ArticleThe Journal of clinical endocrinology and metabolism2025
Influence of Preexisting Psychiatric Morbidity on Liothyronine Use in Hypothyroidism: A Swedish Nationwide Cohort Study.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Minding the mind when prescribing liothyronine.Journal of the Endocrine Society · 2026Article
- Psychiatric morbidity following liothyronine exposure in autoimmune hypothyroidism: a Swedish nationwide cohort study.Journal of the Endocrine Society · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
contextAutoimmune hypothyroidism is a common endocrine disorder affecting 1% to 2% of the population in iodine sufficient areas. While levothyroxine is standard treatment, a substantial number of patients report persistent symptoms despite adequate treatment. The use of liothyronine as an adjunct to levothyroxine therapy has increased. The psychiatric characteristics of patients receiving liothyronine remain largely unknown.
objectiveThis study examines the association between preexisting psychiatric morbidity and subsequent liothyronine use in autoimmune hypothyroidism.
methodsThis nationwide retrospective cohort study includes all adults in Sweden with autoimmune hypothyroidism and initiated on treatment with thyroid hormones between 2006 and 2020. Data were obtained from the National Patient Register and the National Prescribed Drug Register. Psychiatric morbidity prior to diagnosis was identified using ICD-10 codes and ATC codes for psychiatric medications. Logistic models estimated associations, adjusting for sex, age, and region.
resultsAmong 353 708 patients, 44.8% had a history of psychiatric morbidity. These patients were more likely to receive liothyronine (adjusted odds ratio [aOR] 1.90, 95% CI 1.83-1.97, P < .001) than those without a psychiatric history. This was most evident among individuals with affective or anxiety morbidity (aOR 1.91, 95% CI 1.84-1.98, P < .001). No association was found for psychotic morbidity (aOR 1.08, 95% CI 0.98-1.19, P = .11).
conclusionPatients with a psychiatric history before autoimmune hypothyroidism were more likely to receive liothyronine, especially among those with affective or anxiety morbidity. This may reflect persistent symptoms and affect subsequent decisions in the treatment of hypothyroidism.
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