Risk of Death and Adverse Effects in Patients on Liothyronine: A Multisource Systematic Review and Meta-analysis
Pooled result · AEs (meta-analysis of RCTs, n = 2128)Result — go to the resultRelative risk 1.22 95% CI 0.66–2.25Authors' conclusion
Our findings are reassuring that regulated LT3 use is not associated with the risk of death or serious AEs. More studies are needed to supplement existing data.
Study context
- Population
- Patients with hypothyroidism using liothyronine (LT3); 21 randomized controlled trials (RCTs), 4 cohort studies and 27 case reports52 studies
- Comparison
- LT3 vs levothyroxine (LT4) monotherapy
- Outcome
- Safety of LT3: death, AEs and cardiovascular outcomes
Methodological detailsmultisource, PubMed, UK Yellow Card scheme and FAERS, 2 independent reviewers
- Multisource
- PubMed, UK Yellow Card scheme and FAERS
- 2 independent reviewers
Pooled result
AEs (meta-analysis of RCTs, n = 2128)
Relative risk
1.22
95% CI 0.66–2.25
Combinationvs Monotherapy
RR 1.22 (95% CI 0.66–2.25)
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Mortality (cohort meta-analysis, LT3 vs LT4-only users, n = 630 254)Reduced mortality risk with LT3 | 0.70 (0.62–0.78) | |
| 0.512Relative risk (log scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| AF (cohort meta-analysis)No increased risk | 1.10 (0.74–1.63) | |
| HF (cohort meta-analysis)No increased risk | 1.54 (0.95–2.47) | |
| Stroke (cohort meta-analysis)No increased risk | 0.86 (0.11–6.75) | |
| 0.10.31310Relative risk (log scale) |
Original publication
Risk of Death and Adverse Effects in Patients on Liothyronine: A Multisource Systematic Review and Meta-analysis. J Clin Endocrinol Metab. Published 8 August 2025. doi:10.
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