More trials for the unhappy hypothyroid patient on thyroxine: a clinician's perspective

Trends Endocrinol Metab. 2022 Aug;33(8):536-538. doi: 10.1016/j.tem.2022.04.010. Epub 2022 May 23.


Further clinical trials are proposed for the 5-15% of hypothyroid patients who are dissatisfied with thyroxine (T4) monotherapy. Those responding to combination therapy [T4 plus triiodothyronine (T3)] will show suggestive biochemistry and abnormal reflexes. Those with Hashimoto's disease and very high anti-thyroid peroxidase (anti-TPO) thyroid antibody levels may benefit from total thyroidectomy. The remainder have negative clinical and laboratory findings and require supportive management.

Keywords: Hashimoto's disease; abnormal reflexes; combination therapy; hypothyroidism; thyroidectomy.

MeSH terms

  • Hashimoto Disease* / drug therapy
  • Humans
  • Hypothyroidism* / drug therapy
  • Thyroxine / therapeutic use
  • Triiodothyronine / therapeutic use


  • Triiodothyronine
  • Thyroxine