Condition

Hashimoto's Thyroiditis

Autoimmune thyroid disease

100M
People Affected
40
Active Trials
2M
New Cases/Year
2,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Levothyroxine
90% Effectiveness• 98% Confidence• 65% Safety• 11 trials• 5M participants
HIGH EvidenceExcellent ValueDose: 25-300 mcg daily
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Comparative Safety Scale(Higher is safer)

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65
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

lifetime

Response Rate

95%

Remission Rate

95%

Common Side Effects:

Hyperthyroid symptoms (e.g., palpitations, anxiety, weight loss): 10%
Allergic reactions (rare): 0.1%

Annual Cost of Care

Drug Cost

$30

Monitoring

$200

Side Effects

$50

Total Annual

$280

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.2

Cost per Remission

$295

Cost per Responder

$295

Treatment Outcomes
Primary Outcomes
TSH (Thyroid-Stimulating Hormone)15.0 mIU/L
-86.7% (-13.0 mIU/L)
Free T4 (Thyroxine)0.5 ng/dL
+140% (+0.7 ng/dL)
Fatigue Severity Scale (FSS)FSS score: 35/49
-34.3% (-12 points on FSS)
Weight180 lbs
-4.4% (-8 lbs)
Depressive Symptoms (BDI-II)BDI-II score: 25/63
-32% (-8 points on BDI-II)
Secondary Benefits
Constipation Frequency3 bowel movements/week
+100% (+3 bowel movements/week)
Hair Loss SeverityHair Loss Severity (0-5 scale): 4
-50% (-2 points on Hair Loss Severity scale)
Quality of Life (SF-36 Physical Component Summary)SF-36 PCS score: 35/100
+20% (+7 points on SF-36 PCS)
Common Side Effects
Hyperthyroid symptoms (e.g., palpitations, anxiety, weight loss)
+10%
Allergic reactions (rare)
+0.1%

Clinical Trial Phases:

Phase 4
2
Levothyroxine + Liothyronine (Combination Therapy)
85% Effectiveness• 65% Confidence• 60% Safety• 50 trials• 8K participants
MODERATE EvidencePoor ValueDose: LT4: 50-200 mcg, LT3: 5-25 mcg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

lifetime

Response Rate

90%

Remission Rate

90%

Common Side Effects:

Hyperthyroid symptoms (e.g., palpitations, anxiety): 15%
Arrhythmias (rare, higher risk than LT4): 0.5%

Annual Cost of Care

Drug Cost

$430

Monitoring

$250

Side Effects

$100

Total Annual

$780

Cost-Effectiveness

POOR

QALYs Gained

1.2

Cost per Remission

$867

Cost per Responder

$867

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+85%
Response Rate
+90%
Remission Rate
+90%
Common Side Effects
Hyperthyroid symptoms (e.g., palpitations, anxiety)
+15%
Arrhythmias (rare, higher risk than LT4)
+0.5%

Clinical Trial Phases:

Phase 4
3
Desiccated Thyroid Extract (DTE)
85% Effectiveness• 60% Confidence• 60% Safety• 30 trials• 3K participants
LOW EvidencePoor ValueDose: 30-180 mg daily (0.5-3 grains)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

lifetime

Response Rate

90%

Remission Rate

90%

Common Side Effects:

Hyperthyroid symptoms (e.g., palpitations, anxiety): 15%
Allergic reactions (rare): 0.2%

Annual Cost of Care

Drug Cost

$300

Monitoring

$250

Side Effects

$100

Total Annual

$650

Cost-Effectiveness

POOR

QALYs Gained

1.2

Cost per Remission

$722

Cost per Responder

$722

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+85%
Response Rate
+90%
Remission Rate
+90%
Common Side Effects
Hyperthyroid symptoms (e.g., palpitations, anxiety)
+15%
Allergic reactions (rare)
+0.2%

Clinical Trial Phases:

Phase 4
4
Vitamin D (for deficiency)
65% Effectiveness• 75% Confidence• 90% Safety• 2 trials• 50K participants
MODERATE EvidenceExcellent ValueDose: 1000-5000 IU daily
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Comparative Safety Scale(Higher is safer)

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Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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90
DangerousModerateSafe

Time to Effect

1-3 months

Duration

ongoing, as needed

Response Rate

90%

Remission Rate

%

Common Side Effects:

Hypercalcemia (rare, with excessive dosing): 0.1%
Kidney stones (rare, with excessive dosing): 0.05%

Annual Cost of Care

Drug Cost

$20

Monitoring

$75

Side Effects

$10

Total Annual

$105

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.3

Cost per Responder

$117

Treatment Outcomes
Primary Outcomes
Serum 25(OH)D15 ng/mL
+167% (+25 ng/mL)
Anti-TPO Antibodies800 IU/mL
-25% (-200 IU/mL)
Anti-Tg Antibodies500 IU/mL
-20% (-100 IU/mL)
hs-CRP3.5 mg/L
-20% (-0.7 mg/L)
Secondary Benefits
Fatigue Severity Scale (FSS) score55/63
-15% (-8 points)
SF-36 Physical Component Summary35/100
+20% (+7 points)
Patient Health Questionnaire (PHQ-9) score15/27
-33% (-5 points)
Common Side Effects
Hypercalcemia (rare, with excessive dosing)
+0.1%
Kidney stones (rare, with excessive dosing)
+0.05%

Clinical Trial Phases:

Phase 4
5
Myo-inositol + Selenium
55% Effectiveness• 60% Confidence• 88% Safety• 1 trials• 1.5K participants
LOW EvidencePoor ValueDose: Myo-inositol 600mg + Selenium 83-200 mcg daily
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Comparative Safety Scale(Higher is safer)

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Meth💀
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88
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-12 months, then re-evaluate

Response Rate

50%

Remission Rate

%

Common Side Effects:

Mild GI upset (Myo-inositol): 8%
Selenium toxicity (rare, with excessive dosing): 0.1%

Annual Cost of Care

Drug Cost

$70

Monitoring

$50

Side Effects

$10

Total Annual

$130

Cost-Effectiveness

POOR

QALYs Gained

0.08

Cost per Responder

$260

Treatment Outcomes
Primary Outcomes
Anti-Thyroid Peroxidase Antibodies (TPOAb)1100 IU/mL
-45% (-495 IU/mL)
Thyroid-stimulating hormone (TSH)4.8 mIU/L
-25% (-1.2 mIU/L)
Hashimoto's Symptom Score (higher indicates more symptoms)18/30 points
-30% (-5.4 points)
Anti-Thyroglobulin Antibodies (TgAb)320 IU/mL
-35% (-112 IU/mL)
Secondary Benefits
Free Thyroxine (FT4)0.9 ng/dL
+10% (+0.09 ng/dL)
Thyroid Gland Volume15 mL
-12% (-1.8 mL)
SF-36 Vitality Score (higher indicates better vitality)40/100 points
+15% (+6 points)
Common Side Effects
Mild GI upset (Myo-inositol)
+8%
Selenium toxicity (rare, with excessive dosing)
+0.1%

Clinical Trial Phases:

Phase 4
6
Selenium Supplementation
45% Effectiveness• 55% Confidence• 85% Safety• 4 trials• 6K participants
LOW EvidencePoor ValueDose: 100-200 mcg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-12 months, then re-evaluate

Response Rate

40%

Remission Rate

%

Common Side Effects:

Selenium toxicity (rare, with excessive dosing): 0.5%

Annual Cost of Care

Drug Cost

$20

Monitoring

$50

Side Effects

$10

Total Annual

$80

Cost-Effectiveness

POOR

QALYs Gained

0.05

Cost per Responder

$200

Treatment Outcomes
Primary Outcomes
Anti-TPO Antibodies350 IU/mL
-35% (-122.5 IU/mL)
Anti-Tg Antibodies250 IU/mL
-20% (-50 IU/mL)
Thyroid-Specific Quality of LifeThyPRO-39 Total Score: 55/100
-12% (-6.6 points)
TSH (in subclinical hypothyroidism)4.8 mIU/L
-10% (-0.48 mIU/L)
Secondary Benefits
Free T41.0 ng/dL
+7.5% (+0.075 ng/dL)
Fatigue SeverityFatigue Severity Scale: 5.8/7
-15% (-0.87 points)
hs-CRP2.8 mg/L
-18% (-0.5 mg/L)
Common Side Effects
Selenium toxicity (rare, with excessive dosing)
+0.5%

Clinical Trial Phases:

Phase 4