Thank you for that Rod. I'm not given to writing to my GP but in light of his recent (over) reaction to my request for NDT - loud lah lah lah-ing when I mentioned that "some" people buy it on line - I think I will drop it in for him. Education education education ..........
Yes it was surprising to see his exaggerated reaction to buying therapeutic meds online. As if I'd told him I was frequenting a dark multi-storey late at night to buy crack cocaine
By "preferred" I assume they meant "felt better on" as I can see no other reason why they would have preferred it. I wish doctors would listen to patients, it would solve a lot of problems, feeling better usually because of fewer symptoms/side effects must surely save money in the long run as it negates quite a lot of other medications for various secondary illnesses
I think the trial should have been for longer and the doses should have been higher.
When taking NDT, the TSH levels shouldn't be the ones relied on, it should be the thyroid hormones, i.e. FT4 and FT3. Had this been the case, I think the NDT would have been shown as far superior.
I agree that the conversion doses were very conservative (i.e. resulting in too low desiccated thyroid dosing). The advantage of that, for anyone reading and thinking, is that we can interpret those results as "even when under-dosed, a significant proportion of patients preferred desiccated thyroid".
Yes, we need to see trials of some sort going on for much, much longer. After all, if hypothyroidism is most often a life-long condition, so too will be the treatment. So we want to know what happens on the long haul. However, it could become difficult to achieve that on ethical grounds if after, say, two years one or other apparently had an undisputed advantage, then we might never manage to get an assessment of the difference after ten, twenty or thirty years.
Let us also not forget that some people, after trying desiccated thyroid, revert to "synthetic" (whether T4 only, T3 only or a combination) and feel that is better for them. We really don't want to push out a doctrinaire message that people must use desiccated thyroid because others do better on it. Some definitely seem not to do well on it. Horses for courses - whichever works best for you.
But no-one is better off long term with levo, its only T4 and over the years your body starts to just not convert properly, you NEED T3 for all bodily functions, temperature, chemical conversions, muscle and joint health etc. Its a great pity that most doctors (and endocrinologists) do not recognise poor adrenal functions or poor conversion rates not to mention they NEVER listen to their patients!!
Funnily enough, the person going through my mind is a very intelligent woman who has taken desiccated thyroid, levothyroxine tablets, and, I think, liothyronine. So she knows enough and has the experience. Last I heard she was on straight Tirosint and feeling very well.
Those who are allergic to pigs might also have a problem (I know there are a few non-prescription cattle products).
Those with religious or moral objections to some or all animal products also have a problem.
I have absolutely no faith that we patients, struggling as we might, always get it right. We criticise the endos for confining their treatment to things they think they know about, we should not fall into a trap of making any assumptions that ALL people will ALWAYS do better on desiccated thyroid and/or some T3.
No one ever mentions the T2, T1 and the calcitonin that our bodies would get if our thyroids functioned properly. No amount of T4 and T3 can give you these additional 3. So where does that leave us after years of not getting these?
Why do we NOT get T2 and T1 if we do not have thyroids?
T2 and T1 are almost exclusively produced by the conversion from T3 and, in turn, T2. Which takes place in the cells of our bodies. Quite possibly every cell.
There is much confusion suggesting that MIT and DIT are sometimes misidentified as T2 and T1. They are not.
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