Evidence map›Paper›PMID 31485975›Full record

ReviewAdvances in therapy2019

Hypothyroidism in Context: Where We've Been and Where We're Going.

Luca Chiovato, Flavia Magri, Allan Carlé

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Advances in therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 186 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
186citing papers in PubMed, 9 pooled it
18.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

186 citing papers in PubMed, 9 syntheses or guidelines pooled it, 428 citations in OpenAlex.

  1. Pooled it
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  6. Height, Autoimmune Thyroid Disease, and Thyroid Cancer: A Mendelian Randomization Study.Thyroid : official journal of the American Thyroid Association · 2023
    Pooled it
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  10. The effect of reminder mobile application use on medication adherence after total thyroidectomy: a randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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  15. Impact of Therapeutic Ultrasound on Metabolic Hormone Release From Thyroid Gland.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026
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126 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

Luca ChiovatoIstituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. luca.chiovato@icsmaugeri.it.
Flavia MagriIstituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Allan CarléDepartment of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
Aalborg University Hospital · DKIstituti Clinici Scientifici Maugeri · ITUniversity of Pavia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hypothyroidism affects up to 5% of the general population, with a further estimated 5% being undiagnosed. Over 99% of affected patients suffer from primary hypothyroidism. Worldwide, environmental iodine deficiency is the most common cause of all thyroid disorders, including hypothyroidism, but in areas of iodine sufficiency, Hashimoto's disease (chronic autoimmune thyroiditis) is the most common cause of thyroid failure. Hypothyroidism is diagnosed biochemically, being overt primary hypothyroidism defined as serum thyroid-stimulating hormone (TSH) concentrations above and thyroxine concentrations below the normal reference range. Symptoms of hypothyroidism are non-specific and include mild to moderate weight gain, fatigue, poor concentration, depression, and menstrual irregularities, while the consequences of untreated or under-treated hypothyroidism include cardiovascular disease and increased mortality. Levothyroxine has long been the main tool for treating hypothyroidism and is one of the world's most widely prescribed medicines. In adults with overt hypothyroidism, levothyroxine is usually prescribed at a starting dose of 1.6 µg/kg/day, which is then titrated to achieve optimal TSH levels (0.4-4.0 mIU/L), according to the therapeutic target. We here summarise the history of levothyroxine and discuss future issues regarding the optimal treatment of hypothyroidism. Because nearly one-third of patients with treated hypothyroidism still exhibit symptoms, it is important that levothyroxine is used more appropriately to achieve maximum benefit for patients. In order to ensure this, further research should include more accurate assessments of the true prevalence of hypothyroidism in the community, optimisation of the levothyroxine substitution dose, proper duration of treatment, and identification of patients who may benefit from combination therapy with levothyroxine plus levotriiodothyronine.Funding: Merck.Plain Language Summary: Plain language summary available for this article.

Indexed as

AdultCardiovascular DiseasesDepressionFemaleHumansHypothyroidismThyrotropinThyroxineThyrotropinThyroxineChronic patientEndocrinologyHypothyroidismLevothyroxineManagementTreatment

Identifiers

PMID31485975
PMCPMC6822815
OpenAlexW2971859269

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.