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Related Experiment Video

Updated: Sep 16, 2025

Human In Vitro Suppression as Screening Tool for the Recognition of an Early State of Immune Imbalance
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Measuring Hypothyroidism Disease Control Using a TSH-based "Time-in-range".

Matthew D Ettleson1, Nikita Thomas2, Marcelo Ramirez1

  • 1Section of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, IL 60637, USA.

The Journal of Clinical Endocrinology and Metabolism
|July 11, 2025
PubMed
Summary
This summary is machine-generated.

Thyroid stimulating hormone (TSH) time-in-range (TIR) reflects levothyroxine (LT4) treatment control. Sociodemographic factors like male sex and Black race were linked to lower TIR, suggesting disparities in hypothyroidism management.

Keywords:
hypothyroidismlevothyroxinelongitudinal analysisquality of care

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Area of Science:

  • Endocrinology
  • Clinical Research
  • Health Outcomes

Background:

  • Levothyroxine (LT4) therapy is standard for hypothyroidism.
  • Thyroid stimulating hormone (TSH) levels are key indicators of treatment efficacy.
  • Time-in-range (TIR) offers a novel metric for assessing chronic disease control.

Purpose of the Study:

  • To develop a method for estimating TSH TIR in LT4-treated patients.
  • To analyze the influence of sociodemographic factors on TIR.
  • To explore the correlation between TIR and cardiovascular events.

Main Methods:

  • Utilized longitudinal clinical data from 2752 LT4-treated patients (2016-2022).
  • Estimated TIR, time-above-range (TAR), and time-below-range (TBR) using linear interpolation of log-transformed TSH.
  • Employed generalized estimating equations and survival analysis to assess covariate and event associations.

Main Results:

  • Median TIR was 86% over a median follow-up of 3.8 years.
  • LT4 dose negatively correlated with TIR in both males and females.
  • Male sex and Black race were significantly associated with TIR <75%.

Conclusions:

  • TSH TIR estimation effectively identified sociodemographic disparities in hypothyroidism control.
  • LT4 dose impacts TIR, with variations observed across patient groups.
  • Further research is needed to link TIR to significant clinical outcomes.