Chinese medicine warming and invigorating drugs combined with levothyroxine may improve treatment of hypothyroidism caused by Hashimoto disease more than levothyroxine alone.
Systematic Review Hashimoto Disease Hypothyroidism
This systematic review pooled several indices of hypothyroidism caused by HT according to “China’s Guidelines for the Diagnosis and Treatment of Thyroid Disease” and correlation studies. The results showed that the combination of warming and invigorating drugs and levothyroxine increased FT3 and FT4 levels, and reduced TSH, TPOAb, and TGAb levels in patients with hypothyroidism cause by HT more than levothyroxine alone after treatments of 8 weeks or longer. With the exception of FT4, the results were stable.
In conclusion, we cautiously recommend prescribing warming and invigorating drugs along with levothyroxine for the treatment of hypothyroidism caused by Hashimoto disease. However, high-quality evidence is needed to confirm these results. To guarantee evidence quality, a strict study design, which includes a large sample, an unbiased randomization method, full concealment, proper blinding, and appropriate statistical analyses, is vital. In addition, clinical curative effects of TCM, such as TCM syndromes, should be standardized and unified to reduce clinical heterogeneity and methodology heterogeneity. Finally, a strict registration system for clinical trials is required to remove reporting biases.
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