T4 versus T3 and T4 :: Is it a real controversy?

Background: Although thyroid hormone replacement therapy has been a mainstay of endocrinologic therapy, many patients feel unwell despite apparently optimal treatment. Methods and Results: Recently, attempts have been made to improve treatment by administering tri-iodothyroxine (T-3) in addition to thyroxine. Initial results of a crossover study suggested that combination T-3 and T-4 therapy was associated with improvements in several measures of quality of life and increased patient preference. Results of subsequent studies have not supported these initially promising findings. Conclusions: At present, combination treatment cannot be recommended. Further clinical studies that are adequately powered and comprised of homogenous patient populations are needed to determine whether any benefits are associated with sustained-release T-3 preparations. Copyright (c) 2007 S. Karger AG, Basel.