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Lookup NU author(s): Dr Petros PerrosORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2025 Ludgate, McGowan, Moran, Attanasio, Žarković, Nagy, Negro, Papini, Adler Cohen, Akarsu, Alevizaki, Ayvaz, Bednarczuk, Beleslin, Berta, Bodor, Borissova, Boyanov, Buffet, Burlacu, Ćirić, Díez, Dobnig, Fadeyev, Field, Fliers, Führer-Sakel, Galofré, Hakala, Jiskra, Kopp, Krebs, Kršek, Kužma, Lazúrová, Leenhardt, Luchytskiy, Melo, Metso, Morgunova, Niculescu, Perić, Planck, Poiana, Marques Puga, Robenshtok, Rosselet, Ruchala, Riis, Shepelkevich, Tronko, Frølich, Unuane, Vardarli, Visser, Vryonidou, Younes, Yurenya, Perros and Hegedüs.Purpose: Treatment-resistant depression (TRD) is most commonly defined as depression that has not responded to two different pharmacological agents used for an adequate period of time. We explored the views of European specialists via survey, regarding the use of thyroid hormone (TH) in euthyroid patients with TRD as part of ‘Treatment of Hypothyroidism in Europe by Specialists: An International Survey’ (THESIS). Methods: The question “Thyroid hormones may be indicated in biochemically euthyroid patients with treatment resistant depression” was posed to specialists from 28 countries. Results: 5695 valid responses were received following 17,232 invitations (33.0% response rate; 65% female, 90% endocrinologists). 348 (6.1%) stated that TH may be indicated in biochemically euthyroid patients with TRD. This view was more common in males (p<0.01), respondents who saw ≥100 patients with hypothyroidism per year (p<0.01), respondents who worked in private practice (p=0.05) and respondents who were not members of international specialist associations (p=0.05). Geographical variation existed with respondents in Eastern Europe significantly more likely to use TH in TRD (p<0.01). Linear regression showed a statistically significant reduction in the use of TH for TRD with increasing gross national income (F-statistic=7.35, CI -0.15 - -0.02, p=0.01). TH in TRD was recommended in psychiatry guidelines but not endocrinology guidelines. Conclusion: While there is limited evidence for their use, over 6% of respondents stated that TH may be indicated in TRD. Due to the risk of iatrogenic thyrotoxicosis and increased morbidity the use of TH should be addressed in relevant endocrinology guidelines and consensus should be reached between specialties.
Author(s): Ludgate S, McGowan A, Moran C, Attanasio R, Zarkovic M, Nagy EV, Negro R, Papini E, Adler Cohen C, Akarsu E, Alevizaki M, Ayvaz G, Bednarczuk T, Beleslin BN, Berta E, Bodor M, Borissova AM, Boyanov M, Buffet C, Burlacu M-C, Ciric J, Diez JJ, Dobnig H, Fadeyev V, Field BCT, Fliers E, Fuhrer-Sakel D, Galofre JC, Hakala T, Jiskra J, Kopp PA, Krebs M, Krsek M, Kuzma M, Lazurova I, Leenhardt L, Luchytskiy V, Melo M, Metso S, Morgunova T, Niculescu DA, Peric B, Planck T, Poiana C, Marques Puga F, Robenshtok E, Rosselet P, Ruchala M, Riis KR, Shepelkevich A, Tronko MD, Frolich JS, Unuane D, Vardarli I, Visser WE, Vryonidou A, Younes YR, Yurenya E, Perros P, Hegedus L
Publication type: Article
Publication status: Published
Journal: Frontiers in Endocrinology
Year: 2025
Volume: 16
Online publication date: 23/09/2025
Acceptance date: 29/08/2025
Date deposited: 28/10/2025
ISSN (electronic): 1664-2392
Publisher: Frontiers Media SA
URL: https://doi.org/10.3389/fendo.2025.1665720
DOI: 10.3389/fendo.2025.1665720
Data Access Statement: The datasets presented in this article are not readily available because Data is the property of the THESIS sub-committee. Requests to access the datasets should be directed to ludgates@tcd.ie
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