I have posted below the abstract from a piece of research carried out by a non-pharmaceutical research team that has no vested interest other than patient health. Although it doesn't say what measures for quality of life were used, therefore one cannot critique the lack of results showing improvement, a double-blind randomised crossover trial shows that people on NDT feel better. This is sufficient to begin a more widespread - as well as heated - debate in the endocrinology field, and is a starting point not only for the demand for further research, but also to begin to back up the few endos who care for their patients deeply enough to listen, not do harm and do their best for their patients' welfare.
J Clin Endocrinol Metab. 2013 May;98(5):1982-90. doi: 10.1210/jc.2012-4107. Epub 2013 Mar 28.
Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study.
Hoang TD1, Olsen CH, Mai VQ, Clyde PW, Shakir MK.
Author information
Abstract
CONTEXT:
Patients previously treated with desiccated thyroid extract (DTE), when being switched to levothyroxine (L-T₄), occasionally did not feel as well despite adequate dosing based on serum TSH levels.
OBJECTIVE:
Our objective was to investigate the effectiveness of DTE compared with L-T₄ in hypothyroid patients.
DESIGN AND SETTING:
We conducted a randomized, double-blind, crossover study at a tertiary care center.
PATIENTS:
Patients (n = 70, age 18-65 years) diagnosed with primary hypothyroidism on a stable dose of L-T₄ for 6 months were included in the study.
INTERVENTION:
Patients were randomized to either DTE or L-T₄ for 16 weeks and then crossed over for the same duration.
OUTCOME MEASURES:
Biochemical and neurocognitive tests at baseline and at the end of each treatment period were evaluated.
RESULTS:
There were no differences in symptoms and neurocognitive measurements between the 2 therapies. Patients lost 3 lb on DTE treatment (172.9 ± 36.4 lb vs 175.7 ± 37.7 lb, P < .001). At the end of the study, 34 patients (48.6%) preferred DTE, 13 (18.6%) preferred L-T₄, and 23 (32.9%) had no preference. In the subgroup analyses, those patients who preferred DTE lost 4 lb during the DTE treatment, and their subjective symptoms were significantly better while taking DTE as measured by the general health questionnaire-12 and thyroid symptom questionnaire (P < .001 for both). Five variables were predictors of preference for DTE.
CONCLUSION:
DTE therapy did not result in a significant improvement in quality of life; however, DTE caused modest weight loss and nearly half (48.6%) of the study patients expressed preference for DTE over L-T₄. DTE therapy may be relevant for some hypothyroid patients.
PMID: 23539727 [PubMed - indexed for MEDLINE]
Web address: ncbi.nlm.nih.gov/pubmed/235...
Here is a summary article of the trial from the ATA:-
CLINICAL THYROIDOLOGY FOR PATIENTS
A publication of the American Thyroid Association
HYPOTHYROIDISM
Desiccated thyroid extract vs Levothyroxine
in the treatment of hypothyroidism
BACKGROUND
Hypothyroidism, or an underactive thyroid gland, is a common endocrine problem and requires lifelong treatment with thyroid hormone pills. Untreated hypothyroidism is associated with a wide variety of symptoms, many of which are nonspecific. In particular, memory problems and depression (psychometric problems) as well as weight gain are very common symptoms in hypothyroidism but also have multiple other nonthyroidal causes as well. Levothyroxine is the main thyroid hormone produced by the thyroid gland and the synthetic form is the most common form of thyroid hormone replacement therapy. Prior to the availability of the pure levothyroxine, desiccated animal thyroid extract was the only treatment for hypothyroidism. Today, some individuals prefer dessicated thyroid extract as a more “natural” thyroid hormone. In addition, some patients who continue to have symptoms of hypothyroidism when taking levothyroxine report improvement in these symptoms when switched to desiccated thyroid extract. This study was performed to compare levothyroxine to desiccated thyroid extract in terms of thyroid blood tests, changes in weight, psychometric test results and patient preference.
THE FULL ARTICLE TITLE
Hoang TD et al Desiccated thyroid extract compared
with levothyroxine in the treatment of hypothyroidism:
A randomized, double-blind, crossover study. J Clin Endo-
crinol Metab 2013;98:1982-90. Epub March 28, 2013.
SUMMARY OF THE STUDY
This was a study of 70 patients with hypothyroidism who were treated with either desiccated thyroid extract or levothyroxine for 12 weeks followed by a switch to
thyroid.orgthe other option for another 16 weeks. The participants were “blinded” during both phases – they did not know the type of pill they received. After each treatment period patients were weighed, had blood tests, underwent psychometric testing and were asked which therapy they preferred. The researchers report that 49% of the patients preferred desiccated thyroid extract, 19% preferred levothyroxine and 23% had no preference. Desiccated thyroid extract use was also associated with more weight loss. There was no difference in the psychometric testing or in any symptoms. Both types of thyroid hormone were able to normalize the abnormal thyroid blood tests.
WHAT ARE THE IMPLICATIONS
OF THIS STUDY?
Although desiccated thyroid extract is not widely used, this study showed that many patients preferred this option as compared with levothyroxine. This result was observed despite there being no differences in thyroid function blood test and psychometric test results, although use of desiccated thyroid extract was associated with some weight loss. These results suggest that there may be a certain number of patients in who desiccated thyroid extract might be a reasonable treatment option. Further research is needed on this topic to confirm which patients this might benefit the most form desiccated thyroid extract therapy.
Angela M. Leung, MD, MSc
ATA THYROID BROCHURE LINKS
Hypothyroidism: thyroid.org/what-is-hypothy...
Thyroid Hormone Treatment: thyroid.org/
Thyroid research project
