Understanding Hypothyroidism: A Clear Look at Current Research and Treatment

Abstract

Introduction: This narrative review aims to provide a comprehensive overview of current research trends and treatment strategies in hypothyroidism.

Objectives: To provide a comprehensive narrative review of the recent advances in diagnosis and management of hypothyroidism by synthesizing current research evidence.

Methods: A systematic literature search was performed across databases including PubMed, Google Scholar, and Cochrane, using relevant keywords related to hypothyroidism, research trends, and therapeutic strategies. A total of 267 records were identified. After removing 21 duplicates, 246 articles were screened for relevance. Of these, 114 were excluded based on titles and abstracts. Sixty-three full-text articles were sought, with 4 unavailable for retrieval. Fifty-nine reports were assessed for eligibility, and 5 were excluded (3 focusing on thyroid cancer, 2 lacking sufficient information). Finally, 54 studies published up to June 2023 were included in this review.

Results: From 267 records, 54 studies were included. Research trends highlight genetic variants identified through GWAS, advancing precision medicine and early detection. Environmental factors, particularly endocrine disruptors, influence thyroid dysfunction. Novel biomarkers like reverse T3 and deiodinase enzymes improve diagnostics. Besides levothyroxine, therapies under study include combinations of T4 and T3, controlled-release T3, TSH analogs and stem cell therapy. Lifestyle strategies—diet, exercise, stress management and complementary medicine—support care, while systemic effects span cardiology, neurocognition, fertility and mental health.

Conclusions: Thyroid hormone replacement remains central to hypothyroidism management, yet challenges including persistent symptoms, variable response, and diagnostic limitations endure. Advances in genetics, biomarkers, and novel formulations are paving the way for personalized and precise care. Lifestyle and nutritional interventions may complement standard therapy to improve outcomes. Future directions include immunotherapies, stem cell–based approaches, and precision medicine strategies. Collectively, evidence supports a multidimensional framework integrating optimized pharmacological treatment with complementary and emerging therapies to enhance long-term patient quality of life.