![]() The alternative therapeutic approach employed in the past is combination therapy, which consists of administration of both T3 and T4, either synthetic or in the form of desiccated thyroid extract. Additional complications are also present in the form of dosage difficulties, extensive drug interactions and poor patience compliance. However, there is mounting evidence that this is unable to restore thyroid hormone signaling in all tissues due to often persistent symptoms. The current standard of care encompasses thyroid hormone replacement therapy, traditionally in the form of synthetic T4. The incidence rate of primary hypothyroidism is expected to increase in the near future, partially due to increasing survival of patients that have undergone radiotherapy for head and neck cancer, which induces this disease in over half of those treated. Primary hypothyroidism severely impacts the quality of life of patients through a decrease in the production of the thyroid hormones T3 and T4, leading to symptoms affecting cardiovascular, neurological, cognitive, and metabolic function. ![]() 3Department of ENT, Head and Neck Surgery, NHS Lothian, Edinburgh, United Kingdom. ![]() 2Centre for Regenerative Medicine, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, United Kingdom.1Institute for Bioengineering, School of Engineering, The University of Edinburgh, Edinburgh, United Kingdom.Nixon 3, Elaine Emmerson 2 and Anthony Callanan 1*
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