Thyrotoxicosis (eg by hormone doses that suppre... - Thyroid UK

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Thyrotoxicosis (eg by hormone doses that suppress TSH) gives a higher satisfaction than other dosages

diogenes profile image
diogenesRemembering
28 Replies

This review shows that apparent over treatment of T3 or T4 hormone (defined as suppressing TSH) gives a better quality of life. Downloadable.

Perros P, Hegedus L. Enhanced Well-Being Associated with Thyrotoxicosis: A Neglected Effect of Thyroid Hormones?. Int J Endocrinol Metab. 2022;20(2):e127230. doi: 10.5812/ijem-127230.

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diogenes
Remembering
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DippyDame profile image
DippyDame

brieflands.com/articles/ije...

Thank you diogenes ....a must read for me!

As someone who needs a supraphysiolgical dose of T3 to function this jumped out at me!

How and who should judge where the balance lies between harm and benefit, when harm from denial of treatment may equate to disability, while benefit from treatment may be prevention of premature death

Now to read the review closely!

louhop profile image
louhop in reply toDippyDame

What jumped out at me was…

‘For some patients, enhanced well-being associated with thyrotoxicosis is probably a feature of overtreatment with thyroid hormones, especially L-T3 containing preparations, and of untreated or partially treated hyperthyroidism.’

This could be translated by some medical professionals to ‘So you feel really well now - no depression and feeling happy? Oh dear, you could well be over medicated, I think we’d better lower your dosage and see how you get on!’

I know that’s very cynical and an exaggeration but given some of the stories you read on here, it could happen! I only hope this article raises a discussion on ethics around this topic but I fear not!

LindaC profile image
LindaC

Not the P Perros!?

diogenes profile image
diogenesRemembering in reply toLindaC

Some medics (ostriches) seem to be lifting heads out of the sand.

LindaC profile image
LindaC in reply todiogenes

Hmm, no signs of SP!? 🦕 Surprised T3 even mentioned!?

TaraJR profile image
TaraJR in reply toLindaC

Optimistic...!

LindaC profile image
LindaC in reply toTaraJR

🦕🐍😅🔍 I'd be very surprised if any change in that Dept! Still... who can tell!?

LindaC profile image
LindaC

WoW! By G He's Got It!

linda96 profile image
linda96

This is at the bottom of the PDF

Authors’ Contribution: P.P. conceived the idea upon an invitation from the journal EIC.

P.P. and L.H. read and approved the final manuscript. Conflict of Interests: PP and LH have received consultancy fees from IBSA Biochimiqe SA.

Funding/Support: No funding related to this manuscript.

Did they write it?

pennyannie profile image
pennyannie

Well oh well !!!

Who knew !!!

humanbean profile image
humanbean

There have been many people on this forum with treated hypothyroidism whose TSH drops well below range while Free T4 and Free T3 stay low in range.

How this can be classified as thyrotoxicosis baffles me.

linda96 profile image
linda96 in reply tohumanbean

Hegedüs wrote a paper earlier this year and he said (or maybe his ghost writer said) “There is little evidence of durable QOL quality of life improvements with levothyroxine and liothyronine combination therapy, or from therapy with desiccated thyroid hormone, from a multitude of randomized controlled trials and meta-analyses”. Hegedüs, L., et al 2022.

There is no softening of attitude from either of these gentlemen. PP retired earlier this year, he told me so in a private email, but his attitude lives on in print.

Not one thought about the rest of the body, only TSH and if low it must meant thyrotoxicosis. No ifs ands or buts., thyrotoxicosis - and we must like it, next they will be saying T3 is like cocai..!

UrsaP profile image
UrsaP in reply tolinda96

I believe that last bit has already been said linda96 🙄

helvella profile image
helvellaAdministrator in reply toUrsaP

An interesting idea for a combination medicine. :-)

tattybogle profile image
tattybogle in reply tolinda96

I tried to read the it without being too cynical , but failed . then i read it again more carefully and tried much harder to not be so cynical .. and still failed .

Somehow i just don't like the 'tone of voice' this review is written in,,, (by whoever actually wrote it )

With the best will in the world i couldn't stop wondering WHY exactly do they want a new category called 'well being' to investigate ?

.... what's wrong with people just feeling well ?

I'm afraid to say it reads rather like a precursor to launching a new training manual that say's " remember , you MUST explain to your patients that while they may indeed feel an enhanced sense of "well being" and lose weight on T3 (or 'too much' Levo ), they would also feel an enhanced sense of well being and loose weight if you let them have Heroin.. but it's not good for them, so they still can't have it "

And just for the record ( sorry to anyone who does have struggles with weight ) i'm sick of reading stuff saying the 'dissatisfied' thyroid group just want to take 'too much' to help them loose weight .. i 've never been over weight in my life , and i'm just as 'dissatisfied' with my Levothyroxine treatment as someone who is overweight would be ,,, because it doesn't make me feel well , or function properly .... and nobody listens when you tell them "It doesn't work like it say's on the Tin"

jade_s profile image
jade_s in reply totattybogle

It's “miraculous” you were able to read that twice. Very condescending tone.

UrsaP profile image
UrsaP in reply totattybogle

Ive been on T3 mono for 12 years, and my weight only became a problem 20 years early when I started on T4. T3 did not reverse that issue. These forms we now have to complete yearly so our Drs can keep saying they are not issuing T3 for weight issues - surely it is already on record that we are hypo T and that is for life!

Making getting our meds so so difficult and cumbersome to try to deter not just us but our chemists too, giving them more paper work, putting them off wanting to source the T3 for us. All sodding obvious tactics.

TSH110 profile image
TSH110

This reads to me that having a quality of life with a thyroid disorder is fundamentally abnormal and treatment protocol that achieves a decent quality of life for us is “over treatment” with thyroid hormones …not optimal treatment with thyroid hormones. It’s pure Tommy rot and just playing with words and an insult to those with thyroid disorder. I don’t like the terminology one bit. Let us get away from a miserable, under medicated life with hideous health issues, being regarded as “properly treated”, to a quality of life on adequate thyroid hormone therapy as the ideal state to be aimed for. It is not over treatment, it is optimal treatment for the individual concerned.

I don’t want a long miserable life of poor health, brain fog and depression I’d rather have a shorter life worth living.

I curse TSH and Levothyroxine - we were better off with NDT and dosing until symptoms ceased and given t3 monotherapy if not. Simple, common sense and better by a long chalk than the rubbish we have to put up with nowadays

UrsaP profile image
UrsaP in reply toTSH110

There was a T3 debate between Kristien Boelaert and Pete Taylor - the number of times the word ‘miserable(s)’ was mentioned was so obvious, they just keep putting more and more unkind, negative and dismissive labels onto us. Trying to bury us under them.

Look up a BBC programme aired around the time that the consultation to remove T3 from prescription was out, ‘White Gold’ it was called. The episode I saw, not through choice, as others watching depicted a character, a sweet little blonde girl who had married her childhood sweetheart. She had a thyroid problem and had turned into this big, overweight, greedy, face stuffing, angry, rude, depressive, manic prima donna, banshee. It was dreadful but reinforcing the ‘stereotypical’ view they wanted the public to have of us.

I doubt any of this is coincidental.

Would any other ailment be allowed to be depicted in this negative manner? I doubt it. IMO it is pure discrimination.

ps on T3 mono, my TSH is usually low, my T4 practically none existent and my T3 high in range and that suits me, I can live.

lidoplace profile image
lidoplace

Thank you for posting - I am so grateful that NDT is available and some medics are still open minded and courageous enough to prescribe it or T3 in spite of these prevailing attitudes - the rate of the others lifting their heads is much too slow !

SarahJane1471 profile image
SarahJane1471

Now this one I will definitely be showing my GP if I have to raise my Levo again!! My TSH is suppressed but my FT4 and FT3 are in range .Thanks diogenes

Jasp6 profile image
Jasp6

And there I was thinking that you could just possibly explain the improvement in quality of life because the treatment was better. Crikey, how much do these guys worship TSH as a measure of over-treatment? The knots they tie themselves into. Do they never stand back and question their bias?

pennyannie profile image
pennyannie

Luna1390

pennyannie profile image
pennyannie in reply topennyannie

Luna1390

Luna1390 profile image
Luna1390 in reply topennyannie

Got it! Thank you!!!

arTistapple profile image
arTistapple

A promising title. The impression that this was written after listening to patients. However the end result was that the patient cannot possibly have a say that is in any shape or form, sensible. Such lack of respect. Questionnaires are notoriously difficult to design, even those questionnaires with some but limited, differentiation to answer the main question. Tick boxes. I would really like to see copies of the questions and answers put to the patients before I read this research. I would like to be assured the correct questions were being asked in the first place. My imagination takes me to the question which brings about the answer “weight reduction”. I would be very relieved to lose weight but my answer would be fulsome. However they have likely closed down the question before a fulsome answer can be supplied. It reminds me of a loud conversation I overheard in a public place, where a Gynae consultant was telling some of his colleagues about the mother of a patient of his. She had asked whether chlamydia was genetic as both her daughters had been diagnosed with it, to lots of guffawing. Such lack of respect by these fine brains.

pennyannie profile image
pennyannie

NIKEGIRL

pennyannie profile image
pennyannie

NIKEGIRL

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