Use of the hormone Levothyroxine to treat a slightly underactive thyroid gland

One sign of a slightly underactive thyroid gland (subclinical hypothyroidism) is a raised level of the hormone which stimulates the thyroid – known as thyroid-stimulating hormone, or TSH. The hormone levels in the thyroid are still within the normal range at this stage and symptoms are only minimal. To treat this condition in Switzerland, a manufactured form of the body’s own thyroid hormone is used – the hormone Levothyroxine. The aim of this report is to analyse the medical and financial implications of a Levothyroxine treatment in the case of a slightly underactive thyroid.

The consulted studies showed that treatment with Levothyroxine successfully reduces the level of the hormone TSH compared with a placebo treatment or no treatment. However, in the patients studied, there was no discernible reduction in complaints such as exhaustion, depression, problems of the nervous system, joint pain and heart problems. A newly developed model estimated the costs incurred over a five-year period to be between CHF 9 million and CHF 87 million, depending on how often Levothyroxine is used. The literature research did not reveal any ethical, legal, social or organisational problems that could arise as a result of treatment.

The report concludes that treatment with Levothyroxine successfully reduces the level of the TSH hormone, but does not reduce the associated complaints or side effects. The treatment has no significant safety risks. However, depending on the number of prescriptions, use of Levothyroxine could entail high costs for the healthcare system.