diogenes in reply to helvella2 years ago

There is one comment here in the paper.

Few studies have examined the morbidity and mortality of individuals on long-term LT3 treatment. In this large, longterm registry-based study, including the full adult Swedish population on thyroid hormone replacement therapy, we did not observe any increase in breast cancer incidence, any cancer incidence, all-cause mortality, any cancer mortality, or breast cancer mortality in individuals using LT3 compared with LT4-only treatment. These results were similar after correcting for possible confounders. There was evidence of lower mortality in LT3 users in models adjusting for dose.

This I would read as that T3 addition may be helpful and not worse in mitigating adverse effects, but that related to dose, the T3 situation could be an improvement on T4 alone.

helvellaAdministrator in reply to diogenes2 years ago

Thank you.

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helvellaAdministrator in reply to Tythrop2 years ago

This document shows the opinion of several influential doctors towards the end of UK manufactured Thyroid BP.

dropbox.com/s/zbiyjk19wjsq4...

I think it is also the case that at the time of that being originally published, the potency of Thyroid UK was not so well controlled as it could now be.

(I'd have liked to point at the USA desiccated thyroid products as examples of what can be achieved but they have had a pretty bad recent history.)

Probably also didn't help that UK and USA desiccated thyroid products were formulated to different potencies - so one grain of Thyroid BP was less potent than one grain of Thyroid USP. That could have resulted in under-dosing if anyone swapped to Thyroid BP, or over-dosing if they swapped to Thyroid USP, without realising the difference.

TSH110 in reply to Tythrop2 years ago

It’s a nonsense we should be able to choose what therapy we take; they treat us like babies with no rights over what we put inside ourselves whatsoever - it makes me furious I’m not an infant, I’m an intelligent well informed adult, fully able to decide for myself what thyroid therapy suits me best. They should darn well facilitate it. I’ve paid my NI subs all my adult life supposedly to protect my health. I didn’t pay it to be forced on to an inadequate medication that made me ill all because I have the misfortune to suffer from a thyroid disorder, and be effectively lied to by being led to believe it was the only option - it wasn’t. It’s a scandal.

tattybogle in reply to TSH1102 years ago

Well said!

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Tythrop in reply to diogenes2 years ago

You try getting a diagnosis here in uk that will then lead to any therapy. Years of very low T3 (my results are on earlier posts) have helped me not at all.. even endocrinology consultant paid privately (to speed up seeing soneone). Thats why I get Armour fron USA. Would rather do it officially here.

penny in reply to Tythrop2 years ago

I found out that my FT3 was 0.01 at some stage and nothing was said or done about it.

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Tythrop in reply to penny2 years ago

What were they thinking? It is SO disempowering

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helvellaAdministrator in reply to diogenes2 years ago

I do understand that.

However, that begets a question which should make the medical professions uneasy:

Does one TSH test, once a year, constitute careful monitoring?

My view is that it doesn't and can't. That, of course, applies regardless the treatment.

TSH110 in reply to diogenes2 years ago

We are and very much appreciate the post , but we’d like to get it (NDT/T3) prescribed on the NHS, not be buying it on the internet. I even see people here left suffering with highly abnormal blood tests, trying to find out where to buy T4. But the comments were an aside on my part.

tattybogle in reply to Tythrop2 years ago

Also NHS don't look at antithyroid antibodies in blood... at least not in my experience;

i feel quite lucky then ... turns out they've done my TPOab three times without me asking/knowing about it.

but i don't know why they did the second two... one might have been to recheck the original wasn't a mistake as it was so high.

they were then done again about 15yrs later, which might possibly have been triggered by an unexpectedly over range TSH .

I'd never though about your point re. retrospective malpractice due to info available for years.... i guess that could be playing a part in maintaining the staus quo.

Even 20 yrs ago, when i now discover it seemed easier to be prescribed T3 on the NHS and it was much cheaper than now, i wasn't told about an option of 'other' thyroid hormone treatment..... just told to look for 'other causes' of remaining symptoms on Levo. ) ie. in my head .

But they would probably just say there wasn't 'evidence it was better than levo' ., and 'evidence' is unfortunately different to 'knowledge' (and it can be manipulated to say what the authors/funders want it to)

helvellaAdministrator in reply to jimh1112 years ago

A good reason to consider T3?

Depending on how you read this, T3 might reduce mortality.

ThyroidVol. 31, No. 5 Thyroid Dysfunction: Hypothyroidism, Thyrotoxicosis, and Thyroid Function Tests

Liothyronine Use in Hypothyroidism and its Effects on Cancer and Mortality

Tereza Planck, Fredric Hedberg, Jan Calissendorff, and Anton Nilsson

Published Online: 3 May 2021doi.org/10.1089/thy.2020.0388

Abstract

Background: The prescription of liothyronine (LT3) to treat hypothyroidism is increasing worldwide; however, the long-term safety of LT3 use has yet to be determined. Previous studies have suggested a possible association between LT3 use and breast cancer. The aim of this study was to examine the effects of LT3 use on cancer incidence and mortality.

Methods: Our sample included the full adult population of individuals living in Sweden with at least three purchases of thyroid hormone therapy between July 2005 and December 2017. Individual-level data on drug purchases were linked to registry data on cancer incidence and mortality. There were 575,461 individuals with at least three purchases, of which 11,147 had made at least three purchases of LT3, including combinations of levothyroxine (LT4) and LT3. Individuals were followed for a median follow-up time of 8.1 years. We applied Cox regression with a time-varying exposure variable, comparing LT3 users (individuals with at least three cumulative purchases of LT3) with LT4-only users (the rest). Outcomes included breast cancer incidence, any cancer incidence, all-cause mortality, any cancer mortality, and breast cancer mortality. We adjusted for age, sex, previous thyroid cancer, previous other cancer, use of antithyroid preparations, use of sex hormones, and dose in multivariate analyses.

Results: Multivariate analyses produced a hazard ratio of 0.93 (95% confidence interval [0.75–1.15]) for breast cancer incidence (only females), 0.97 (0.87–1.08) for any cancer incidence, 0.69 (0.61–0.77) for all-cause mortality, 0.78 (0.62–0.98) for any cancer mortality, and 0.91 (0.50–1.66) for breast cancer mortality (only females).

Conclusions: In this large, Swedish, long-term registry-based study, the use of LT3 did not lead to increased breast cancer incidence, any cancer incidence, all-cause mortality, any cancer mortality, or breast cancer mortality compared with LT4 use. Somewhat surprisingly, there was evidence of lower mortality in LT3 users in models adjusting for dose, potentially an artifact of underlying associations between dose and health status/diagnosis.

liebertpub.com/doi/10.1089/...