Lower FT3 a sign of increased risk of mortality in diabetes

[diogenes]

This recent paper shows the adverse forecast for mortality with lower FT3.

Lower free triiodothyronine levels are associated with higher all-cause and cardiovascular mortality in people with diabetes-NHANES 2007-2012

• Diabetes Research and Clinical Practice 202:110811

• DOI: 10.1016/j.diabres.2023.110811

• Chang Lui

• Zhong Xin

• Lin Hua

Lower free triiodothyronine levels within the reference range are associated with higher cardiovascular mortality: An analysis of the NHANES panel

Abstract

Objective: Thyroid hormone plays a key role in maintaining cardiovascular system homeostasis. However, there is limited evidence regarding the correlation between normal range thyroid hormone levels and all-cause mortality or cardiovascular mortality among individuals with diabetes. Method: This retrospective study analyzed data from 1,208 individuals with diabetes who participated in the National Health and Nutrition Survey (NHANES) conducted in the United States between 2007 and 2012. Weighted Kaplan-Meier (KM) analysis and Cox proportional hazards models were used to explore the association between thyroid hormone indices and mortality. Results: The Weighted Kaplan-Meier (KM) analysis revealed statistically significant differences in survival probabilities across free triiodothyronine (FT3), free thyroxine (FT4), FT3/FT4 ratio and thyroid-stimulating hormone (TSH) groups (p < 0.05 or < 0.001). In the multivariate adjusted Cox proportional hazards models, higher levels of FT3 were founded to be associated with decreased all-cause mortality (HR (95% CI), 0.715 (0.567, 0.900)), cardio-cerebrovascular mortality (0.576 (0.408, 0.814)) and cardiovascular mortality (0.629 (0.438, 0.904)). Notably, this correlation was more significant among individuals over the age of 60, as indicated by the results of the nonlinear regression analysis. Conclusion: FT3 is an independent predictor of all-cause death, cardio-cerebrovascular and cardiovascular death in euthyroid subjects with diabetes.

[DippyDame]

Something else to show the naysayers that T3 is vitally important!

[Nat107]

Thanks Diogenes, my mum has hypothyroidism and diabetes, she was diagnosed with heart failure last year, then hospital kept her in after her follow up appointment they found her to have heart block so a pacemaker was fitted the next day

[klr31]

I thought that low FT3 can be an indicator of risk of death in older patients anyway?

Karen

[LindaC]

well, Well, WELL - naysayers who have since accepted the use of T3, have since stated that some people need to be above range... oh, but not when dx'd by the likes of Dr S, Dr P. This whole field seems so appallingly misunderstood; deliberately? who can tell in these strange times!?

[jimh111]

The study is here sciencedirect.com/science/a... . Note that you can get a copy for free by requesting 'Patient Access' on the top line.

This is a very compex study so I won't have time to read it. I'm not sure but I think it has a flaw in that they don't appear to have excluded people who died within a year of two of the thyroid blood test. This is important because cardiac problems present with 'low T3 syndrome' and so the study could have suffered bias.

In general people with TSH, fT3 or fT4 outside the reference interval tend to have shorter lives. There are a number of studies that show cardiac risk increases with fT4 even within the reference interval (after excluding the first two years after the assay). This is explained by actions of T4 on cell membrane receptors. There are also studies that show adequate T3 is needed for good cardiac health, I can't be specific on this as I've only glanced at them over the years.

A rather obvious observation is that human (and animal) evolution over thousands of years has produced combination therapy. It is rational to assume that this gives a survival benefit. There is some variance in individual T3 and T4 levels but I have never seen a case of thyroxine monotherapy occuring in nature.

[Brightness14]

I have read many articles that state the same. Keep up the T3 levels.

[arTistapple in reply to Brightness14]

Yes and yet it seems to be completely absent from any guidelines. I have overt heart symptoms and even although I am seventy years old with a heart attack (no known cause allegedly) twenty years behind me with continuing symptoms; I can’t get a proper NHS referral to an endo (particularly useless in my area anyway). I am beavering away but at some point (assuming I will survive long enough) I will have to confront the powers that be, properly about this negligence.

[Brightness14 in reply to arTistapple]

I know that when I had a bad batch of Ndt Thyroid s that I started falling over and bumping into things too. I had my thyroid out 8 years ago and have no other gut or Hashi so starting from a level playing field. I am fine when my FT3 is above 6. After I tested it regarding the bad batch in just forty days it was 2.76 Ft3 I know that's the reason for the falling down.

Also if you have low FT3 results and no thyroid you cannot be operated on my operation on my ear has been delayed until September. Doctors give all sorts of reasons for aches and pains apart from the real reason Low T3. That is my opinion for what it's worth.

I live in France and the health care system here is great. If I wanted to see and Endo I would just go online and book an appointment.

You can take T3 with food you know but it would work out at a lower percentage of medication.