title: Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee.
abstract: The management of primary hypothyroidism with levothyroxine (L-T4) is simple, effective and safe, and most patients report improved well-being on initiation of treatment. However, a proportion of individuals continue to suffer with symptoms despite achieving adequate biochemical correction. The management of such individuals has been the subject of controversy and of considerable public interest. The American Thyroid Association (ATA) and the European Thyroid Association (ETA) have recently published guidelines on the diagnosis and management of hypothyroidism. These guidelines have been based on extensive reviews of the medical literature and include sections on the role of combination therapy with L-T4 and liothyronine (L-T3) in individuals who are persistently dissatisfied with L-T4 therapy. This position statement by the British Thyroid Association (BTA) summarises the key points in these guidelines and makes recommendations on the management of primary hypothyroidism based on the current literature, review of the published positions of the ETA and ATA, and in line with best principles of good medical practice. The statement is endorsed by the Association of Clinical Biochemistry, (ACB), British Thyroid Foundation, (BTF), Royal College of Physicians (RCP) and Society for Endocrinology (SFE).
authors.affiliation: Medicine, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: Onyebuchi
authors.initials: O
authors.lastname: Okosieme
authors.affiliation: Endocrinology, King's College Hospital, London, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Gilbert
authors.affiliation: Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Prakash
authors.initials: P
authors.lastname: Abraham
authors.affiliation: Division of Medical Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Kristien
authors.initials: K
authors.lastname: Boelaert
authors.affiliation: Centre for Endocrine and Diabetes Sciences, Cardiff University, Cardiff, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Dayan
authors.affiliation: Endocrinology, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Gurnell
authors.affiliation: Medical Research Institute, University of Dundee, Dundee, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Leese
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: McCabe
authors.affiliation: Endocrinology, Royal Victoria Infirmary, Newcastle, UK.
authors.forename: Petros
authors.initials: P
authors.lastname: Perros
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Vicki
authors.initials: V
authors.lastname: Smith
authors.affiliation: Molecular Endocrinology Group, Department of Medicine, Imperial College London, London, UK.
authors.forename: Graham
authors.identifier: 0000-0002-8555-8219
authors.initials: G
authors.lastname: Williams
authors.affiliation: Endocrinology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Vanderpump
mesh_terms: D019468:Disease Management; D004359:Drug Therapy, Combination; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D013974:Thyroxine / Q000627:therapeutic use; D014284:Triiodothyronine / Q000627:therapeutic use
chemical_list: D014284:Triiodothyronine; D013974:Thyroxine