Challenges in management of hypothyroidism in primary care

Module summary

Hypothyroidism is one of the most frequently encountered conditions in general practice. Although management is often straightforward, clinicians continue to face challenges regarding diagnosis thresholds, persistent symptoms, use of liothyronine and treatment in special circumstances, such as in those planning pregnancy or taking medication that affects thyroid function.

In this module, endocrinologists Dr Peter Taylor and Professor Kristien Boelaert provide their insights on these challenges, drawing on the latest evidence and guidance including NICE guidance, the British Thyroid Association/Society for Endocrinology Consensus Statement regarding liothyronine and their Lancet 2024 ‘Seminar on hypothyroidism’ providing practical answers to five common clinical questions.

Learning objectives

This module will support your knowledge and confidence in managing hypothyroidism, with a focus on:

• How to interpret thyroid function tests and decide when to treat subclinical hypothyroidism.
• How to support patients who remain symptomatic despite normal biochemistry.
• When thyroid pain or goitre changes the diagnostic or management approach.
• How and when liothyronine can be considered.
• How to manage hypothyroidism caused by or complicated by other medications.

Authors: Dr Peter N Taylor, Consultant Endocrinologist at Cardiff University, and Professor Kristien Boelaert, Professor of Endocrinology and Consultant Endocrinologist at University of Birmingham

Date published: 16.12.2025