Peeters RP (2017) Subclinical hypothyroidism. N Engl J Med 376:2556–2565. https://doi.org/10.1056/NEJMcp1611144

Article  PubMed  Google Scholar 

Medici BB, Nygaard B, la Cour JL et al (2019) Changes in prescription routines for treating Hypothyroidism between 2001 and 2015: an observational study of 929,684 primary care patients in Copenhagen. Thyroid 29:910–919. https://doi.org/10.1089/thy.2018.0539

Article  CAS  PubMed  Google Scholar 

Taylor PN, Albrecht D, Scholz A et al (2018) Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol 14:301–316. https://doi.org/10.1038/nrendo.2018.18

Article  PubMed  Google Scholar 

Garmendia Madariaga A, Santos Palacios S, Guillén-Grima F, Galofré JC (2014) The incidence and prevalence of thyroid dysfunction in Europe: a Meta-analysis. J Clin Endocrinol Metabolism 99:923–931. https://doi.org/10.1210/jc.2013-2409

Article  CAS  Google Scholar 

Ross JS, Rohde S, Sangaralingham L et al (2019) Generic and brand-name thyroid hormone drug Use among commercially insured and Medicare Beneficiaries, 2007 through 2016. J Clin Endocrinol Metab 104:2305–2314. https://doi.org/10.1210/jc.2018-02197

Article  PubMed  Google Scholar 

Garber JR, Cobin RH, Gharib H et al (2012) Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American thyroid Association. Endocr Pract 18:988–1028. https://doi.org/10.4158/EP12280.GL

Article  PubMed  Google Scholar 

Younes YR, Perros P, Hegedüs L et al Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of UK endocrinologists. Clinical Endocrinology n/a: https://doi.org/10.1111/cen.14812

Gharib H, Papini E, Garber JR, AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES–2016 UPDATE (2016) Endocr Pract 22:622–639. https://doi.org/10.4158/EP161208.GL

Article  PubMed  Google Scholar 

Wiersinga WM, Duntas L, Fadeyev V et al (2012) 2012 ETA guidelines: the Use of L-T4 + L-T3 in the treatment of Hypothyroidism. Eur Thyroid J 1:55–71. https://doi.org/10.1159/000339444

Article  PubMed  PubMed Central  Google Scholar 

Brito JP, Ross JS, El Kawkgi OM et al (2021) Levothyroxine Use in the United States, 2008–2018. JAMA Intern Med 181:1402–1405. https://doi.org/10.1001/jamainternmed.2021.2686

Article  CAS  PubMed  PubMed Central  Google Scholar 

la Cour JL, Medici BR, Grand MK et al (2021) Risk of over- and under- treatment with levothyroxine in primary care in Copenhagen, Denmark. Eur J Endocrinol 185:673–679. https://doi.org/10.1530/EJE-21-0485

Article  PubMed  Google Scholar 

Esfandiari NH, Reyes-Gastelum D, Hawley ST et al (2019) Patient requests for tests and treatments Impact Physician Management of Hypothyroidism. Thyroid 29:1536–1544. https://doi.org/10.1089/thy.2019.0383

Article  CAS  PubMed  PubMed Central  Google Scholar 

Centanni M, Benvenga S, Sachmechi I (2017) Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report. J Endocrinol Invest 40:1289–1301. https://doi.org/10.1007/s40618-017-0706-y

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ross DS (2022) Treating hypothyroidism is not always easy: when to treat subclinical hypothyroidism, TSH goals in the elderly, and alternatives to levothyroxine monotherapy. J Intern Med 291:128–140. https://doi.org/10.1111/joim.13410

Article  CAS  PubMed  Google Scholar 

Janett-Pellegri C, Wildisen L, Feller M et al (2021) Prevalence and factors associated with chronic use of levothyroxine: a cohort study. PLoS ONE 16:e0261160. https://doi.org/10.1371/journal.pone.0261160

Article  CAS  PubMed  PubMed Central  Google Scholar 

Somwaru LL, Arnold AM, Joshi N et al (2009) High frequency of and factors associated with thyroid hormone over-replacement and under-replacement in men and women aged 65 and over. J Clin Endocrinol Metab 94:1342–1345. https://doi.org/10.1210/jc.2008-1696

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lillevang-Johansen M, Abrahamsen B, Jørgensen HL et al (2018) Over- and under-treatment of hypothyroidism is Associated with excess mortality: a Register-based Cohort Study. Thyroid 28:566–574. https://doi.org/10.1089/thy.2017.0517

Article  CAS  PubMed  Google Scholar 

Evron JM, Hummel SL, Reyes-Gastelum D et al (2022) Association of thyroid hormone treatment intensity with Cardiovascular Mortality among US veterans. JAMA Netw Open 5:e2211863. https://doi.org/10.1001/jamanetworkopen.2022.11863

Article  PubMed  PubMed Central  Google Scholar 

Saravanan P, Chau W-F, Roberts N et al (2002) Psychological well-being in patients on ‘adequate’ doses of l-thyroxine: results of a large, controlled community-based questionnaire study. Clin Endocrinol 57:577–585. https://doi.org/10.1046/j.1365-2265.2002.01654.x

Article  CAS  Google Scholar 

Feller M, Snel M, Moutzouri E et al (2018) Association of thyroid hormone therapy with quality of life and thyroid-related symptoms in patients with subclinical hypothyroidism: a systematic review and Meta-analysis. JAMA 320:1349–1359. https://doi.org/10.1001/jama.2018.13770

Article  CAS  PubMed  PubMed Central  Google Scholar 

Levothyroxine - Drug Usage Statistics ClinCalc DrugStats Database. https://clincalc.com/DrugStats/Drugs/Levothyroxine. Accessed 23 Jan 2023

Hepp Z, Lage MJ, Espaillat R, Gossain VV (2021) The direct and indirect economic burden of hypothyroidism in the United States: a retrospective claims database study. J Med Econ 24:440–446. https://doi.org/10.1080/13696998.2021.1900202

Article  PubMed  Google Scholar 

Livadas S, Bothou C, Androulakis I et al (2018) Levothyroxine replacement therapy and overuse: a Timely Diagnostic Approach. Thyroid 28:1580–1586. https://doi.org/10.1089/thy.2018.0014

Article  CAS  Google Scholar 

Mateo RCI, Hennessey JV (2019) Thyroxine and treatment of hypothyroidism: seven decades of experience. Endocrine 66:10–17. https://doi.org/10.1007/s12020-019-02006-8

Article  CAS  PubMed  PubMed Central  Google Scholar 

Koutras DA, Alevizaki M, Tsatsoulis A, Vagenakis AG (2003) Greece is iodine sufficient. Lancet 362:405–406

Article  CAS  PubMed  Google Scholar 

Jeong SH, Hong HS, Lee JY (2019) The association between thyroid echogenicity and thyroid function in pediatric and adolescent Hashimoto’s thyroiditis. Med (Baltim) 98:e15055. https://doi.org/10.1097/MD.0000000000015055

Article  Google Scholar 

Watt T, Hegedüs L, Groenvold M et al (2010) Validity and reliability of the novel thyroid-specific quality of life questionnaire, ThyPRO. Eur J Endocrinol 162:161–167. https://doi.org/10.1530/EJE-09-0521

Article  CAS  PubMed  Google Scholar 

Mintziori G, Watt T, Veneti S et al (2018) ThyPROgr: the Greek edition of the ThyPRO questionnaires for patients with benign thyroid diseases. Hormones 17:107–112. https://doi.org/10.1007/s42000-018-0015-7

Article  PubMed  Google Scholar 

Burgos N, Toloza FJK, Singh Ospina NM et al (2021) Clinical outcomes after discontinuation of thyroid hormone replacement: a systematic review and Meta-analysis. Thyroid 31:740–751. https://doi.org/10.1089/thy.2020.0679

Article  CAS  PubMed  PubMed Central  Google Scholar 

Rosario PW (2010) Levothyroxine in subclinical hypothyroidism: a lifelong therapy? Clin Endocrinol (Oxf) 72:718–720. https://doi.org/10.1111/j.1365-2265.2009.03711.x

Article  CAS  PubMed  Google Scholar 

Rosario PW, Calsolari MR (2016) Levothyroxine therapy in the subclinical hypothyroidism: a lifelong therapy? A long-term study. Clin Endocrinol (Oxf) 85:819–820.