Background: Recent surveys have highlighted substantial variability in the management of hypothyroidism that is associated with physician demographic and geo-economic characteristics. This study aimed to assess preferences for thyroid hormone therapy among medical thyroid specialists in Korea. Methods: An online survey was conducted using the Treatment of Hypothyroidism in Europe by Specialists: An International Survey (THESIS) questionnaire. Participants were medical thyroid specialists who were members of the Korean Thyroid Association (KTA). Results: Among the 349 regular members of the KTA who were physicians, 53 (15.2%) completed the survey. All respondents reported prescribing levothyroxine (LT4) as the initial treatment of choice for hypothyroidism. For patients with biochemical euthyroidism, 64.2% of respondents indicated that treatment was unnecessary; however, several conditions were cited as potential indications for thyroid hormone use (multiple responses were allowed), including female infertility with elevated thyroid antibody levels (30.2%), enlarging simple goiter (17.0%), and severe hypercholesterolemia as adjunctive therapy (9.4%). Although 24.5% of respondents reported avoiding LT4+liothyronine (LT3) therapy because of low-quality evidence, 62.3% indicated that they would consider it for symptomatic patients receiving LT4 monotherapy with normal thyroid-stimulating hormone levels. Conclusion: Korean thyroid specialists generally adhere to current clinical guidelines, favoring LT4 as the standard treatment for hypothyroidism. However, there is considerable willingness to use LT4+LT3 combination therapy and to prescribe thyroid hormones for certain non-thyroid conditions. Ongoing educational efforts are needed to improve understanding that many persistent symptoms despite biochemical euthyroidism are influenced by psychosocial factors and to facilitate consistent implementation of evidencebased, guideline-aligned clinical practice.
Yoon et al. (Wed,) studied this question.