{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:34:18Z","timestamp":1787582058380,"version":"build-2736575974"},"reference-count":80,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Although some patients with hypothyroidism prefer combination therapy with liothyronine (LT3) and levothyroxine (LT4), the safety of LT3 remains unresolved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We undertook a multisource systematic review and meta-analysis of LT3 safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>We searched PubMed for articles relating to death, adverse events (AEs), and cardiovascular outcomes in LT3 users. We also searched AEs data in the UK Yellow Card scheme and US Food and Drug Administration Adverse Reporting System (FAERS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Data was extracted independently by 2 reviewers. Out of 1814 articles identified, 52 studies were selected, comprising 21 randomized controlled trials (RCTs), 4 cohort studies, and 27 case reports. Meta-analyses were conducted for adverse outcomes in RCTs and cohort studies of combination vs monotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>LT3-related AEs were only reported with unregulated LT3 use or pharmacy compounding errors. LT3 and LT4 showed similar adverse severity profiles in the Yellow Card scheme. Disproportionality analysis in the FAERS database showed no increased LT3 safety signals. A meta-analysis of RCTs (n = 2128) showed a similar AEs risk for combination vs monotherapy [relative risk (RR) 1.22, 95% confidence interval (CI) 0.66-2.25]. A cohort study meta-analysis (LT3 vs LT4-only users, n = 630 254) showed no increased risk of atrial fibrillation (RR 1.10, 95% CI 0.74-1.63), heart failure (RR 1.54, 95% CI 0.95-2.47), or strokes (RR 0.86, 95% CI 0.11-6.75), but reduced mortality risk was observed for LT3 (RR 0.70, 95% CI 0.62-0.78).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings are reassuring that regulated LT3 use is not associated with the risk of death or serious AEs. More studies are needed to supplement existing data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf449","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T11:46:40Z","timestamp":1754567200000},"page":"3278-3288","source":"Crossref","is-referenced-by-count":11,"title":["Risk of Death and Adverse Effects in Patients on Liothyronine: A Multisource Systematic Review and Meta-analysis"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3216-896X","authenticated-orcid":false,"given":"Suhani","family":"Bahl","sequence":"first","affiliation":[{"name":"Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, Wales CF14 4XN ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N","family":"Taylor","sequence":"additional","affiliation":[{"name":"Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, Wales CF14 4XN ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakdasa D","family":"Premawardhana","sequence":"additional","affiliation":[{"name":"Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, Wales CF14 4XN ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Stedman","sequence":"additional","affiliation":[{"name":"Res Consortium , Andover SP10 5RG ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Heald","sequence":"additional","affiliation":[{"name":"The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester , Manchester M14 4PX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin M","family":"Dayan","sequence":"additional","affiliation":[{"name":"Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, Wales CF14 4XN ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onyebuchi E","family":"Okosieme","sequence":"additional","affiliation":[{"name":"Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, Wales CF14 4XN ,","place":["UK"]},{"name":"Diabetes Department, Prince Charles Hospital, Cwm Taf Morgannwg University Health Board , Merthyr Tydfil, Wales CF47 9DT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"issue":"1606","key":"2025101519590590100_dgaf449-B1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1136\/bmj.2.1606.796","article-title":"Note on the treatment of myxoedema by hypodermic injections of an extract of the thyroid gland of a sheep","volume":"2","author":"Murray","year":"1891","journal-title":"Br Med J"},{"issue":"5","key":"2025101519590590100_dgaf449-B2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"10460","key":"2025101519590590100_dgaf449-B3","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/S0140-6736(24)01614-3","article-title":"Hypothyroidism","volume":"404","author":"Taylor","year":"2024","journal-title":"Lancet"},{"issue":"10101","key":"2025101519590590100_dgaf449-B4","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0140-6736(17)30703-1","article-title":"Hypothyroidism","volume":"390","author":"Chaker","year":"2017","journal-title":"Lancet"},{"issue":"15","key":"2025101519590590100_dgaf449-B5","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1517\/14656566.2011.600307","article-title":"Thyroid hormone replacement: current status and challenges","volume":"12","author":"Okosieme","year":"2011","journal-title":"Expert Opin Pharmacother"},{"issue":"5","key":"2025101519590590100_dgaf449-B6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/S2213-8587(22)00004-3","article-title":"The relevance of T(3) in the management of hypothyroidism","volume":"10","author":"Salvatore","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"1","key":"2025101519590590100_dgaf449-B7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S2213-8587(18)30334-6","article-title":"Liothyronine cost and prescriptions in England","volume":"7","author":"Taylor","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"6","key":"2025101519590590100_dgaf449-B8","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1089\/thy.2017.0681","article-title":"An online survey of hypothyroid patients demonstrates prominent dissatisfaction","volume":"28","author":"Peterson","year":"2018","journal-title":"Thyroid"},{"issue":"5","key":"2025101519590590100_dgaf449-B9","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1046\/j.1365-2265.2002.01654.x","article-title":"Psychological well-being in patients on \u2018adequate\u2019 doses of l-thyroxine: results of a large, controlled community-based questionnaire study","volume":"57","author":"Saravanan","year":"2002","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"2025101519590590100_dgaf449-B10","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/cen.12824","article-title":"Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee","volume":"84","author":"Okosieme","year":"2016","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2025101519590590100_dgaf449-B11","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1089\/thy.2021.0270","article-title":"Benefits and harms of levothyroxine\/L-triiodothyronine versus levothyroxine monotherapy for adult patients with hypothyroidism. Systematic review and meta-analysis","volume":"31","author":"Millan-Alanis","year":"2021","journal-title":"Thyroid"},{"issue":"7","key":"2025101519590590100_dgaf449-B12","doi-asserted-by":"crossref","first-page":"2592","DOI":"10.1210\/jc.2006-0448","article-title":"Thyroxine\u2013triiodothyronine combination therapy versus thyroxine monotherapy for clinical hypothyroidism: meta-analysis of randomized controlled trials","volume":"91","author":"Grozinsky-Glasberg","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2025101519590590100_dgaf449-B13","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1097\/MNM.0b013e32832c79e0","article-title":"Thyroxine alone or thyroxine plus triiodothyronine replacement therapy for hypothyroidism","volume":"30","author":"Ma","year":"2009","journal-title":"Nucl Med Commun"},{"issue":"3","key":"2025101519590590100_dgaf449-B14","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1210\/clinem\/dgae651","article-title":"Treatment preferences in patients with hypothyroidism","volume":"110","author":"de Lima Beltr\u00e3o","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"2025101519590590100_dgaf449-B15","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1089\/thy.2014.0028","article-title":"Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement","volume":"24","author":"Jonklaas","year":"2014","journal-title":"Thyroid"},{"issue":"2","key":"2025101519590590100_dgaf449-B16","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000339444","article-title":"2012 ETA guidelines: the use of L-T4 + L-T3 in the treatment of hypothyroidism","volume":"1","author":"Wiersinga","year":"2012","journal-title":"Eur Thyroid J"},{"issue":"2","key":"2025101519590590100_dgaf449-B17","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/cen.14935","article-title":"Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association\/Society for endocrinology consensus statement","volume":"99","author":"Ahluwalia","year":"2023","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2025101519590590100_dgaf449-B18","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1159\/000512970","article-title":"Evidence-based use of levothyroxine\/liothyronine combinations in treating hypothyroidism: a consensus document","volume":"10","author":"Jonklaas","year":"2021","journal-title":"Eur Thyroid J"},{"issue":"10","key":"2025101519590590100_dgaf449-B19","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1089\/thy.2020.0153","article-title":"Liothyronine and desiccated thyroid extract in the treatment of hypothyroidism","volume":"30","author":"Idrees","year":"2020","journal-title":"Thyroid"},{"issue":"12","key":"2025101519590590100_dgaf449-B20","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1080\/03007995.2024.2435460","article-title":"A review of the safety of triiodothyronine in combination with levothyroxine for the management of hypothyroidism","volume":"40","author":"Gottwald-Hostalek","year":"2024","journal-title":"Curr Med Res Opin"},{"key":"2025101519590590100_dgaf449-B21","first-page":"PS1-07-02","article-title":"Liothyronine and a sudden unexplained death: cause or coincidence?","volume":"101","author":"Bahl","year":"2024","journal-title":"Endocr Abstr"},{"key":"2025101519590590100_dgaf449-B22","author":"FDA"},{"key":"2025101519590590100_dgaf449-B23","author":"MHRA"},{"key":"2025101519590590100_dgaf449-B24","author":"MedDRA"},{"key":"2025101519590590100_dgaf449-B25","author":"Wells"},{"issue":"9","key":"2025101519590590100_dgaf449-B26","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1002\/sim.1761","article-title":"What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data","volume":"23","author":"Sweeting","year":"2004","journal-title":"Stat Med"},{"key":"2025101519590590100_dgaf449-B27","doi-asserted-by":"crossref","first-page":"1323057","DOI":"10.3389\/fdsfr.2023.1323057","article-title":"Conducting and interpreting disproportionality analyses derived from spontaneous reporting systems","volume":"3","author":"Cutroneo","year":"2024","journal-title":"Front Drug Saf Regul"},{"issue":"1","key":"2025101519590590100_dgaf449-B28","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/0962280211403604","article-title":"Shrinkage observed-to-expected ratios for robust and transparent large-scale pattern discovery","volume":"22","author":"Nor\u00e9n","year":"2013","journal-title":"Stat Methods Med Res"},{"key":"2025101519590590100_dgaf449-B29","doi-asserted-by":"crossref","unstructured":"Bahl S, Taylor PN, Premawardhana LD, et al \u00a0Supplementary data for Risk of death and adverse effects in patients on Liothyronine: a multi-sourcesystematic review and meta-analysis. 2025. 10.6084\/m9.figshare.29402231.v1","DOI":"10.1210\/clinem\/dgaf449"},{"issue":"Supplement_1","key":"2025101519590590100_dgaf449-B30","doi-asserted-by":"crossref","first-page":"A955","DOI":"10.1210\/jendso\/bvab048.1952","article-title":"Stress cardiomyopathy due to exogenous thyrotoxicosis from T3 supplementation","volume":"5","author":"Shaw","year":"2021","journal-title":"J Endocr Soc"},{"issue":"2","key":"2025101519590590100_dgaf449-B31","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.cjco.2022.11.019","article-title":"Amiodarone thyrotoxicosis: a case of pharmacy error obscured by amiodarone suppression of symptoms of highly elevated thyroxine concentration","volume":"5","author":"Manasra","year":"2023","journal-title":"CJC Open"},{"issue":"Supplement_1","key":"2025101519590590100_dgaf449-B32","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1210\/jendso\/bvaa046.968","article-title":"SAT-519 armour thyroid and liothyronine combination potentiated thrombosis","volume":"4","author":"Shin","year":"2020","journal-title":"J Endocr Soc"},{"issue":"8","key":"2025101519590590100_dgaf449-B33","doi-asserted-by":"crossref","first-page":"2973","DOI":"10.1016\/S0735-1097(23)03417-4","article-title":"Bodybuilder's cardiomyopathy: a unique case of hormone induced heart failure","volume":"81","author":"Miklin","year":"2023","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"2025101519590590100_dgaf449-B34","doi-asserted-by":"crossref","first-page":"e232867","DOI":"10.1136\/bcr-2019-232867","article-title":"Delayed diagnosis of T3 supplementation in a bodybuilder presenting with tachycardia and features of sepsis","volume":"13","author":"Warner","year":"2020","journal-title":"BMJ Case Rep"},{"issue":"6","key":"2025101519590590100_dgaf449-B35","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1016\/j.eprac.2021.04.835","article-title":"Abstract #1003897: physician induced psychosis","volume":"27","author":"Parimi","year":"2021","journal-title":"Endocr Pract"},{"issue":"3","key":"2025101519590590100_dgaf449-B36","first-page":"002362","article-title":"A 29-year-old bodybuilder with liothyronine-induced thyrotoxic hypokalaemic periodic paralysis","volume":"8","author":"van Bokhorst","year":"2019","journal-title":"Eur J Case Rep Intern Med"},{"issue":"8144","key":"2025101519590590100_dgaf449-B37","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/S0140-6736(79)92105-6","article-title":"Triiodothyronine intoxication","volume":"314","author":"Dahlberg","year":"1979","journal-title":"Lancet"},{"issue":"1","key":"2025101519590590100_dgaf449-B38","doi-asserted-by":"crossref","first-page":"e227946","DOI":"10.1136\/bcr-2018-227946","article-title":"Thyroxine-induced periodic paralysis: a rare complication of nutritional supplements","volume":"11","author":"Cheema","year":"2018","journal-title":"BMJ Case Rep"},{"issue":"12","key":"2025101519590590100_dgaf449-B39","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/01.ccm.0000510361.50996.51","article-title":"1688: acute Thyrotoxicosis factitia: thyrotoxicosis secondary to acute overdose of exogenous t3 and t4","volume":"44","author":"Quan","year":"2016","journal-title":"Crit Care Med"},{"key":"2025101519590590100_dgaf449-B40","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.clinms.2018.11.003","article-title":"Thyrotoxicosis due to 1000-fold error in compounded liothyronine: a case elucidated by mass spectrometry","volume":"11","author":"Khan","year":"2019","journal-title":"Clin Mass Spectrom"},{"issue":"7","key":"2025101519590590100_dgaf449-B41","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1089\/105072502320288528","article-title":"Massive triiodothyronine intoxication: efficacy of hemoperfusion?","volume":"12","author":"Sol\u00e1","year":"2002","journal-title":"Thyroid"},{"issue":"6","key":"2025101519590590100_dgaf449-B42","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/jca.21536","article-title":"Iatrogenic thyrotoxicosis and the role of therapeutic plasma exchange","volume":"32","author":"Shah","year":"2017","journal-title":"J Clin Apher"},{"issue":"13","key":"2025101519590590100_dgaf449-B43","doi-asserted-by":"crossref","first-page":"353","DOI":"10.15585\/mmwr.mm6513a4","article-title":"Notes from the field: thyrotoxicosis after consumption of dietary supplements purchased through the Internet\u2013Staten Island, New York, 2015","volume":"65","author":"Regina","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"2025101519590590100_dgaf449-B44","first-page":"123","article-title":"Acute myocarditis in bodybuilder from coxsackievirus and thyrotoxicosis","volume":"14","author":"Kwak","year":"2016","journal-title":"J Cardiol Cases"},{"issue":"1","key":"2025101519590590100_dgaf449-B45","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4212\/cjhp.v68i1.1426","article-title":"Iatrogenic thyrotoxicosis secondary to compounded liothyronine","volume":"68","author":"Bains","year":"2015","journal-title":"Can J Hosp Pharm"},{"issue":"1","key":"2025101519590590100_dgaf449-B46","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/01.MAJ.0000310783.66897.b6","article-title":"An unusual cause of thyrotoxic periodic paralysis: triiodothyronine-containing weight reducing agents","volume":"337","author":"Chou","year":"2009","journal-title":"Am J Med Sci"},{"issue":"6","key":"2025101519590590100_dgaf449-B47","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1007\/s00414-010-0423-y","article-title":"Lethal thyroid storm after uncontrolled intake of liothyronine in order to lose weight","volume":"124","author":"Hartung","year":"2010","journal-title":"Int J Legal Med"},{"key":"2025101519590590100_dgaf449-B48","doi-asserted-by":"crossref","first-page":"2019-8-4","DOI":"10.7573\/dic.2019-8-4","article-title":"Thyrotoxicosis after massive triiodothyronine (LT3) overdose: a coast-to-coast case series and review","volume":"9","author":"He","year":"2020","journal-title":"Drugs Context"},{"issue":"6","key":"2025101519590590100_dgaf449-B49","first-page":"553","article-title":"A case of thyrotoxicosis due to a compounding error","volume":"49","author":"De La Calzada-Jeanlouie","year":"2011","journal-title":"Clin Toxicol"},{"issue":"12","key":"2025101519590590100_dgaf449-B50","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1089\/thy.2011.0353","article-title":"Thyroid storm due to inappropriate administration of a compounded thyroid hormone preparation successfully treated with plasmapheresis","volume":"22","author":"Jha","year":"2012","journal-title":"Thyroid"},{"issue":"3","key":"2025101519590590100_dgaf449-B51","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1097\/MJT.0b013e3181c960a9","article-title":"Thyrotoxic hypokalemic periodic paralysis due to dietary weight-loss supplement","volume":"18","author":"Akinyemi","year":"2011","journal-title":"Am J Ther"},{"issue":"6","key":"2025101519590590100_dgaf449-B52","doi-asserted-by":"crossref","first-page":"e211","DOI":"10.1097\/MJT.0b013e318288a460","article-title":"I lost weight, but I became weak and cannot walk\u2014a case of nutraceutical (T3)-induced thyrotoxic periodic paralysis","volume":"21","author":"Panikkath","year":"2014","journal-title":"Am J Ther"},{"issue":"3","key":"2025101519590590100_dgaf449-B53","first-page":"558\u2013","article-title":"Pure T3-thyrotoxicosis from a Mexican weight loss supplement","volume":"19","author":"Daniels","year":"2013","journal-title":"Endocr Pract"},{"issue":"5","key":"2025101519590590100_dgaf449-B54","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1210\/jc.2004-2111","article-title":"Combined therapy with levothyroxine and liothyronine in two ratios, compared with levothyroxine monotherapy in primary hypothyroidism: a double-blind, randomized, controlled clinical trial","volume":"90","author":"Appelhof","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"2025101519590590100_dgaf449-B55","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1089\/thy.2023.0135","article-title":"Preliminary results of a double-blind randomized controlled trial evaluating the cardiometabolic effects of levothyroxine and liothyronine compared to levothyroxine with placebo in athyreotic low-risk thyroid cancer patients","volume":"33","author":"Biondi","year":"2023","journal-title":"Thyroid"},{"issue":"1","key":"2025101519590590100_dgaf449-B56","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/ejendo\/lvad172","article-title":"Randomized double-blind placebo-controlled trial on levothyroxine and liothyronine combination therapy in totally thyroidectomized subjects: the LEVOLIO study","volume":"190","author":"Brigante","year":"2024","journal-title":"Eur J Endocrinol"},{"issue":"22","key":"2025101519590590100_dgaf449-B57","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1001\/jama.290.22.2952","article-title":"Combined levothyroxine plus liothyronine compared with levothyroxine alone in primary hypothyroidism: a randomized controlled trial","volume":"290","author":"Clyde","year":"2003","journal-title":"JAMA"},{"issue":"6","key":"2025101519590590100_dgaf449-B58","doi-asserted-by":"crossref","first-page":"412","DOI":"10.7326\/0003-4819-142-6-200503150-00007","article-title":"Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone","volume":"142","author":"Escobar-Morreale","year":"2005","journal-title":"Ann Intern Med"},{"issue":"5","key":"2025101519590590100_dgaf449-B59","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1210\/jc.2012-4107","article-title":"Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study","volume":"98","author":"Hoang","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2025101519590590100_dgaf449-B60","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1590\/2359-3997000000192","article-title":"Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study","volume":"60","author":"Kaminski","year":"2016","journal-title":"Arch Endocrinol Metab"},{"issue":"9","key":"2025101519590590100_dgaf449-B61","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1080\/03007995.2018.1448771","article-title":"Sexual function and depressive symptoms in young women with hypothyroidism receiving levothyroxine\/liothyronine combination therapy: a pilot study","volume":"34","author":"Krysiak","year":"2018","journal-title":"Curr Med Res Opin"},{"issue":"6","key":"2025101519590590100_dgaf449-B62","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1530\/EJE-09-0542","article-title":"Effect of combination therapy with thyroxine (T4) and 3,5,3\u2032-triiodothyronine versus T4 monotherapy in patients with hypothyroidism, a double-blind, randomised cross-over study","volume":"161","author":"Nygaard","year":"2009","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2025101519590590100_dgaf449-B63","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4158\/EP.11.4.223","article-title":"Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone","volume":"11","author":"Rodriguez","year":"2005","journal-title":"Endocr Pract"},{"issue":"2","key":"2025101519590590100_dgaf449-B64","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1210\/jc.2004-1672","article-title":"Partial substitution of thyroxine (T4) with tri-iodothyronine in patients on T4 replacement therapy: results of a large community-based randomized controlled trial","volume":"90","author":"Saravanan","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2025101519590590100_dgaf449-B65","doi-asserted-by":"crossref","first-page":"4551","DOI":"10.1210\/jc.2003-030139","article-title":"Does a combination regimen of thyroxine (T4) and 3,5,3\u2032-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double-blind, randomized, controlled trial","volume":"88","author":"Sawka","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"2025101519590590100_dgaf449-B66","doi-asserted-by":"crossref","first-page":"e4400","DOI":"10.1210\/clinem\/dgab478","article-title":"Comparative effectiveness of levothyroxine, desiccated thyroid extract, and levothyroxine + liothyronine in hypothyroidism","volume":"106","author":"Shakir","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2025101519590590100_dgaf449-B67","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1111\/j.1365-2265.2004.02050.x","article-title":"Replacement therapy with levothyroxine plus triiodothyronine (bioavailable molar ratio 14:1) is not superior to thyroxine alone to improve well-being and cognitive performance in hypothyroidism","volume":"60","author":"Siegmund","year":"2004","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2025101519590590100_dgaf449-B68","doi-asserted-by":"crossref","first-page":"4115","DOI":"10.1210\/jc.2007-0297","article-title":"Thyroid hormone replacement for central hypothyroidism: a randomized controlled trial comparing two doses of thyroxine (T4) with a combination of T4 and triiodothyronine","volume":"92","author":"Slawik","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"5728","key":"2025101519590590100_dgaf449-B69","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1136\/bmj.4.5728.145","article-title":"Controlled clinical trial of combined triiodothyronine and thyroxine in the treatment of hypothyroidism","volume":"4","author":"Smith","year":"1970","journal-title":"Br Med J"},{"issue":"3","key":"2025101519590590100_dgaf449-B70","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1080\/07435800903156340","article-title":"Efficacy of combined levothyroxine and liothyronine as compared with levothyroxine monotherapy in primary hypothyroidism: a randomized controlled trial","volume":"34","author":"Valizadeh","year":"2009","journal-title":"Endocr Res"},{"issue":"10","key":"2025101519590590100_dgaf449-B71","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.1210\/jc.2003-030249","article-title":"Combined thyroxine\/liothyronine treatment does not improve well-being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism","volume":"88","author":"Walsh","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2025101519590590100_dgaf449-B72","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1385\/ENDO:18:2:129","article-title":"Thyroxine vs thyroxine plus triiodothyronine in treatment of hypothyroidism after thyroidectomy for Graves' disease","volume":"18","author":"Bunevicius","year":"2002","journal-title":"Endocrine"},{"issue":"6","key":"2025101519590590100_dgaf449-B73","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1056\/NEJM199902113400603","article-title":"Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism","volume":"340","author":"Bunevicius","year":"1999","journal-title":"N Engl J Med"},{"issue":"3","key":"2025101519590590100_dgaf449-B74","doi-asserted-by":"crossref","first-page":"245","DOI":"10.14310\/horm.2002.1274","article-title":"Combined therapy with L-thyroxine and L-triiodothyronine compared to L-thyroxine alone in the treatment of primary hypothyroidism","volume":"9","author":"Fadeyev","year":"2010","journal-title":"Hormones (Athens)"},{"issue":"11","key":"2025101519590590100_dgaf449-B75","doi-asserted-by":"crossref","first-page":"3466","DOI":"10.1210\/jc.2011-1329","article-title":"Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine","volume":"96","author":"Celi","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2025101519590590100_dgaf449-B76","doi-asserted-by":"crossref","first-page":"816566","DOI":"10.3389\/fendo.2022.816566","article-title":"Effect of liothyronine treatment on quality of life in female hypothyroid patients with residual symptoms on levothyroxine therapy: a randomized crossover study","volume":"13","author":"Bjerkreim","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"6","key":"2025101519590590100_dgaf449-B77","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/cen.13052","article-title":"Liothyronine use in a 17 year observational population-based study\u2014the tears study","volume":"85","author":"Leese","year":"2016","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5","key":"2025101519590590100_dgaf449-B78","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1089\/thy.2020.0388","article-title":"Liothyronine use in hypothyroidism and its effects on cancer and mortality","volume":"31","author":"Planck","year":"2021","journal-title":"Thyroid"},{"issue":"7","key":"2025101519590590100_dgaf449-B79","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1089\/thy.2021.0634","article-title":"Heart failure and stroke risks in users of liothyronine with or without levothyroxine compared with levothyroxine alone: a propensity score-matched analysis","volume":"32","author":"Yi","year":"2022","journal-title":"Thyroid"},{"issue":"3","key":"2025101519590590100_dgaf449-B80","doi-asserted-by":"crossref","first-page":"e1143","DOI":"10.1210\/clinem\/dgad629","article-title":"A cross-sectional analysis of cardiovascular and bone health care utilization during treatment with thyroid hormone","volume":"109","author":"Penna","year":"2024","journal-title":"J Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaf449\/63984956\/dgaf449.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/11\/3278\/63984956\/dgaf449.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/11\/3278\/63984956\/dgaf449.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T23:59:25Z","timestamp":1760572765000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/110\/11\/3278\/8227161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":80,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,8,8]]},"published-print":{"date-parts":[[2025,10,16]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaf449","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,8,8]]}}}