The following I've probably published before but may be of interest to newer members who are having problems with levothyroxine. I don't have a link so the article is below:-
Increased Incidence of Disease and Medication Use Among Patients on T4-replacement
Researchers recently conducted the first large, community-based study in the UK of the health status of hypothyroid patients using T4-replacement therapy.[37] Compared to matched control patients, hypothyroid patients on "adequate" dosages of T4 had a higher reported incidence of four diseases: depression, hypertension, diabetes, and heart disease. Hypothyroid patients on inadequate T4-replacement (their TSH levels were elevated) also had a higher incidence of strokes. In addition, hypothyroid patients chronically used more prescription drugs, especially for diabetes, cardiovascular disease, and gastrointestinal conditions.
We’ve recently been consulted by many hypothyroid patients whose physicians have reduced their T4 dosages to extremely low amounts, in some cases as low as 25 mcg. The patients report to us that their physicians refer to reports by endocrinologists that TSH suppression increases the risk of atrial fibrillation three-fold. As I explain in Addendum 4, this is an unjustified generalization from a study of elderly (60 years of age and older) sedentary people. This misguided practice by physicians is likely to increase the patients’ incidence of coronary artery disease and cardiac fatalities.
The dosage of T4 that suppresses the TSH level varies considerably, but may be as much as 171 mcg or as little as 50 mcg.[56][57][58][59][60][61][62] Hypothyroid patients should be concerned when their physicians restrict them to lower-end dosages of T4. In one study, researchers used coronary angiography to assess the progression of coronary atherosclerosis in elderly hypothyroid patients. In 5 of 6 patients who kept their T4 dosages at 150 mcg or more, the disease didn’t progress. But in all 6 patients whose dosages were 100 mcg or less, the disease had progressed.[63] This study suggests that elderly patients whose TSH levels are suppressed by fairly low dosages of T4, and whose physicians insist on keeping their TSH levels within the reference range, may, as a result, have increased progression of coronary artery disease, leading to strokes and/or heart attacks. In that the incidence of atherosclerosis is high even among young individuals in modern societies, younger hypothyroid patients should be concerned over the possibility of lower dosages of thyroid hormone inducing or exacerbating atherosclerosis.
Dilemma for the Endocrinology Specialty
The four studies that are the subject of this document clearly show that neither T4- nor T4/T3-replacement is effective for many hypothyroid patients. The ineffectiveness of the two replacement therapies translates into three likely adverse consequences for these patients with inadequate thyroid hormone regulation: continued suffering from symptoms, susceptibility to potentially disabling or lethal diseases, and increased use of drugs to control the symptoms and diseases. The endocrinology specialty sets and maintains practice guidelines for the diagnosis and treatment of hypothyroidism; that it does so imposes upon it an ethical and humanitarian responsibility to expediently act to protect hypothyroid patients from the three adverse consequences. That responsibility is the compelling reason for the endocrinology specialty to promptly reform its incorrect official position that T4-replacement is safe and effective for all hypothyroid patients.
Many researchers, physicians, and patient advocates believe that the endocrinology specialty has been curiously obstinate in its advocacy of T4-replacement. Its obstinacy is evident in its disregard for the protests of thousands of patients and a growing number of doctors that T4-replacement is ineffective and harmful for many patients.
The specialty’s obstinacy may be sustained by financial incentives from corporations that profit from the practice of T4-replacement therapy. This suspicion of financial motivation is reinforced by the specialty’s standard method of enforcing the practice of T4-replacement among doctors: political tyranny rather than scientific argument and debate. The suspicion will only mount if the specialty—despite the recent studies showing replacement therapies to be ineffective[1][2][3][4] and harmful[37][63] for many hypothyroid patients—sidesteps the issue now at hand. How safe and effective is T4-replacement compared to alternate approaches to thyroid hormone therapy now in widespread use? For its own credibility, it is imperative that the specialty immediately address this issue free from prejudicial preconceptions.
This is a good example of what present accepted assumptions are regarding T4 treatment, combination therapy re control by TSH levels
Evidence that T3 may be required by some people
