Study questions value of TSH levels as indicator that disease is under control.
About 15 percent of the 10-12 million people in the U.S. with hypothyroidism, or an underactive thyroid, continue to feel sick despite following the standard of care recommended by the American Thyroid Association. Physicians routinely prescribe levothyroxine, a synthetic thyroid hormone, adjusting the dose until blood levels of thyroid-stimulating hormone (TSH) stabilize.
Despite normal TSH tests, these patients still have many nagging symptoms of hypothyroidism. "Patients complain of being depressed, slow and having a foggy mind," said Rush's Antonio C. Bianco, MD, PhD, an immediate past president of the American Thyroid Association that is professor of medicine at Rush and an expert on thyroid disorders "They have difficulty losing weight. They complain of feeling sluggish and have less energy. Yet we doctors keep telling them, 'I'm giving you the right amount of medication and your TSH is normal. You should feel fine.'"
Journal Reference:
(Score: 3, Insightful) by tcj_phx on Monday October 17 2016, @04:42AM
Levothyroxine, aka Synthroid [wikipedia.org], "a synthetic thyroid hormone", is T4. This drug is "bioidentical", which means that it's the same as what the body produces for itself. This substance has 4 iodine atoms. It is the "storage" version of the thyroid hormone. T4 has no effect on the body's metabolism.
T4 is activated by stripping one of the Iodines to make T3. This substance has the effect of turning on cells' metabolism. From the link above:
If the patient's liver and/or kidneys aren't working very well, they are unable to deiodinize T4 to make T3. Their Thyroid Stimulating Hormone lab #'s look fine, but they still have no metabolism and no energy.
Doctors used to treat hypothyroidism based on a person's symptoms. Then lab tests and "new and improved" drugs were invented. Patients are now commonly treated with the fancy standardized synthetic drug Synthroid. Their lab tests look good, but they still feel awful.
(Score: 2) by jdavidb on Monday October 17 2016, @01:51PM
ⓋⒶ☮✝🕊 Secession is the right of all sentient beings
(Score: 3, Informative) by fubari on Monday October 17 2016, @05:43PM
Your summary sounds exactly right.
Just something to think about: compounding pharmacies [mcguffpharmacy.com] make a lot of sense to me - this is just an example plucked at random out of the search results, but I think it is worth looking into. Lots of doctors out there, if yours isn't doing it for you then shop around.
Also worth looking at are overall hormone levels, this is complex and requires lots of research on the patient's part to see if it makes sense...
bioidentical hormone replacement [wikipedia.org]
Car analogy: don't just check the oil dipstick, also check the other fluid levels from time to time (brake, transmission, coolant, windshield washer). Car works better when fluid levels are optimal.
If you (or a loved one) isn't feeling 100%, keep looking until you find a combination of things that work for them.
(Score: 1) by tcj_phx on Monday October 17 2016, @06:32PM
The original Armour thyroid formula may have been more effective than its reformulation/replacement... But yes, glandular thyroid has T3 and T2 and other substances in addition to T4.
It's best to address the cause of low thyroid function, but it's nice to have medications while you figure it out.