Guides lines on Levothyroxine out of date

[debsdoyle71]

I came across this yesterday, in a magazine from my local health food shop.

gla.ac.uk/news/headline_520...

What do you all think? As I was hoping to be prescribed levothyroxine.......unsure now what to do!

[greygoose]

If you can get it prescribed, get it! They don't give any alternative, do they? So, what else are your going to do? Continue to suffer? Even if it doesn't get rid of all your symptoms, it might be better than nothing. You should at least try it.

There seems to be some conspiracy, at the moment, to stop treating 'older' people all together - just let them rot, I suppose! Cheaper that way. So, I wouldn't be inclined to listen to any study that didn't come up with a better solution to propose. You know that studies can be made to prove anything they want to prove.

But, I'm just an 'older' cynic...

[helvella Administrator in reply to greygoose]

Abstract of paper here:

nejm.org/doi/pdf/10.1056/NE...

Seems to me that older people might exhibit poorer conversion of T4 to T3. In that case, adding a bit of levothyroxine (T4) might have little benefit - on its own. The doses were based on TSH with the treated lot achieving a mean of TSH = 3.63. We really wouldn't expect anyone's issues to resolve when under-treated, would we? I started noticing symptoms with a TSH of a tiny bit over 2.0. What would have happened if treatment had been increased to the point of TSH = 1 (or nearby)?

It would, in my view, have been appropriate to identify the individuals and how their symptoms changed. Looking only at the bulk statistics covers up individual changes.

Surely any trial like this requires knowing that the subjects have adequate selenium? B12? etc.

As always, lack of full detail allows us to speculate but not fully understand.

[greygoose in reply to helvella]

That's always the problem in these studies, isn't it! They under-treat, and ignore the FT3. Always the same!

[helvella Administrator in reply to greygoose]

I also question why we would expect TSH production to remain intact and completely unimpaired in someone who is a) long-term hypothyroid; b) older (and hence many organs are working less effectively)? After all, it is a classic that older people eat less, and can only manage smaller meals - at least partly their digestive systems cannot digest large meals.

[humanbean]

The research being mentioned is probably the paper discussed in this post by helvella :

healthunlocked.com/thyroidu...

The paper came up with the stupid conclusion by making sure that they gave the subjects the absolute bare minimum of levothyroxine to get them into the reference range. In other words the subjects were left under-medicated. Since they still had loads of symptoms the conclusion was that treating subclinical hypothyroidism in the elderly was pointless.

In my view the research was completely dishonest, and cruel and sadistic in every way. I bet the aim of it was simply to find a way of reducing prescription costs.

[greygoose in reply to humanbean]

Totally agree. They also ought to redefine their definition of 'sub-clinical'. If the patients had symptoms, they weren't 'sub-clinical'!

[cwill in reply to greygoose]

Another example of bad science. Just running a study but not actually understanding the issues such that you don't measure what you should. Nothng added to our understanding other than how poor this lot are at research. But they 'meausred' something.

[debsdoyle71]

Thank you for your replies, No I don't want to continue to suffer, I will now put that cut out I have in the bin where it belongs!

I am so new to all of this, so reading everything I can on hashimoto's thyroid, B12 and vit D......my head hurts with it all 😂

[greygoose]

Shaws, I'm not sure you understood. They are not saying that 'older' people should be given something other than levo, they are saying they should be given nothing at all.

[shaws Administrator in reply to greygoose]

Greygoose, I have certainly misunderstood not thinking that I am one of the 'older' people - in that case it is ridiculous. Off for another read of post.

[greygoose in reply to shaws]

It certainly is rediculous!