There is evidence that HT exerts a multidimensional impact beyond endocrine dysfunction, with chronic autoimmunity and low-grade inflammation contributing to impaired QoL. These findings should be taken into account and perhaps challenge a purely TSH-centric model and call for a broader, patient-centered approach that integrates immunological, psychological, and subjective outcomes. Properly designed longitudinal and interventional trials are required to establish causal pathways and support the personalization of therapy.
Alfì et al. (Mon,) studied this question.