Shepelkevich, A P, Dydyshka, Yu V, Yurenya, E V et al. · Problemy endokrinologii · 2021 · DOI
This survey asked 146 Belarusian doctors how they treat thyroid problems. Most doctors use levothyroxine (LT4) as the first treatment for low thyroid function. Some doctors said they might add a second thyroid hormone (LT3) for patients who keep feeling tired and unwell even after their blood tests show normal thyroid levels. The doctors noted that when patients have normal thyroid tests but ongoing symptoms, the cause is often stress, other health problems, or unrealistic expectations rather than actual thyroid disease.
This study is relevant to ME/CFS patients because it documents physician recognition that some patients experience persistent fatigue and systemic symptoms despite normalized thyroid function tests—a pattern that overlaps with ME/CFS presentations. The finding that doctors attribute such symptoms to fatigue syndrome and chronic illness burden rather than thyroid disease suggests potential missed diagnostic opportunities or the possibility that thyroid dysfunction and ME/CFS may coexist or interact in ways not fully understood.
This study does not prove that thyroid hormone treatment is effective for ME/CFS, nor does it establish whether ME/CFS patients have undiagnosed thyroid disorders. The survey captures only physician opinions, not actual patient outcomes or whether adding LT3 therapy actually improves symptoms in any patient population. Cross-sectional questionnaire data cannot demonstrate causation or the prevalence of thyroid-related problems in ME/CFS cohorts.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Shepelkevich, A P, Dydyshka, Yu V, Yurenya, E V, Lоbashova, V L, Attanasio, R, Hegedüs, L, et al. (2021). [Features of the use of synthetic analogues of thyroid hormones: а 2020 THESIS* questionnaire survey of members of the Belarusian Public Medical Association of Endocrinology and Metabolism].. Problemy endokrinologii. https://doi.org/10.14341/probl12828
BibTeX
@article{mecfsatlas-shepelkevich-2021-features-use,
author = {Shepelkevich, A P and Dydyshka, Yu V and Yurenya, E V and Lоbashova, V L and Attanasio, R and Hegedüs, L and Nagy, E and Negro, R and Papini, E and Perros, P},
title = {[Features of the use of synthetic analogues of thyroid hormones: а 2020 THESIS* questionnaire survey of members of the Belarusian Public Medical Association of Endocrinology and Metabolism].},
journal = {Problemy endokrinologii},
year = {2021},
doi = {10.14341/probl12828},
note = {PubMed: 35262294},
url = {https://www.mecfsatlas.com/evidence/shepelkevich-2021-features-use},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/shepelkevich-2021-features-use
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