About this Research Topic
The issue of whether or not to consider combination therapy for hypothyroidism remains controversial. Although clinical trials of combination therapy have not shown a benefit of combination therapy over levothyroxine monotherapy, patients still express considerable interest in combination therapy. Moreover, some studies show a discrepancy between serum TSH and other biomarkers of thyroid status, and animal studies show that combination therapy normalizes a number of tissue parameters reflecting euthyroidism better than levothyroxine does.
The goal of this Research Topic is to review and consolidate current understanding of how to provide physiologic therapy for hypothyroidism that restores euthyroidism in all tissues of the body and ensures patient satisfaction with therapy. The action of T3 in various tissues and the role of deiodinases in maintaining “tissue euthyroidism” and normalizing cellular T3 levels will be discussed. There will be a focus on the potential role of combination therapy for treating hypothyroidism and design of studies to determine whether there are specific sub-populations who will benefit from combination therapy. This compilation of articles will delineate the current state of this field, provide a stimulus for fresh consideration of the area, and define future directions for research to advance the field.
Original research articles, reviews, meta-analyses, and opinion pieces will be considered as suitable material, and consideration of both animal and human data is encouraged. Specific areas of interest include, but are not limited to the following:
1. What are the best methods for measuring T3?
2. What parameters best define euthyroidism?
3. What effect does T3 have on specific tissues such as the brain, heart, and liver?
4. What role do deiodinases play in maintaining normal T3 levels in various tissues?
5. What role do polymorphisms in deiodinases and thyroid hormone transporters play in determining the ability of levothyroxine therapy to restore normal physiology?
6. What factors determine patient satisfaction with therapy for hypothyroidism, and how do these factors interact?
7. How is patient satisfaction and quality of life best measured during therapy for hypothyroidism?
8. What constitutes an ideal combination therapy trial?
9. What are the benefits and risks of combination therapy?
10. How can physicians balance patient preferences and ensure good patient outcomes?
11. What is the role of sustained release liothyronine preparations, and what progress has been made in development of such products?
Keywords: Hypothyroidism, Levothyroxine, Combination Therapy, Liothyronine, Satisfaction
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.