Trial of Mycophenolate for Persistent Symptoms of Hypothyroidism (TRIUMPH) 

Researchers from Newcastle University have opened a clinical trial to investigate whether persistent thyroid inflammation may contribute to fatigue in patients with autoimmune hypothyroidism, also known as Hashimoto’s thyroiditis. 

They are now recruiting women aged 18 to 50 living in North East England to find out whether a medicine called mycophenolate mofetil (an anti-inflammatory treatment) can help women with Hashimoto’s thyroiditis who have ongoing symptoms such as tiredness, lethargy, weight issues, aches and pains and 'brain fog'. 

Find out more about the TRIUMPH trial 

The study follows on from an online survey shared by the Newcastle research team to try and understand how widespread fatigue is in people with hypothyroidism, and how severe their symptoms are. 

The results of the study have now been published in the European Thyroid Journal. We asked principal investigator, Prof Simon Pearce, about the survey results.

What was the aim of the study?  

We knew that fatigue was a prominent concern of people with hypothyroidism but even perfectly healthy people feel fatigue from time to time depending on what you have been doing. So we wanted to be able to say what proportion of hypothyroid people had fatigue that could be considered abnormal, how severe people’s fatigue was and how these fatigue levels in hypothyroid people compared to those of people with different chronic conditions.

What did it involve?

With the help of the BTF team, we made an online survey based on a validated fatigue score for chronic illness that was developed for cancer patients, and this was disseminated by both BTF and the Thyroid Trust to their memberships via digital media links.

What were the findings?

Firstly, we were amazed by the interest with more than 1,200 responses in just over one month. It turns out that nearly 90% of people who responded to the survey had a degree of fatigue that can be considered as abnormal, and the average severity of fatigue in these hypothyroid patients is worse than that of patients with cancer, anaemia, inflammatory bowel disease, multiple sclerosis and those on kidney dialysis.

Were there any particularly significant or surprising results?

Although we might have expected fatigue to be worse in patients who were older or who had just recently been diagnosed as having hypothyroidism, this was not the case. Fatigue severity was unrelated to time since diagnosis and if anything older respondents had slightly less fatigue.

Were there any limitations to the study?

We can’t know how representative the sample is compared to everyone who has hypothyroidism in the UK: it may be that people who feel the worst take the time to look into the symptoms and had the time to take the survey. It is possible that hypothyroid people who felt great just didn’t bother to engage. Another issue it that 98% of the responses were received from women, so we don’t really know if the same findings apply to men.

How can fatigue be addressed in this patient group?

There is no clear way forward here as randomised, blinded trials that have either changed levothyroxine doses or added T3 show that this does not improve the situation for most people. There are studies that show change of lifestyle factors including increasing exercise can be helpful for fatigue, but this is self-evidently not an easy answer if you feel exhausted.

Read the full study

Grixti L, Fisher H, Priestley J, McMullan C, Woollven A, Perros P, Mitchell AL, Gan EH, Pearce SH: Prevalence and severity of fatigue in treated hypothyroidism: results of a UK survey. European Thyroid Journal (doi.org/10.1530/ETJ-25-0044)

Interview dated November 2024

Study link added May 2025

Trial link added November 2025