The standard of care for overt hypothyroidism is levothyroxine at doses that normalize serum TSH levels. Whether this approach universally restores thyroid hormone signaling is unknown.
Objective
To review studies of overt hypothyroidism in which participants were treated with levothyroxine to normalize serum TSH levels and measured other objective markers of thyroid hormone signaling.
Design
Databases were searched for studies that reported objective markers of thyroid hormone signaling (serum low-density lipoprotein (LDL), total cholesterol (TC), sex hormone-binding globulin (SHBG), creatine kinase and/or ferritin levels; cognition, energy expenditure, and/or renal function) in levothyroxine monotherapy for overt, primary hypothyroidism among nonpregnant adults with normal serum TSH levels. For studies with LDL, TC and SHBG outcomes, data were pooled using random effects meta-analysis.
Results
A total of 99 studies met inclusion criteria, including 65 that reported serum cholesterol data. Meta-analysis showed that levothyroxine-treated hypothyroid participants with normal serum TSH levels had 3.31 ± 1.64 mg/dL higher serum LDL levels (p=0.044) and 9.60 ± 3.55 mg/dL higher serum TC levels (p=0.007) compared to controls. In studies that did not concomitantly assess healthy controls, serum LDL levels were 138.3 ± 4.6 mg/dL (p<0.001) and serum TC levels were 209.6 ± 3.4 mg/dL (p<0.001). Meta-analysis of 2 studies showed no significant difference between SHBG levels of levothyroxine-treated participants and controls.
Conclusions
In studies that utilized levothyroxine monotherapy at doses that normalized the serum TSH for overt, primary hypothyroidism, not all systemic biological markers of thyroid hormone signaling were normalized, including serum LDL and TC levels.
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holyshedballs
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I am not aware of a single person amongst my immediate family, and aunts, uncles and cousins, who has (or had) diabetes of any kind - with one exception - my mother became diabetic after being put on statins.
I wouldn't touch statins with a barge pole!
Has your husband managed to put his diabetes into remission with dietary changes and giving up statins?
I think it is because they are taught that women are frequently hysterical, depressed and anxious. They have learned that having a thyroid problem makes this worse. They have learned that anti-depressants are the answer to depression and anxiety. And they have learned that statins are the answer to a high cholesterol level. Any patient who disputes any of these "facts" is hysterical, depressed and anxious, and so we come full circle.
Well,if that is the limited extent of their knowledge, then it is high time that we started to educate them, for the sake of following generations of sufferers........
In my case they assume I'm one of the hysterical, depressed and anxious types so I never go and see them. I would have to have a leg dropping off before I'd be happy to see them.
in reply to
Just my opinion but I think GP's (PCP's-Primary Care Physicians here in the US) have too much on their medical plates to effectively keep up with an illness (hypothyroidism) that may be best handled by endos. Even if they are motivated primary care is a specialty in itself. Adding another special body of knowledge would put me on overload. I suspect they might feel overwhelmed. I know they are pressured to handle many illnesses that ideally should go to a specialist. And there is always the money factor. Still, our systems rarely put patients first in this day and age. As usual,just my opinion. Take care. irina
in reply to
I feel that I must make one small comment..........
T4 converts to T3 which is the active hormone that is needed in every cell in our bodies,to be used for our health and well being.A lack of T3 leads to many conditions such as have been mentioned here.If we know that then so should GPs and yet they often refuse to test T3 levels.
The thyroid is a small but most important gland,fundamental to everyone's good health. Thank goodness we have Thyroid UK.
in reply to
I agree. Sometimes I think the thyroid is the most important organ, If our thyroid isn't working sooner or later every other system develops problems.
The curriculum given to teaching colleges for GPs by the Royal College of General Practitioners regarding Endocrine disorders at 3.17(Care of People with Metabolic Problems) has very little on thyroid problems. it has a section on thyrotoxicosis (thyroid storm) but the section GPs get hung up on is the line that states a GP should "Recognise the potential for abuse of thyroxine and propose strategies to reduce dosage".
Ironically this line is in the Communication and Cunsultation tab.
Dr Malcolm Kendrick’s book “The Great Cholesterol Con” explains why statins are not necessary for most people and how the side effects are can be harmful.
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