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Updated: Jan 27, 2026

A Personalized 3D-Printed Model for Preoperative Evaluation in Thyroid Surgery
Published on: February 17, 2023
Personalized p-THYROSIM model for thyroid hormone dynamics, hypothyroidism treatment & implementation in an iOS
Joseph DiStefano1, Katarina Reid1, Karim Ghabra1
1Biocybernetics Laboratory, Departments of Computer Science and Medicine, University of California at Los Angeles (UCLA), Los Angeles, United States.
This study refines p-THYROSIM, a thyroid hormone simulation tool, for personalized levothyroxine (LT4) and LT4+liothyronine (LT3) dosing in hypothyroid patients. The updated tool and new app improve prediction accuracy for hormone replacement therapy.
Area of Science:
- Endocrinology
- Computational Biology
- Pharmacology
Background:
- Hypothyroidism affects millions globally, requiring precise hormone replacement therapy.
- Current dosing strategies for levothyroxine (LT4) and liothyronine (LT3) can be challenging to personalize.
- Mathematical modeling offers a promising approach to optimize individual treatment plans.
Purpose of the Study:
- To refine the p-THYROSIM simulation tool for enhanced prediction of thyroid hormone regulation.
- To develop user-friendly software (iOS app and Python version) for personalized LT4 and LT4+LT3 dosing in hypothyroid patients.
- To improve the accuracy of simulations by incorporating individual height and weight, rather than BMI.
Main Methods:
- Refitted male and female data to establish blood volume as a function of height and weight separately.
- Removed a superfluous parameter and adjusted FT4/FT3 plotting to align with current assay ranges.
- Developed an iOS app for 100-day simulations and a Python version for 1000-day simulations.
Main Results:
- The iOS app was tested in clinical applications, including simulations for hemi-thyroidectomy and hormone replacement therapy.
- Simulations demonstrated that combination LT4+LT3 therapy is more effective than LT4 alone in achieving normal plasma FT4, FT3, and TSH levels.
- Graphic hormone responses for simulated Hashimoto's disease patients undergoing different replacement therapies were illustrated.
Conclusions:
- The refined p-THYROSIM tool and associated software can accurately predict personalized LT4 and LT4+LT3 replacement therapies for hypothyroid patients.
- Combination therapy requires relatively low doses of LT3 (typically 5-7.5 ug) in addition to LT4 to restore euthyroid levels.
- Further research into safe and effective combination therapies with lower LT3 doses and slow-release formulations is warranted.

