Benefits of T3 on QoL in patients symptomatic on T4 only

[diogenes]

Paper showing benefit of T3 on female patients on T4 only and displaying symptoms

Frontiers in Endocrinol (Lausanne)

. 2022 Feb 22;13:816566. doi: 10.3389/fendo.2022.816566. eCollection 2022.

Effect of Liothyronine Treatment on Quality of Life in Female Hypothyroid Patients With Residual Symptoms on Levothyroxine Therapy: A Randomized Crossover Study

Betty Ann Bjerkreim 1 2 , Sara Salehi Hammerstad 3 4 , Hanne Løvdal Gulseth 5 , Tore Julsrud Berg 1 2 , Lars Johan Omdal 6 , Sindre Lee-Ødegård 7 , Erik Fink Eriksen 3 8

PMID: 35273566 PMCID: PMC8902821 DOI: 10.3389/fendo.2022.816566

[JGBH]

Thank you for pointing this paper out. Couldn’t access it but will try later again. Was this published by professor Olivier Lamy et al? If so I have come across it in the past few months. I was on levothyroxine monotherapy for decades post thyroidectomy for papillary adenocarcinoma and have been on combined T4/T3 for 2 years now. It has made a difference to my QoL from the thyroïdism front. I have other health issues though.

[NieuwOndaatje]

Many thanks! I think the full version is also accessible from the following hyperlink: ncbi.nlm.nih.gov/pmc/articl...

[TaraJR in reply to NieuwOndaatje]

Yes, excellent, thank you

[jimh111]

I think you've mentioned this one already healthunlocked.com/thyroidu... .

[diogenes Remembering in reply to jimh111]

May well have done, as there's so much data similar to this one coming out now. Too much for my head to keep all of it in. However in this regard I smell a bandwagon!There's scope for a lot more of this to come, as it now seems exciting to the medics so as to get more papers out on a juicy topic, to the benefit of their research programmes and prestige. I do sense a change in the intellectual air, however.

[jimh111 in reply to diogenes]

Very typical of medical research, noone is interested until a brave team sets a new standard and then everyone is able to get funding and publish studies no matter how trivial.

The classic example is helicobacter pylori, no journal was interested only the New York Times and "The Star" (the thrash tabliod). Since then there have been 47,728 papers published pubmed.ncbi.nlm.nih.gov/?te... .

[Mollyfan]

This is great, thanks for highlighting it!

[Geegee777]

Thank you 🌸🌸🌸🌸🌸

[knitwitty]

Hi Diogenes many thanks for posting this.Could I ask, do you think any UK Gp's are likely to take any notice if we present them with information such as this , which is non UK research?

I have just written to my GP asking for T3 to be prescribed, following 6 letters from the Endo asking for it to be included alongside my Levothyroxine prescription.

I have been up against a brick wall for almost 3 years , but I am hoping that now the practice has merged , and we are part of a much larger practice they will prescribe it finally.

Having documents such as this, if they would be accepted by a UK GP, might help if I am refused again.

[diogenes Remembering in reply to knitwitty]

Could help. Nothing to be lost in doing so.

[knitwitty in reply to diogenes]

Thank you, I am hoping that I won't need to ask again but it's always good to have some research up one's sleeve !!

[Hennerton]

Sadly there appeared to be no thyroidectomy patients in this study. Why are we always excluded from such studies? Or more to the point why is there not a study purely for thyroidectomy patients? We are forgotten in all respects and yet there are plenty of us around.

[diogenes Remembering in reply to Hennerton]

I don't think it matters too much how the thyroid has been operated on. Loss by Hashimoto's. or by surgical thyroidectomy or radioactive thyroidectomy all lead to the same thing - a deficiency or loss of the gland. What follows is up to the rest of the body and brain to respond to..

[Hennerton]

Sorry to disagree with you but I am not convinced of this.

With failure of the thyroid, such as Hashimoto’s, this happens slowly and the T1, 2, 3, 4 and calcitonin are presumably still produced, albeit in smaller quantities. With radioactive treatment, again the gland is still there, possibly producing some hormones and possibly the body may adjust in its own way, even though eventually it will totally fail.

Thyroidectomy is an immediate assault on the body and whilst we are automatically given Levothyroxine, it takes months to become consistently euthyroid and in fact as soon as I was considered “balanced,” the levels would change again over a few weeks. It was like living on a seesaw. Even now, with the benefit of Liothyronine, (after struggling for six years on just Levothyroxine) I am still not the person I was before my operation. Most patients will probably agree with me and if they do not, I should love to know their secret. Please tell the rest of us.

Only by regularly including patients who have had a full thyroidectomy, will studies be worthwhile. To ignore them because they are considered exactly the same as other patients is why we struggle so much to lead a full and happy life. I should love to be given T1, T2 and calcitonin, even though I am told it is not necessary. Has a study ever been done to prove it? I think the short answer is probably “ no” .

I am sorry to sound so forceful and I do not wish to upset you, because I know you have done wonderful studies and have helped us in many ways but I think I speak for the many thyroidectomy patients across the world.

[diogenes Remembering in reply to Hennerton]

For me, the principal problem with surgical thyroidectomy is that it routinely upsets and/or destroys the working of the parathyroid gland. This gland is so intertwined with the thyroid that it often gets removed partially or wholly and sets up future problems for the body in addition to thyroid loss. I take your point about the suddenness of surgical thyroidectomy but I think there is more to it than that.

[Hennerton in reply to diogenes]

I agree that there is probably more to our long term problems than the shock to the body but surely we shall never find out if thyroidectomy patients do not figure in all the studies?

[Hennerton]

If the parathyroids are routinely upset and mine definitely were, is this long term damage? I was given to believe it was only temporary and that they would recover 100%. I have not had symptoms of which I am aware, apart from the initial ones, immediately after the operation. Are you suggesting that the damage is long term, even if we are not aware of it? What other symptoms would we have, please?

[diogenes Remembering in reply to Hennerton]

Parathyroids at best get a temporary shock after thyroidectomy and recover. But you are unfortunate and too much gets removed and you then have to treat hypocalcinemia for life.

[bantam12 in reply to Hennerton]

It’s possible to manage perfectly well with a very small amount of one parathyroid left after surgery. I had a parathyroid tumour removed and the surgeon thought it was the last parathyroid I had as he couldn’t find anything else, I did have hypocalcemia afterwards and was on high calcium supplements for a few weeks but whatever parathyroid was left lurking somewhere it recovered enough to function.