Treatment of Hypothyroidism

The goals for treatment of primary hypothyroidism are to restore euthyroidism with normalization of serum thyroid-stimulating hormone (TSH) and fT4 concentrations and to eliminate symptoms. Thyroxine, as levothyroxine sodium (L-T4), is the therapy of choice, and its use in most patients’ treatment is straightforward. In a minor patient group, persistent symptoms are present although thyroid function parameters are normalized. In these patients, it is pertinent to search for alternative explanations for the symptoms other than thyroid disease. A possible effect of a combination of L-T4 and L-T3 is disputed. Overtreatment with suppressed serum TSH must be avoided due to risks of cardiovascular disease, osteoporosis, and dementia.