Condition

Hashimoto's Thyroiditis

Autoimmune thyroid disease

100M

People Affected

Active Trials

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.

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)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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

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💧

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

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)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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

Vitamin D (for deficiency)

65% Effectiveness• 75% Confidence• 90% Safety• 2 trials• 50K participants

MODERATE EvidenceExcellent ValueDose: 1000-5000 IU daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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

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)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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

Selenium Supplementation

45% Effectiveness• 55% Confidence• 85% Safety• 4 trials• 6K participants

LOW EvidencePoor ValueDose: 100-200 mcg daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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