Hypothyroidism: an overview of the disease and current treatment approach

Abstract

Hypothyroidism (underactive thyroid) is a condition where the thyroid gland does not produce enough thyroid hormones to meet the body’s needs. As these hormones regulate how the body uses energy (metabolism), their deficiency causes many body functions to slow down. Common causes include Hashimoto’s disease (autoimmune attack), iodine deficiency, or post-treatment effects. Symptoms develop slowly, including fatigue, cold intolerance, weight gain, constipation, dry skin/hair, hoarse voice, depression, and memory issues. Levothyroxine monotherapy is the standard treatment for hypothyroidism. Nonetheless, numerous unclear inquiries remain about patients who are biochemically stable yet dissatisfied with their therapy results. The present review is to give an overview of hypothyroidism disease, epidemiology of the disease, causes of hypothyroidism, highlighting the key considerations in diagnosis and current treatment of hypothyroidism along with providing future directions for research and improve management of the disease. Future research should investigate whether alternate regimens could offer a solution for a particular group of people with remaining symptoms. Investigation of the efficacy of new formulations (e.g., slow-release liothyronine) or increased administration frequency of levothyroxine-liothyronine combination therapy (e.g., tri-daily liothyronine) in alleviating patient symptoms, alongside the identification of patient subgroups that may benefit from alternatives to levothyroxine monotherapy (e.g., through the identification of additional genetic polymorphisms that could elucidate the individual thyroid set-point) could provide a new dimension to hypothyroidism management.