The T3-4-Hypo trial (Netherlands): As with all... - Thyroid UK

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The T3-4-Hypo trial (Netherlands)

helvella profile image
helvellaAdministratorThyroid UK
11 Replies

As with all such trials, we can hope.

The T3-4-Hypo trial

A Dutch national randomized placebo-controlled double-blind multicenter trial of LT4/LT3 combination therapy in patients with autoimmune hypothyroidism.

t3-4-hypotrial.nl/english/

I note that the criteria specify "assay-specific reference ranges" for TSH. At last! A trial that formally recognises assay variations.

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helvella
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SarahJane1471 profile image
SarahJane1471

🙌please tell me this is good news and maybe it could be we get a trial like this here?

I’m being thick……. TSH would have to be in range?

helvella profile image
helvellaAdministratorThyroid UK in reply to SarahJane1471

Yes - TSH in range at start of trial!

I have not gone down into the detailed protocol of the trial. Someone pointed it out to me and I immediately thought it worth posting.

SarahJane1471 profile image
SarahJane1471 in reply to helvella

it really could be great news then! You’ve put a smile on my face helvella

Jaydee1507 profile image
Jaydee1507Administrator

I'm liking "persistent compaints, based on the patients own experience, without judgement of the treating physician."

Gaslighting needs to stop!

helvella profile image
helvellaAdministratorThyroid UK in reply to Jaydee1507

Very much agreed.

Jaydee1507 profile image
Jaydee1507Administrator in reply to helvella

However I'm not a fan of this part.

Serum TSH levels are measured at every visit, and medication dosages adjusted if needed, with the goal to normalize serum TSH to levels within the assay-specific reference range.

So when does the TSH get discredited finally? I suspect this study will fail to prove anything.

RedApple profile image
RedAppleAdministrator in reply to Jaydee1507

'So when does the TSH get discredited finally?'

The trial is about whether LT4/LT3 combination therapy is helpful for 'severe tiredness', whilst keeping TSH within range. I don't see that as unreasonable as long as absolute bottom of range TSH is acceptible.

Jaydee1507 profile image
Jaydee1507Administrator in reply to RedApple

True, it might help, but it's really not the complete answer, still I suppose progress.

helvella profile image
helvellaAdministratorThyroid UK in reply to Jaydee1507

I know this means yet further delay in proper acceptance of T3 regimes, but the outcome of this might be a very helpful stepping stone.

If, for example, much of the tiredness resolves while keeping within TSH reference interval, it could argue that at least slightly higher T3 dose, leading to a slightly lower TSH would look much less controversial as a way of resolving the remaining excess tiredness.

BB001 profile image
BB001

I like that they've included patients with subclinical hypothyroidism. It's almost as though they're admitting subclinical hypothyroidism is just hypothyroidism - though I doubt they are.

Zephyrbear profile image
Zephyrbear

I hope that, by insisting the TSH remain within “range” this research isn’t being deliberately set up to fail… my TSH dropped drastically and became almost undetectable within months of my having T3 added to my T4 and yet, I feel fine. Insisting on TSH “normal values” is not going to prove of any benefit to either participants or the research.

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