Re: Hypothyroidism

[Guest guest]

Hi, all! I'm BACK from the World Lupus Congress, LFA meetings, and PIttsburgh (yes, Sue, it was super to meet you, too! What a great group in PA!). I'll recap the Congress in a later post (after I've been able to go through my notes). Meantime, I wanted to address what someone wrote about hypothyroidism. She wrote (in part):

"The next hurdle would be to find a doctor that will treat on symptoms and not on lab values. And, quite often the Synthroid doesn't help and you have to fight even harder to get the natural thryoid hormone called Armour. Armour contains all the hormones your body naturally makes T1,T2,T3, T4 and calcitonin. Synthroid only contains synthetic T4. There are so many testimonials on the yahoo thyroid lists about Armour."

There is a lot of conflicting information on the internet regarding treatment of hypothyroidism. I know there are several proponents of treating symptoms and not just lab values. I am NOT a doctor, however I am the author of a comprehensive book on hypothyroidism and spoke with many endocrinologists about thyroid disease and treatment. I attended seminars (professional medical seminars) and am also a thyroid patient (I had Graves' disease which has swung 'round to Hashimoto's thyroiditis). Here's my take on the whole "treat the symptoms not the lab values" and other issues.

First, although many symptoms such as weight gain and fatigue might be attributable in part or in whole to hypothyroidism, they can also stem from a myriad of other ailments and lifestyle issues. To insist on treating these symptoms to the point of ruling out the possibility that normal lab values DO mean that the thyroid is functioning normally could preclude the patient from discovering what might really be at the root of these symptoms. Taking thyroid hormone unnecessarily can lead to severe health problems, including heart involvment, and should NEVER be used to help weight loss or as merely an "upper."

As much as there is some feeling in some parts of the healthcare industry that hypothyroidism can occur when labs are normal, there is no significant, widely accepted view that this occurs with great regularity. There is such a thing as "subclinical hypothyroidism," but many doctors don't agree on whether it needs to be treated, much less to what degree. As lupus patients and as patients of other diseases, we MUST understand the difference between anecdotal-based beliefs and those that are based on more broad-ranging and scientifically-anchored study findings. Endocrinologists are continuing their research, and I really believe that some mysteries will be brought to light and unraveled in time. But some "truths" I've read about on the internet and elsewhere are not founded in any solid science and might potentially bring more harm than good.

As for synthetic versus "natural" thyroid hormone, there are many reasons why one is preferable to the other. Sometimes, patients respond better to "natural" thyroid hormone (Armour is one brand; there are others). Sometimes, they only need synthetic (of which Synthroid is one). Synthetic isn't necessarily "bad" and natural isn't necessarily "good." It depends on what hormones are needed and only a doctor who works with thyroid patients (preferably a reputable endocrinologist) can make that call. Also, if someone is vegetarian or has certain religious beliefs and practices, he or she should remember that "natural" thyroid hormone (which is still an artificially produced product) comes from animal thyroid glands (this has varied through the history of using natural thyroid supplemental hormone from sheep to pig).

And whether it is synthetic or natural, thyroid hormone supplement must be prescribed by a physician; it is not available over the counter in the U.S.

It is also possible to more finely calibrate the amount of T4 and T3 hormones a hypothyroid patient takes by taking a T4 dosage and a T3 dosage in separate, synthetically manufactured pills. In the natural thyroid hormone pills, T4 and T3 hormones (the hormones that play the most major roles in regulating metabolism) are combined in the same pill and dosages of one more than another cannot be separated from one anther. For example, I take Synthroid and Cytomel (which is synthetic T3) so that I can get specific doses of T4 and specific doses of T3 each day. This works for me. It might or might not work for someone else. Only a trained, reputable endocrinologist or thyroidologist can really determine this for sure.

In all of my research for my own health and my books, I've learned that although there are some doctors who fall short, the majority want what is best for their patients. If there were a cure for lupus, for example, our rheumies would be only too happy to provide us with it. An "us versus them" approach can only serve to create more of a rift at a time when we as patients need to be medically supported. Yes, we sometimes have to find a better, more well-trained or sympathetic doctor. But we also have to be honest with ourselves as to whether we want to find someone who will tell us what we want to know, or if we truly want to hear the truth about aspects of our conditions. For example, weight gain directly attributable to hypothyroidism, from all of my research and my own experience, is not usually significant. Eating and exercise habits play a much greater role in determining the amount of weight gained beyond the first 5-10 pounds of weight that can usually be attributable to an underactive thyroid gland. We also have to be aware of our moods, our willingness to change diet, and the support we get from our loved ones. We have to do our part, as hard as that might be at times when we feel our worst.

I've received sharp criticism from certain camps that I don't wholly embrace some of the new anecdotes and smaller studies that have shown some interesting varieties in diagnosing and treating hypothyroidism. I REALLY believe we have to work with our good, well-trained doctors. Medicine isn't perfect, but neither are we. Time will tell with the research that is being conducted now. And I'm committed to taking charge of the elements in my life that will help my outcome with the treatment I receive today, for lupus, hypothyroidism, Sjogren's, etc.!

Oooh, didn't mean to be so long-winded! But as you can tell, I feel really strongly about these (and other) topics! I REALLY appreciate this loop as a forum and as a place of friends -- I mean everything I say out of true compassion and fellow patient-hood!

The lowdown on the World Lupus Congress will be forthcoming...

Thanks for letting me ramble,

Maureen

www.maureenpratt.com