Hypothyroidism is a condition that, traditionally, is characterised by low levels of thyroid hormone (such as thyroxine), which in turn can lead to symptoms such as fatigue, mental sluggishness and low mood, weight gain, sensitivity to cold, cold hands and feet, dry skin, dry hair and thinning of the hair. The diagnosis of hypothyroidism is usually made on the basis of a blood test, and tends to hinge on levels of the hormone ‘thyroid stimulating hormone’ (secreted by the pituitary gland at the base of the brain). Raised levels of TSH are generally required for a diagnosis of hypothyroidism to be made.
I’ve learned over the years that the diagnosis and management of hypothyroidism can be a controversial area. To begin with, there are reasons to believe that conventional medical tests are not the reliable indicator of thyroid function and status they are made out to be. I wrote about this issue here.
Another sometimes controversial aspect of thyroid management concerns treatment. Standard conventional treatment is based on ‘levo-thyroxine’ (also known as T4). However, T4 is not very metabolically active, and essentially needs to be converted into what is known as T3 to exert its beneficial effects in the body. However, some individuals will not convert T4 to T3 efficiently, and can end up still being low in T3 and hypothyroid despite having normal T4 and TSH levels. In the UK, T3 levels are rarely taken into consideration when making decisions regarding the diagnosis and management of possibly hypothyroidism.
Some practitioners, myself included, will sometimes suggest the use of thyroid medication based on ‘natural desiccated thyroid’. These preparations are generally made from porcine (pig) thyroid, and are usually standardised to contain specific amounts of T4 and T3. Desiccated thyroid extract does not contain just T4 and T3, but also other things that might support thyroid status and help relieve thyroid symptoms such as the hormones T2 and T1.
Natural desiccated thyroid is not necessarily for everyone, but my experience in practice tells me that, overall, it is more effective than levo-thyroxine (T4 alone) in the treatment of hypothyroidism, and often helps individuals who found that levo-thyroxine did little for them. The treatment is, though, controversial and generally frowned upon by many doctors and particularly endocrinologists (in my experience). Yet, the results I’ve seen in practice lead me to conclude that desiccated thyroid is a useful alternative to conventional thyroid treatment.
I was therefore interested to read here about a recent study which was presented recently at The Endocrines Society’s annual meeting in San Francisco in the US. The study was published in the Journal of Clinical Endocrinology and Metabolism last month .
In this study, hypothyroid individuals were treated, at separate times, with levo-thyroxine and desiccated thyroid (for 16 weeks each). Neither the researchers nor the study subjects knew which treatment of the two they were taking at any time.
According to the report and summary of the study, desiccated thyroid did not result in improved quality of life compared with thyroxine alone, but did lead to ‘modest’ weight loss (3 lbs on average). When individuals were asked whether or not they preferred one of the treatments (neither the researchers nor the patients knew which treatment they were taking), almost half (48.6%) expressed a preference for desiccated thyroid, while only 18.6% expressed a preference for thyroxine. The authors of this study concluded that: “[Desiccated thyroid extract] therapy may be relevant for some hypothyroid patients.” I couldn’t agree more.
1. Hoang TD, et al. Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study, J Clin Endocrinol Metab. 2013;98(5):1982-90
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