Evidence map›Paper›PMID 40500219›Full record

ArticleEndocrine journal2025

A questionnaire survey of thyroid specialists in Japan on the use of thyroid hormones in hypothyroid and euthyroid patients.

Yuji Nagayama, Junichi Tajiri, Tsukasa Murakami, Natsuko Watanabe, Shinya Sato, Hisakazu Shindo, Seigo Tachibana, Roberto Attanasio, Enrico Papini, Petros Perros and 4 more

Abstract read
In one paragraph

Article in Endocrine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

14 authors.

Yuji NagayamaDepartment of Endocrinology, Yamashita Thyroid Hospital, Fukuoka, Japan.ORCID http://orcid.org/0000-0002-5058-9349
Junichi TajiriTajiri Thyroid Clinic, Kumamoto, Japan.
Tsukasa MurakamiDepartment of Endocrinology, Noguchi Thyroid Clinic and Hospital Foundation, Oita, Japan.ORCID http://orcid.org/0000-0002-6433-9869
Natsuko WatanabeDepartment of Internal Medicine, Ito Hospital, Tokyo, Japan.ORCID http://orcid.org/0000-0003-2297-5004
Shinya SatoDepartment of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan.ORCID http://orcid.org/0000-0002-0761-6209
Hisakazu ShindoDepartment of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan.ORCID http://orcid.org/0000-0002-1424-620X
Seigo TachibanaDepartment of Endocrinology, Yamashita Thyroid Hospital, Fukuoka, Japan.ORCID http://orcid.org/0000-0003-4154-500X
Roberto AttanasioScientific Committee, Associazione Medici Endocrinologi, Milan, Italy.
Enrico PapiniDepartment of Endocrinology and Metabolism, Regina Apostolorum Hospital, Lifenet Health Group, Rome, Italy.
Petros PerrosInstitute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, United Kingdom.
Endre V NagyDivision of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Laszlo HegedüsDepartment of Endocrinology, Odense University Hospital, Odense C, Denmark.
Koichi ItoDepartment of Surgery, Ito Hospital, Tokyo, Japan.
Hiroyuki YamashitaDepartment of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan.ORCID http://orcid.org/0009-0001-0805-8886

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Levothyroxine (LT4) is the established treatment for hypothyroidism but some controversies, such as whether combining it with liothyronine (LT3) for hypothyroid patients and whether prescribing it to euthyroid patients, exist on its use. This survey was conducted to investigate current trends about thyroid hormone use in hypothyroid and euthyroid patients in Japan. Members of the Japan Thyroid Association (JTA) were invited to participate in an online questionnaire based on the THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) survey. Anonymous responses from 207 of 874 (23.7%) JTA-certified thyroid specialists were analyzed. LT4 was the first line treatment for hypothyroidism by all respondents. 18.8% and 28.0% would also use LT3 and LT3 + LT4 combination, respectively. LT3 + LT4 combination was preferred for patients on LT4 with residual symptoms or low serum T3 levels. Psychological factors and comorbidities were considered as the main contributors to residual symptoms. Respondents would prescribe thyroid hormones in euthyroid subjects for female infertility with positive anti-thyroid antibodies (46.9%), for Hashimoto's disease with a huge goiter (29.0%), and for pregnant or infertile women with TSH between 2.5-4 mU/L irrespective of anti-thyroid antibody status (43.0 and 76.8%, and 46.9 and 77.3%, respectively). In conclusion, Japanese thyroid specialists chose LT4 as first line treatment for hypothyroidism in accordance with current guidelines. The use of LT3 + LT4 combination is less frequent in Japan than in other countries, whereas the use of thyroid hormones for non-hypothyroid indications is similarly high worldwide, which is not necessarily in accord with pertinent society guidelines.

Indexed as

Hormone Replacement TherapyHypothyroidismPractice Patterns, Physicians'Thyroid HormonesThyroxineTriiodothyronineAdultDrug Therapy, CombinationEndocrinologistsEndocrinologyFemaleHashimoto DiseaseHumansJapanMaleMiddle AgedThyroid HormonesThyroxineTriiodothyronineHypothyroidismLevothyroxineLiothyronineTHESIS questionnaireThyroid hormones

Identifiers

PMID40500219
PMCPMC12340252

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Registered trials

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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.