A good paper on the progress of T3-only patients and no extra AF or osteoporosis compared with normals.

[diogenes]

A paper by Dr G Leese has appeared in Clinical Endocrinology. This shows that for 400 patients on T3 only for 17 years followup there was no increase in AF or osteoporosis compared with normals and no increase in statin use. Louise Warvill has the paper in full if you want to download it. The paper's site if anyone can download direct is: Graham P Leese, Enrique Solo-Pedre, Louise A Donnelly

Clinical Endocrinology: Accepted manuscript online: 4 March 2016

DOI: 10.1111/cen.13052

Rather makes a nonsense of many other papers on the risks of AF and OP when T3 is used even in conjunction with T4.

[HarryE]

Is this the same Graham Leese that made a fool of himself in the Scottish Parliament recently?

[diogenes Remembering in reply to HarryE]

It most certainly is. I felt he behaved there like a "timid rebel". That is, he had this info which went against traditional beliefs but was too scared to bring it out in the open for fear of offending the great and good. So therefore, he came out very badly as a person who couldn't make a decisive answer to anything.

[HarryE in reply to diogenes]

That's exactly how he came out!

[Hidden in reply to HarryE]

Ammunition for Lorraine surely??!!

[SmallBlueThing]

Doesn't the risk of atrial fibrillation increase with free T4, giving another argument for substituting some T3?

[diogenes Remembering in reply to SmallBlueThing]

The studies on increased risks of AF and OP are all fatally compromised because 1) FT3 was often never done so we don't know if some were indeed overdosed, and 2) we now know that people have varying abilities to convert T4 to T3 from the really very good, through the average, to the poor. As all studies mixed these up, we don't know if the really good converters were those who were at greatest risk of overdosing and thus contributed overmuch to the overall outcome. I think all these studies can be tipped into the scientific dustbin as inadequate and unproven.

[humanbean]

Helvella wrote a post about this paper a few days ago :

healthunlocked.com/thyroidu...

[diogenes Remembering in reply to humanbean]

I don't have anything on my site since the publication of this full paper on March 4th. Perhaps you are referring to an earlier precis paper he put out before this more formal effort.

[jimh111]

This is interesting. I haven't got the full paper yet. Some purely academic comments:-

One would expect L-T4 to be a little safer than L-T3 due to the regulatory role of deiodinase and more stable hormone levels.

It's reasonable to expect patients receiving L-T3 to be more severly hypothyroid (more difficult patients) and this might be why there was an increased incident use of antipsychotic medication. Also, L-T3 is known to help some patients who are refractory to anti-depressants and so may have been prescribed for this purpose.

My guess is that the lower hazard ratios for atrial fibrillation and fractures was because (presumably) more attention was paid to signs and symptoms rather than blood tests (the L-T3 patients had LOWER TSH values). This confirms that signs and symptoms are more relevant than blood tests.