Hypothyroidism is usually treated by levothyroxine (L-T4) which usually resolves the thyroid-related symptoms. For patients with continued symptoms on treatment with L-T4 alone, alternative treatment options with desiccated thyroid extract (DTE) or combination therapy (L-T4 with liothyronine, L-T3) have been used with some success. The current study aimed to evaluate the clinical effects of DTE, L-T4, and combination therapy (L-T4 and L-T3) in patients with hypothyroidism.