Recently there has been more interest in adjusting the range of normal for the diagnosis of low thyroid. This has been controversial, but would allow more patients thyroid supplementation for their hypothyroid symptoms. Overall, this has been a good thing for patients. If the labs and the clinical symptoms are monitored, there is little downside. There are some who disregard laboratory data in favor of body temperature and pulse, however, it is clear that the blood work is far more accurate than physical diagnosis. Physicians should use both.

There has also been interest in adjunctive T3 to improve energy and sense of well being. This has been utilized in select psychiatric patients and has some support in the literature. Again, this has been controversial, and the vast majority of patients seem to do well with T4 alone.

This can be powerful medicine, and one must continue to diligently monitor patients laboratory data as well as clinical symptoms. Iatrogenic hyperthyroidism could potentially cause cardiac dysrhythmias or less likely osteoporosis.