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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Wish I could find a doctor who would at least let me try it here in California. When I broached the subject with my current doctor, he trotted out the old info he had learned in school (many, many years ago) and informed me that the porcine thyroid extract was “unreliable, old-fashioned” and he couldn’t prescribe it. Then he topped it all off by saying, “Sure it’s natural. So is dog poop.” I was so stunned I dropped the subject. I’ve been taking strictly T4 ever since. But I’ve recently changed insurance plans and I’m about to drop that doctor. Now all I need is to find the elusive open-minded enough doctor who is willing to let me give it a go.
Yuo have to get your priorities right. I can’t forgive myself now for not being more persistant years ago with my request for a natural thyroid from my family doctor. The dessicated thyroid is available in US in regular pharmacies, at the begining you will have to experiment with different doses, it is normal. Shat that GP up, it is about your health, after all. I experienced a significan difference after changing my medication. Not a weight loss, but more energy, less cold sencitivity, I don’t need 10 hours of sleep to not feel like a zomby any longer.
#Susan, I had the same discussion here in the UK last year. The GP (primary care doctor) said that he would not be prepared to prescribe it and he did not know any endocrinologist who would.
When I was originally diagnosed the consultant (a Professor at one of our leading Universities no less) told me ‘some people promote natural thyroid but they are wrong.’ He was wrong as it clearly is a better product for some people as proven in the above.
In my opinion the medical profession (excluding a few sane people with integrity such as Dr Briffa) here in the UK is shockingly unscientific, blinkered, arrogant and self serving. Our Department for Health is no better.
There are GPs here who will give it. See ‘Stop the thyroid madness’ for a list.
I wish I could find someone who would even listen to me about this. I’ve been trying for years to get natural thyroid medication but no-one I have seen will even consider it.
There is also the fact that some Doctors have had their registration taken away by the GMC because they have prescribed it and gone against the establishment.
This is a much bigger problem than your blog would indicate, John. Your’re being very cautious in your remarks, but with good reason, given the treament meted out by the GMC to Drs Peatfield, Skinner, et al, for going back to what used to be a the standard treament for hypothyroidism. Ironically, the desiccated extracts on the market now are probably of a much more consistent standard than they were back in the 1940s and 50s.
There is a great deal to say about this subject, so I’ll confine myself to just a few points. The duration of treatment in the quoted study is actually quite short, especially if the hypohtyroid state is longstanding in the individual. I experienced improvements over a period of four years: increased tolerance of cold and generally improved temperature regulation; improved pulse rate and BP; loss of myxodematous fatty/fluid deposits around face, trunk and joints; hair regrowth on brows and scalp; skin infections of 20+ years duration cleared; very yellow skin and hair returned to normal colour; resumption of the ability to tan instead of burning after a short time in the sun; improved hearing, et cetera, et cetera. I still have a little way to go to raise my basal temperature to normal. I do best on synthetic T3 alone – the whole extract still had too much T4 in it for me. I have other health problems, so I’m far from well, but proper treatment has lightened my load and improved my well-being.
Individuals vary, but parameters for diagnosis and treatment are very rigid in the UK, with the RCP digging in its heels in response to pressure for change from patient groups. This is all about power and perceived authority that must be preserved at all costs – including patient well-being. I’ve had to go private entirely, but with supervision from an endocrinologist familiar with the Broda Barnes protocol. He can’t prescribe directly because he had his licence to practise suspended by the GMC, despite never having having harmed a patient. I am faced with the dilemma that I may not be able to fund my treatment long term, because our modest household income has declined (and will do so again next year) in an era of rising prices.
Hi Susan, it is unfortunate that some medical practitioners do not keep themselves up to date with the latest medical literature. I understand it is very frustrating. If it’s important to your health, why not find another doctor which is open to your suggestion?