A freind recently pointed out that recent research casts doubts on the efficacy of Levothyroxine. I think this is the research she meant
I've been on gradually increased dose (to 75mg) for a couple of years. Symptoms vary but dont perceive any overall benefit. Medics seem to be far more concerned with my diagnosed rogue parathyroid gland.
Any thoughts?
This research - if you can call it that! - is about sub-clinical hypothyroidism. Were you diagnosed with sub-clinical hypothyroidism?
My thoughts on levo… Well, whilst it didn't suit me, I think that levo, like all other forms of thyroid hormone replacement, is only as good as the doctor that prescribes. And, most of them have scant knowledge of thyroid, so little wonder that it doesn't help a lot of people.
Two main reasons why it might not help:
1. You're not given enough of it.
2. You can't convert it to T3.
There are other complications, but those are the two problems we find the most often on here. And, doctors don't understand that just prescribing levo in increasingly large doses, until the TSH comes down to somewhere in the range, is not good enough.
Levo suits millions of people perfectly well - I don't know how many of them were sub-clinical, but, then again, I dispute the definition of 'sub-clinical'.
The trouble with all research is that it can be made to prove whatever you want it to prove. And, as doctors hate nothing so much as diagnosing and treating hypothyroidism, they would be very happy if research proved it wasn't worth the bother.
So, if I were you, I would take that 'research' with a pinch of salt. And, if you want opinions as to why you're not benefiting from levo, post your latest results on here, and lets have a look - for a start, you're probably under-medicated, because 75 mcg is only a small dose. 
There were very many of posts on here last week deriding this "research "
Hardly surprising many on Levothyroxine don't feel benefit, far too frequently patients are left on far too low a dose - Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine
Absolutely essential to do FULL Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Medichecks currently have an offer on until end of May - 20% off
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)
nhs.uk/medicines/levothyrox...
' "There were very many of posts on here last week deriding this "research" '
Oh, that research! Say no more!!!
I don't think the paper is throwing doubts on the efficacy of levothyroxine at all; in effect, the opposite is being implied, because it is rejecting the necessity of it being prescribed to those who allegedly don't need it ie those with subclinical hypothyroidism. There have been several other threads about it, one of which gives a link to the full paper if you wanted to read the detail behind the graphics.
There have been a few threads in the last couple of weeks discussing this research. These are some I found - it probably isn't a complete list :
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Hoping diogenes might consider submitting a suitable response to this article in the BMJ ?
bmj.com/content/365/bmj.l20...
We see hundreds, if not thousands, of patients whose TSH is under 10 with clear and obvious symptoms of hypothyroidism.
No mention anywhere in this article of thyroid antibodies, low vitamin levels or substantial impact on quality of life that hypothyroidism can have. No mention of central hypothyroidism either
A low TSH doesn't rule hypothyroidism out, because just testing TSH is completely inadequate
When I was diagnosed my TSH was "only 8" but both TPO and TG Thyroid Antibodies were in the many thousands .....I was extremely fortunate to have a good GP who didn't only test TSH
I'm rather busy at the moment. Our group has two papers in submission for review and another on the stocks almost ready to go. And having been severely bruised by reviewers on this journal, with another year spent in trying to get the rejected paper actually published elsewhere (which it eventually was after much travail) I don't feel like taking on more. I think Tania Smith said it all. Perhaps when we have more of the story out I can begin to think about more work. T3 only is still a minefield because the evidence of its safety hasn't yet filtered through generally. And our group haven't T3-only experience. Central hypo shortcomings of TSH we do mention now and then.
Research papers
Dr Pete Taylor’s Fund Thyroid Research Petition 📣🔔🔊💬
Fibromyalgia research funding petition
