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The prevalence of noncompliant hypothyroid patients has been reported to be between 30% and 80% () despite the simplicity of l-T 4 replacement therapy and its once-daily oral administration.
Sorafenib has been associated with TSH elevations in about 18% of patients with metastatic renal cell carcinoma and in 33% of patients with thyroid carcinoma ().
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The addition of T 3 to T 4 monotherapy should be restricted to persistently symptomatic hypothyroid patients despite their biochemical euthyroidism during l-T 4 replacement therapy with the goal of achieving improved QOL.
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However, these studies did not differentiate between the beneficial effects of TSH suppression according to the aggressiveness of DTC.
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Children born from mothers with prolonged hypothyroxinemia living in iodine-deficient areas may have a deficit of motor and mental development and an increased incidence of attention deficit disorder, hyperactivity disorder, and reduced IQ with a higher risk of expressive language delay and nonverbal cognitive delay compared with controls ().
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Although this experimental observation cannot be extrapolated to humans without the usual caveats, some studies have reported that low serum FT 3 and significantly higher serum FT 4 levels can be observed in thyroidectomized patients receiving l-T 4 replacement therapy ().
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