Thyroid Hormone Treatment Controversies
Issues of Debate Regarding Hypothyroid Therapies
Sep 21, 2009
Doctors who treat hypothyroidism should see each patient as an individual who needs monitored for both the effectiveness and possible problems that might arise, as related to the thyroid hormone therapy. If a patient fails to experience satisfactory symptom relief, a trial of a different type of hormone replacement therapy might hold the answer to better treatment success.
Brand Favoritism In-Balance
Doctors should certainly form their opinions as to which thyroid hormone type works better in the general population of hypothyroid patients. When a doctor however, highly favors a particular brand of thyroid hormone over all others, to the point of unwillingness to switch patients struggling with unresolved symptoms to trials of other types, this could result in missed opportunities for more successful symptom-relief for individual patients who sometimes have unique treatment-needs.
Doctors should also be willing to consider suggestions by their patients, as to which thyroid hormone therapy they feel might be better suited for them. All available types will require being prescribed by a treating doctor who will also monitor the treatment; patient-preference for a particular type or brand does not change this fact. Doctors who do not specialize in thyroid treatment but who are having problems treating patients with difficult cases, should also be willing to refer them to Thyroid Specialists or Endocrinologists.
Does Synthetic T4 Restore Metabolism?
There has been very strong debate by advocates on both sides, one being represented by proponents who feel natural brands of T4 and T3 combination are the best treatment-option for hypothyroidism, the other being proponents who believe synthetic T4-only to be the best treatment-option. Points that are often included in the debate include the view that both T4 and T3 are needed to restore normal metabolism in hypothyroid patients.
Once a proper dose-level of synthetic T4 is administered, the proof of how well the hormone is being used by the body can be seen in follow-up blood tests. These tests and retests can include one that measures the Free T3 level which can reveal that the patient’s body is recognizing the hormone and converting it into the proper level of this more metabolically active hormone. The other consideration is “symptom improvement” (including correction of elevated cholesterol levels) and if both of these factors are satisfactorily taking place, why would a patient or doctor want to see the type or brand of treatment switched? Trying to fix things that are not broken can sometimes cause more problems than solutions.
T3 Does Not Add Benefit for Some Patients
This type statement fits into the “one size fits all” category of debate-view and while it may be true in some cases it will not be true in all cases. One aspect that is often added to this argument against the addition of T3 hormone into a treatment for a hypothyroid patient is the fact that the hormone is fast-acting and has a shorter half-life than T4 has. The opinion therefore is that it is unstable in patients and causes spikes and crashes in T3 levels. The fact is however that treatment containing T3 is taken on a daily basis and this alone helps to keep levels stable.
Additionally, the same mentions in the previous subheading in regard to blood retests that monitor thyroid hormone replacement therapy also apply to therapies that include T3. If blood levels remain stable and symptom-relief is experienced, this should signal treatment success to both the patient and doctor.
There are also medical studies that have concluded that hypothyroid therapy in depressed patients with difficult to resolve depression symptoms, can benefit from the addition of T3 to their thyroid hormone replacement therapy. This too is a factor demonstrating patient-individuality and another consideration both patient and doctor should look at if this scenario involving depression exists in a patient.
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