The brief history of Hashimoto’s treatment

The long way to discover treatment for an underactive thyroid

Today we are still a long way from the perfect treatment solving all of the symptoms for each and every one of us, but we have seen some tremendous advancements making it possible for the most us to have focused and productive lives. And the future brings some promise too.

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A century worth of thyroid replacement

In the early days of treatment, at the end of 19th and the beginning of 20th century, scientists found out that lost thyroid function can be compensated for by adding an external thyroid. Many of the severe symptoms, including death could be prevented by this discovery.

Cow and pig thyroid glands were used as the first treatments for an underactive thyroid. Nowadays they are used for the production of natural thyroid medications.

The rise of Levothyroxine

The breakthrough in underactive thyroid treatment happened after the discovery of the structure of T4 and understanding that our body is able to convert T4 to T3. This was in the 1950s, and marked the start of Levothyroxine (T4) therapy (5). Even today, this is a major therapy approach to restore low thyroid hormone levels.

Levothyroxine became the first prescription choice for doctors in the 1970s and the medical community worked under the assumption that Levothyroxine was the one-cure-fits-all solution. However, it quickly became apparent that the drug didn’t work for a pool of people. In the beginning, the remaining symptoms in patients were attributed to other diseases, or it was believed that patients were not compliant to the therapy (6).

Levothyroxine is not a silver bullet

1–2 in 10 of people with hypothyroid condition cannot convert T4 into T3 because of a faulty enzyme called deiodinase (11, 12). Enzymes are big molecules necessary for many of the chemical reactions in our body. Deiodinase removes one of the four molecules of iodine from T4, and by this process it turns it into an active hormone T3, containing three molecules of iodine.

What about non-hypothyroid Hashimoto’s problems?

Lastly, we come to the unsolved part of Hashimoto’s: the immune system. While Hashimoto’s is an autoimmune disease, it is not treated as one.

How to treat Hashimoto’s?

Is cortisone an option? Cortisone was effective in other autoimmune diseases (16), but what about Hashimoto’s ?

Are there other options?

Is there anything that would allow our immune system to start resembling normally balanced and healthy system? In biology this is sometimes called re-programming. When the immune cells that have one function are basically re-educated and retrained to do another job. This re-programming can be done in several ways.


How did the treatment on underactive thyroid advance through time. Adaptation from McAninch et al (2016).

Levothyroxine is still the prefered therapy choice for most of healthcare professionals. However medical community increasingly accepts patient diversity, therefore the treatment and disease management should become more personalized. It will be exciting to see what new treatments will emerge in the years to come.

Boosted — by BOOST Thyroid App

Companion health app for people diagnosed with Hashimoto’s and an underactive thyroid.

Thanks to Mikael Högqvist.

Dr. Vedrana Högqvist Tabor

Written by

CEO @Boost_HealthApp|| TEDx speaker || Cancer hunter || Hashimoto’s patient|| Parentpreneur || Learning from own mistakes since 1977

Boosted — by BOOST Thyroid App

Companion health app for people diagnosed with Hashimoto’s and an underactive thyroid.