited by 427 · cited 4× · see citing works
“Currently, the drug of choice for the treatment of hypothyroidism is levothyroxine sodium (1-5), and LT4/ LT3 combination therapy should be considered solely as an experimental treatment modality (7).”
BackgroundInfluentialDanese, M. D., Ladenson, P. W., Meinert, C. L., & Powe, N. R. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.85.9.2993 · Cited by 423 · see citing works
Panicker, V., Saravanan, P., Vaidya, B., Evans, J., Hattersley, A. T., Frayling, T. M., & Dayan, C. M. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1301 · Cited by 327 · see citing works
Danese, M. D., Ladenson, P. W., Meinert, C. L., et al. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.9.6841 · Cited by 308 · see citing works
Levothyroxine Monotherapy Cannot Guarantee Euthyroidism in All Athyreotic Patients
Gullo, D., Latina, A., Frasca, F., Le Moli, R., Pellegriti, G., & Vigneri, R. (2011) · PLoS ONE · doi:10.1371/journal.pone.0022552 · Cited by 307 · see citing works
Grozinsky-Glasberg, S., Fraser, A., Nahshoni, E., Weizman, A., & Leibovici, L. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0448 · Cited by 296 · see citing works
Escobar-Morreale, H. F., Obregón, M. J., Escobar del Rey, F., & Morreale de Escobar, G. (1995) · Journal of Clinical Investigation · doi:10.1172/jci118353 · Cited by 287 · see citing works
Escobar-Morreale, H. F., del Rey, F. E., Obregón, M. J., & de Escobar, G. M. (1996) · Endocrinology · doi:10.1210/endo.137.6.8641203 · Cited by 261 · see citing works
Walsh, J. P., Shiels, L., Lim, E. M., Bhagat, C. I., Ward, L. C., Stuckey, B. G. A., Dhaliwal, S. S., Chew, G. T., Bhagat, M. C., & Cussons, A. J. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030249 · Cited by 210 · see citing works
Okosieme, O., Gilbert, J., Abraham, P., Boelaert, K., Dayan, C., Gurnell, M., Leese, G., McCabe, C., Perros, P., Smith, V., et al. (2016) · Clinical Endocrinology · doi:10.1111/cen.12824 · Cited by 208 · cited 2× · see citing works
“Currently, the drug of choice for the treatment of hypothyroidism is levothyroxine sodium (1-5), and LT4/ LT3 combination therapy should be considered solely as an experimental treatment modality (7).”
BackgroundClyde, P. W., Harari, A. E., Getka, E. J., & Shakir, K. M. M. (2003) · JAMA · doi:10.1001/jama.290.22.2952 · Cited by 195 · see citing works
Appelhof, B. C., Fliers, E., Wekking, E. M., Schene, A. H., Huyser, J., Tijssen, J. G. P., Endert, E., van Weert, H. C. P. M., & Wiersinga, W. M. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-2111 · Cited by 183 · see citing works
Escobar-Morreale, H. F., Botella-Carretero, J. I., Gómez-Bueno, M., Galán, J. M., Barrios, V., & Sancho, J. (2005) · Annals of Internal Medicine · doi:10.7326/0003-4819-142-6-200503150-00007 · Cited by 182 · see citing works
Sawka, A. M., Gerstein, H. C., Marriott, M. J., MacQueen, G. M., & Joffe, R. T. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030139 · Cited by 175 · cited 2× · see citing works
“Most studies have assessed changes in mood, cognition function and QoL during combination therapy with LT4/LT3 (11,12,21,2326,28,30-32,40,41).”
BackgroundResultClinical practice guidelines for the management of hypothyroidism
Brenta, G., Vaisman, M., Sgarbi, J. A., Bergoglio, L., de Andrada, N. C., Bravo, P. P., Orlandi, A. M., & Graf, H. (2013) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302013000400003 · Cited by 161 · see citing works
Self-citationNygaard, B., Jensen, E. W., Kvetny, J., Jarløv, A., & Faber, J. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0542 · Cited by 153 · see citing works
Siegmund, W., Spieker, K., Weike, A. I., Giessmann, T., Modess, C., Dabers, T., Kirsch, G., Sänger, E., Engel, G., Hamm, A. O., et al. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.02050.x · Cited by 152 · see citing works
Hoang, T. D., Olsen, C. H., Mai, V. Q., Clyde, P. W., & Shakir, M. K. M. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-4107 · Cited by 151 · see citing works
Defending plasma T3 is a biological priority
Abdalla, S. M., & Bianco, A. C. (2014) · Clinical Endocrinology · doi:10.1111/cen.12538 · Cited by 147 · cited 1× · see citing works
“The remaining 80% of the circulating T3 derives from peripheral 5’-deiodination of the secreted T4 (17).”
BackgroundSaravanan, P., Simmons, D. J., Greenwood, R., Peters, T. J., & Dayan, C. M. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1672 · Cited by 136 · cited 5× · see citing works
“Furthermore, no significant changes were detected in arterial blood pressure, in concordance with previous clinical trials (10-12,22-24,32).”
BackgroundMethodResultInfluentialSamuels, M. H., Schuff, K. G., Carlson, N. E., Carello, P., & Janowsky, J. S. (2007) · Thyroid · doi:10.1089/thy.2006.0252 · Cited by 124 · see citing works
Combination Treatment with T4 and T3: Toward Personalized Replacement Therapy in Hypothyroidism?
Biondi, B., & Wartofsky, L. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-3399 · Cited by 124 · see citing works
Paradigm shifts in thyroid hormone replacement therapies for hypothyroidism
Wiersinga, W. M. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.258 · Cited by 114 · cited 3× · see citing works
“Mounting evidence suggests that LT4 monotherapy cannot assure a euthyroid state in the blood and in all tissues simultaneously, and that normal serum thyroidstimulating hormone (TSH) levels in patients receiving LT4 reflect only pituitary euthyroidism (8).”
BackgroundInfluentialSmith, R. N., Taylor, S. A., & Massey, J. C. (1970) · BMJ · doi:10.1136/bmj.4.5728.145 · Cited by 106 · cited 4× · see citing works
“These showed no positive results regarding patient preference toward LT4/LT3 therapy and revealed a high incidence of hyperthyroid symptoms (possibly due to excessive doses of LT4/LT3) (10).”
BackgroundResultInfluentialTeixeira, P. D. F. D. S., Reuters, V. S., Ferreira, M. M., Almeida, C. D. P., Reis, F. A. A., Buescu, A., Costa, A. J. L., & Vaisman, M. (2008) · Translational research · doi:10.1016/j.trsl.2007.12.006 · Cited by 103 · see citing works
Beydoun, M. A., Beydoun, H. A., Kitner‐Triolo, M. H., Kaufman, J. S., Evans, M. K., & Zonderman, A. B. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1813 · Cited by 102 · see citing works
Saravanan, P., Siddique, H., Simmons, D., Greenwood, R., & Dayan, C. (2007) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2007-973071 · Cited by 100 · see citing works
Van Der Deure, W. M., Appelhof, B. C., Peeters, R. P., Wiersinga, W. M., Wekking, E. M., Huyser, J., Schene, A. H., Tijssen, J. G. P., Hoogendijk, W. J. G., Visser, T. J., et al. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03267.x · Cited by 97 · see citing works
Thyroxine alone or thyroxine plus triiodothyronine replacement therapy for hypothyroidism
Chao, M., Jiawei, X., Xia, H., Guoming, W., Yangang, W., Xufu, W., & Shuyao, Z. (2009) · Nuclear Medicine Communications · doi:10.1097/mnm.0b013e32832c79e0 · Cited by 93 · see citing works
Appelhof, B. C., Peeters, R. P., Wiersinga, W. M., Visser, T. J., Wekking, E. M., Huyser, J., Schene, A. H., Tijssen, J. G. P., Hoogendijk, W. J. G., & Fliers, E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0451 · Cited by 91 · see citing works
Saravanan, P., Visser, T. J., & Dayan, C. M. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0414 · Cited by 90 · see citing works
Spectrum of quality of life impairment in hypothyroidism
Jaeschke, R., Guyatt, G. H., Cook, D., Harper, S., & Gerstein, H. C. (1994) · Quality of Life Research · doi:10.1007/bf00451724 · Cited by 82 · see citing works
Rodriguez, T., Lavis, V. R., Meininger, J. C., Kapadia, A. S., & Stafford, L. F. (2005) · Endocrine Practice · doi:10.4158/ep.11.4.223 · Cited by 80 · see citing works
Bunevičius, R., & Prange, A. J. (2000) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145700001826 · Cited by 78 · see citing works
Fadeyev, V. V., Morgunova, T. B., Melnichenko, G. A., & Dedov, I. I. (2010) · Hormones · doi:10.14310/horm.2002.1274 · Cited by 77 · see citing works
A 2013 Survey of Clinical Practice Patterns in the Management of Primary Hypothyroidism
Burch, H. B., Burman, K. D., Cooper, D. S., & Hennessey, J. V. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-1046 · Cited by 73 · see citing works
Valizadeh, M., Seyyed-Majidi, M. R., Hajibeigloo, H., Momtazi, S., Musavinasab, N., & Hayatbakhsh, M. R. (2009) · Endocrine Research · doi:10.1080/07435800903156340 · Cited by 65 · cited 2× · see citing works
“Most studies have assessed changes in mood, cognition function and QoL during combination therapy with LT4/LT3 (11,12,21,2326,28,30-32,40,41).”
BackgroundBoeving, A., Paz-Filho, G., Radominski, R. B., Graf, H., & de Carvalho, G. A. (2011) · Thyroid · doi:10.1089/thy.2010.0315 · Cited by 58 · see citing works
Self-citationDo we need still more trials on T4 and T3 combination therapy in hypothyroidism?
Wiersinga, W. M. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0879 · Cited by 43 · see citing works
Combination L-T3 and L-T4 therapy for hypothyroidism
Wartofsky, L. (2013) · Current Opinion in Endocrinology, Diabetes & Obesity · doi:10.1097/01.med.0000432611.03732.49 · Cited by 42 · cited 1× · see citing works
“A suggestive indication to the presence of this polymorphism could be a higherthan-normal ratio of free T4 to free T3 (6,44).”
BackgroundRegalbuto, C., Maiorana, R., Alagona, C., Paola, R. D., Cianci, M., Alagona, G., Sapienza, S., Squatrito, S., & PEZZINO, V. (2007) · Thyroid · doi:10.1089/thy.2006.0084 · Cited by 32 · see citing works
Escobar-Morreale, H. F., Botella-Carretero, J. I., & Morreale de Escobar, G. (2015) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2014.10.004 · Cited by 30 · see citing works
Evaluation of Dermal Symptoms in Hypothyroidism and Hyperthyroidism
Razi, A., Golforoush, F., Nejad, A. B. S., & Goldust, M. (2013) · Pakistan Journal of Biological Sciences · doi:10.3923/pjbs.2013.541.544 · Cited by 17 · see citing works
Paz-Filho, G., Graf, H., & Ward, L. S. (2013) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302013000400001 · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
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
An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction
Peterson, S. J., Cappola, A. R., Castro, M. R., Dayan, C. M., Farwell, A. P., Hennessey, J. V., Kopp, P. A., Ross, D. S., Samuels, M. H., Sawka, A. M., et al. (2018) · Thyroid · doi:10.1089/thy.2017.0681 · Cited by 231 · see citing works
Jonklaas, J., Bianco, A. C., Cappola, A. R., Celi, F. S., Fliers, E., Heuer, H., McAninch, E. A., Moeller, L. C., Nygaard, B., Sawka, A. M., et al. (2021) · Thyroid® · doi:10.1089/thy.2020.0720 · Cited by 172 · see citing works
Treatment of Thyroid Dysfunction and Serum Lipids: A Systematic Review and Meta-analysis
Kotwal, A., CORTES, T. M., Genere, N., Hamidi, O., Jasim, S., Newman, C. B., Prokop, L. J., Murad, M. H., & Alahdab, F. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa672 · Cited by 168 · see citing works
Primary hypothyroidism and quality of life
Hegedüs, L., Bianco, A. C., Jonklaas, J., Pearce, S. H., Weetman, A. P., & Perros, P. (2022) · Nature Reviews Endocrinology · doi:10.1038/s41574-021-00625-8 · Cited by 144 · see citing works
Optimal thyroid hormone replacement
Jonklaas, J. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab031 · Cited by 89 · see citing works
Jonklaas, J., Bianco, A. C., Cappola, A. R., Celi, F. S., Fliers, E., Heuer, H., McAninch, E. A., Moeller, L. C., Nygaard, B., Sawka, A. M., et al. (2021) · European Thyroid Journal · doi:10.1159/000512970 · Cited by 78 · see citing works
Millan-Alanis, J. M., González-González, J. G., Flores-Rodríguez, A., Singh Ospina, N., Maraka, S., Moreno-Peña, P. J., Brito, J. P., González-Velázquez, C., & Rodríguez-Gutiérrez, R. (2021) · Thyroid® · doi:10.1089/thy.2021.0270 · Cited by 60 · see citing works
Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism
Idrees, T., Palmer, S., Maciel, R. M. B., & Bianco, A. C. (2020) · Thyroid® · doi:10.1089/thy.2020.0153 · Cited by 58 · see citing works
Hennessey, J. V., & Espaillat, R. (2018) · International Journal of Clinical Practice · doi:10.1111/ijcp.13062 · Cited by 49 · see citing works
Physician Choice of Hypothyroidism Therapy: Influence of Patient Characteristics
Jonklaas, J., Tefera, E., & Shara, N. (2018) · Thyroid · doi:10.1089/thy.2018.0325 · Cited by 41 · see citing works
de Carvalho, G. A., Paz-Filho, G., Mesa, C. O., & Graf, H. (2018) · European Journal of Endocrinology · doi:10.1530/eje-17-0947 · Cited by 41 · see citing works
Self-citationPersistent hypothyroid symptoms in a patient with a normal thyroid stimulating hormone level
Jonklaas, J. (2017) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000355 · Cited by 38 · see citing works
Akirov, A., Fazelzad, R., Ezzat, S., Thabane, L., & Sawka, A. M. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00477 · Cited by 37 · see citing works
T4 + T3 combination therapy: any progress?
Wiersinga, W. M. (2019) · Endocrine · doi:10.1007/s12020-019-02052-2 · Cited by 35 · 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
Prescribing Therapy for Hypothyroidism: Influence of Physician Characteristics
Jonklaas, J., Tefera, E., & Shara, N. (2019) · Thyroid · doi:10.1089/thy.2018.0369 · Cited by 31 · see citing works
Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement
Stamatouli, A. M., Bedoya, P., & Yavuz, S. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00888 · Cited by 34 · see citing works
DiStefano, J., & Jonklaas, J. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00746 · Cited by 28 · see citing works
Borson‐Chazot, F., Terra, J., Goichot, B., & Caron, P. J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10071386 · Cited by 27 · see citing works
Jonklaas, J., Tefera, E., & Shara, N. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00031 · Cited by 23 · see citing works
Brigante, G., Santi, D., Boselli, G., Margiotta, G., Corleto, R., Monzani, M. L., Craparo, A., Locaso, M., Sperduti, S., Roy, N., et al. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad172 · Cited by 22 · see citing works
Combination Therapy for Hypothyroidism: Rationale, Therapeutic Goals, and Design
Madan, R., & Celi, F. S. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00371 · Cited by 18 · see citing works
Ye, L., Hu, L., Liu, W., Luo, Y., Li, Z., Ding, Z., Hu, C., Wang, L., Zhu, Y., Liu, L., et al. (2021) · BMC Cancer · doi:10.1186/s12885-021-08875-5 · Cited by 15 · see citing works
Bahl, S., Taylor, P. N., Premawardhana, L. D., Stedman, M., Heald, A., Dayan, C. M., & Okosieme, O. E. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf449 · Cited by 11 · see citing works
Chen, Y., & Tai, H.-Y. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej19-0583 · Cited by 12 · see citing works
Triiodothyronine alongside levothyroxine in the management of hypothyroidism?
Gottwald-Hostalek, U., & Kahaly, G. J. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1984219 · Cited by 9 · see citing works
Bjerkreim, B. A., Hammerstad, S. S., Gulseth, H. L., Berg, T. J., Lee-Ødegård, S., & Eriksen, E. F. (2022) · Journal of Thyroid Research · doi:10.1155/2022/6423023 · Cited by 8 · see citing works
Vargas‐Uricoechea, H., & Wartofsky, L. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25179218 · Cited by 11 · see citing works
Hypothyroidism: playing the cardiometabolic risk concerto
Kahaly, G. J., Liu, Y., & Persani, L. (2025) · Thyroid Research · doi:10.1186/s13044-025-00233-y · Cited by 11 · see citing works
Role of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism
Jonklaas, J. (2022) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2021.12.003 · Cited by 7 · see citing works
Gottwald-Hostalek, U., & Tayrouz, Y. (2024) · Current Medical Research and Opinion · doi:10.1080/03007995.2024.2435460 · Cited by 6 · see citing works
Metabolic Systemic Effects Triiodothyronine
Troshina, E. A., & Семеновна, С. Е. (2020) · The Russian Archives of Internal Medicine · doi:10.20514/2226-6704-2020-10-4-262-271 · Cited by 6 · see citing works
Hajtalebi, F., Alaei-Shahmiri, F., Golgiri, F., Shahini, N., Akbari, H., Assadian, K., & Mosalamiaghili, S. (2025) · BMC Endocrine Disorders · doi:10.1186/s12902-025-01840-4 · Cited by 6 · see citing works
Levothyroxine Monotherapy: What Works Better for the Individual With Hypothyroidism?
Hennessey, J. V. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2022.12.013 · Cited by 3 · see citing works
Hao, D., Tian, L., He, H., Zhu, C., Guo, L., Zhang, K., & Zhang, J. (2023) · European Journal of Translational Myology · doi:10.4081/ejtm.2023.11582 · Cited by 3 · see citing works
Jonklaas, J. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2492789 · Cited by 2 · see citing works
Tsanava, I. A., Bulgakova, S. V., & Melikova, A. V. (2021) · Russian Clinical Laboratory Diagnostics · doi:10.51620/0869-2084-2021-66-5-261-265 · Cited by 1 · see citing works
Clinical thyroidology: beyond the 1970s’ TSH-T4 Paradigm
Lindner, H. H. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1529791 · Cited by 1 · see citing works
Essentials of Thyroid Hormone Treatment in Differentiated Thyroid Cancer
Aydoğan, B. İ., & Gürsoy, A. (2021) · Nuclear Medicine Seminars · doi:10.4274/nts.galenos.2021.0002
Quarde, A. (2023) · Wiley eBooks · doi:10.1002/9781119863564.ch2
Hypothyroidism Management: Beyond TSH: A Clinical Review
Mazza, A. D., & Dehn, B. (2026) · Clinical Journal for Nurse Practitioners in Women s Health · doi:10.1891/cjnpwh-2025-0063
- Authors
- Kaminski, J., Miasaki, F. Y., Paz-Filho, G., Graf, H., & Carvalho, G. A. D.
- Affiliations
- Hospital de Clínicas Universidade Federal do Paraná (BR)
- Australian National University (AU)
- Venue
- Archives of Endocrinology and Metabolism
- Published
- 2016-12
- Volume
- 60
- Issue
- 6
- Pages
- 562-572
- ISSN
- 2359-3997 (ISSN-L)
- PMC
- PMC10522160
- OpenAlex
- W2515067460
- Cited by
- 42
- References
- 47
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 5 · 2017: 1
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Archives of Endocrinology and Metabolism (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Hormonal and reproductive studies
- Keywords
- primary hypothyroidism, levothyroxine, liothyronine, combination thyroid hormone therapy, fixed-dose combination, free thyroxine, thyroid-stimulating hormone, heart rate, lipid profile, body weight, quality of life
- MeSH terms
- Adult, Blood Glucose, Body Weight, Cholesterol, Double-Blind Method, Drug Combinations, Female, Humans, Hypothyroidism, Male, Middle Aged, Quality of Life, Thyroid Function Tests, Thyrotropin, Thyroxine, Triiodothyronine, Cross-Over Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
