(Re)defining Hypothyroidism: The Key to Patient-centered Treatment
zA series of five research articles by sixteen leading researchers in the field which looks beyond TSH.
While a stated goal of the treatment of hypothyroidism is to resolve symptoms, most physicians focus on normalization of serum TSH values, which is the marker used to diagnose hypothyroidism and adjust the replacement dose of levothyroxine. However, complete physiological replacement has not been possible in other hormones deficiency syndromes, and it may be presumptuous to assume that it can easily be achieved in hypothyroidism. Given the residual symptoms and metabolic abnormalities experienced by some patients, there is therefore a need to question and redefine therapeutic success in hypothyroidism. Potential issues to consider are whether there are other biomarkers of thyroid status, in addition to TSH, that may be important, and whether different biomarkers are important for different tissues. In addition, the relevance of the origin of the hypothyroidism and how to balance benefit in long-term versus immediate clinical outcomes.