THE ROLE OF MICRONUTRIENTS AND SUPPLEMENTS IN HYPOTHYROIDISM MANAGEMENT: A LITERATURE REVIEW

Zuzanna Wróbel; Katarzyna Torbacka; Joanna Kaczor; Maja Torbacka; Katarzyna Rozkosz; Natalia Wróbel; Olga Jakubik; Patrycja Podlejska; Aleksandra Sosin; Wojciech Bednarz

doi:10.31435/ijitss.4(48).2025.4434

Authors

Zuzanna Wróbel The West Hospital in Grodzisk Mazowiecki, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland https://orcid.org/0009-0005-7529-0641
Katarzyna Torbacka 5 Military Clinical Hospital with Polyclinic SPZOZ, Wrocławska 1/3, 30-901 Kraków, Poland https://orcid.org/0009-0002-7208-3725
Joanna Kaczor Independent Public Healthcare Institution in Myślenice, Szpitalna 2, 32-400 Myślenice, Poland https://orcid.org/0009-0002-1714-2630
Maja Torbacka Jagiellonian University Collegium Medicum, Świętej Anny 12, 31-008 Kraków, Poland https://orcid.org/0009-0000-7139-2134
Katarzyna Rozkosz Independent Public Health Care Center of the Ministry of the Interior and Administration in Katowice named after sergeant Grzegorz Załoga, Wita Stwosza 39-41, 40-042 Katowice, Poland https://orcid.org/0009-0000-3610-1901
Natalia Wróbel 5 Military Clinical Hospital with Polyclinic SPZOZ, Wrocławska 1/3, 30-901 Kraków, Poland https://orcid.org/0009-0005-9236-9802
Olga Jakubik Praski Hospital, Sp. z o.o., al. "Solidarności" 67, 03-401 Warszawa, Poland https://orcid.org/0009-0006-4378-7087
Patrycja Podlejska Independent Public Health Care Center of the Ministry of the Interior and Administration in Katowice named after sergeant Grzegorz Załoga, Wita Stwosza 39-41, 40-042 Katowice, Poland https://orcid.org/0009-0002-0074-9778
Aleksandra Sosin Jagiellonian University Collegium Medicum, Świętej Anny 12, 31-008 Kraków, Poland https://orcid.org/0009-0008-0440-5431
Wojciech Bednarz Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Kraków, Kronikarza Galla 25, 30-053 Kraków, Poland https://orcid.org/0009-0003-9522-6298

DOI:

https://doi.org/10.31435/ijitss.4(48).2025.4434

Keywords:

Hypothyroidism, Autoimmune Thyroiditis, Levothyroxine Resistance, Micronutrient Supplementation

Abstract

Background: Despite standard levothyroxine (LT4) therapy, many patients with hypothyroidism continue to report persistent symptoms such as fatigue, cognitive impairment, and reduced quality of life. This has prompted growing interest in adjunctive therapies, particularly micronutrients and supplements, which may modulate immune function and thyroid gland metabolism.

Aim: To evaluate the clinical impact of vitamin D, selenium, zinc, myo-inositol, and synbiotic supplementation in hypothyroid patients—especially those with autoimmune thyroiditis and subclinical hypothyroidism—by analyzing their effects on thyroid function, antibody titers, and patient-reported outcomes.

Materials and methods: A systematic literature search was conducted predominantly in PubMed and related biomedical databases. The review included randomized controlled trials (RCTs), systematic reviews, and relevant observational studies published between 2015 and 2025. Studies were analyzed for their findings on selected micronutrients and their influence on biochemical markers (TSH, FT4, FT3, anti-TPO, anti-Tg), immune modulation, and quality of life parameters.

Results: Adjunctive supplementation with micronutrients such as selenium, vitamin D, zinc, myo-inositol, and synbiotics shows potential clinical benefits in hypothyroidism management. These include reductions in thyroid autoantibody levels, improvements in thyroid hormone profiles, and better patient-reported outcomes. Synergistic effects were noted particularly for combined regimens, though results varied by baseline nutrient status and study design.

Conclusions: Supplementation with selected micronutrients may provide meaningful support in managing hypothyroidism, particularly in patients with residual symptoms despite LT4 therapy. However, larger multi-center RCTs are needed to confirm efficacy, establish optimal dosing, and identify patient subgroups most likely to benefit.

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