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Treatment of Clinical Hypothyroidism With Thyroxine and Triiodothyronine: A Literature Review and Metaanalysis

Received February 27, 2006; revised March 7, 2007; accepted May 10, 2007. From the Dept. of Psychiatry, Dept. of Preventive Medicine, and the Div. of Endocrinology and Dept. of Medicine, UMDNJ–New Jersey Medical School, Newark, NJ; the Dept. of Psychiatry, Sunnybrook Hospital, and the Univ. of Toronto, Toronto, Ontario, Canada. Send correspondence and reprint requests to Russell T. Joffe, M.D., New Jersey Medical School, 111 Dunnell Rd., Maplewood, NJ 07040. e-mail: joffe{at}umdnj.edu
© 2007 The Academy of Psychosomatic Medicine

Thyroxine is the standard replacement therapy for patients with clinical hypothyroidism. However, there has been recent interest in examining the potential advantages of combined thyroxine and triiodothyronine treatment for the treatment of hypothyroidism. The authors review the nine studies to-date and conclude that the variability and limitations in study design make definitive and clinically useful recommendations difficult. They therefore conducted a metaanalysis of the nine controlled studies examining the impact of combined thyroxine-plus-triiodothyronine versus thyroxine alone, with measures of psychiatric symptoms as the primary outcome. Their analysis reveals no significant difference in treatment effect on psychiatric symptoms in the nine controlled studies to date.

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