Use of Other Thyroid Hormone Preparations [ref. 9]

There are few indications for thyroid hormone preparations other than levothyroxine. Liothyronine may be useful prior to treatment of thyroid cancer with radioactive iodine, as patients can be withdrawn from liothyronine for shorter periods of time than levothyroxine. Chronic liothyronine therapy for hypothyroidism is not recommended, since its use is associated with a greater degree of iatrogenic hyperthyroidism. Some individuals, especially elderly individuals, are very sensitive to the deleterious effects of T₃. Biological and synthetic thyroid hormone preparations containing both T₄ and T₃ are also not currently recommended for therapy since they produce fluctuating and often elevated T₃ concentrations, although their use is not necessarily contraindicated.

Use of Thyroid Hormone for Other Situations [ref. 13]

Thyroid hormone therapy has been used for nonthyroidal problems, including obesity, infertility, menstrual irregularity, short stature, and chronic fatigue. There is no scientific proof that such conditions respond to thyroid hormone therapy and its use is not felt to be appropriate. Some psychiatrists, however, report the benefit of adding thyroid hormone medication to tricyclic antidepressants in selected patients with depression, and clinical improvements have been noted.

From the Division of Endocrinology, Diabetes, and Hypertension, University of Southern California School of Medicine, Los Angeles (Dr Singer); Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Md (Drs Cooper and Ladenson); Division of Endocrinology, Mt Sinai Hospital, Baltimore, Md (Dr Cooper); Division of Endocrinology, University of Miami (Fla) School of Medicine (Dr Levy); Division of Endocrinology, University of Massachusetts Medical School, Worcester (Dr Braverman); Thyroid Unit, Massachusetts General Hospital, Boston (Dr Daniels); Division of Endocrinology, University of California, San Francisco School of Medicine (Dr Greenspan); Division of Nuclear Medicine, Stanford (Calif) University School of Medicine (Dr McDougall); and Marshfield (Wis) Clinic (Dr Nikolai).

The authors gratefully acknowledge the expert secretarial assistance of Elsa C. Ahumada. Reprint requests to University of Southern California, 1355 S San Pablo St, Room 120, Los Angeles, CA 90033 (Dr Singer).