A new paper provoking strong negative responses on Twitter.

[TaraJR]

For those on Twitter / X ...

x.com/Bianco_Lab/status/186...

Prof Bianco wrote: The authors are concerned with the increasing utilization of LT3 in the treatment of hypothyroidism" Title: "Limiting the use and misuse of liothyronine in hypothyroidism"

Note: Bianco doesn't personally comment on it. There is no online access to it at the moment, but I've been sent it as a PDF. I'll paste below; apologies for the length. Take a deep breath.

Limiting the use and misuse of liothyronine in hypothyroidism

Authors: Laszlo Hegedüs, Endre Vezekenyi Nagy, Enrico Papini & Petros Perros

Liothyronine treatment for some patients with hypothyroidism has preoccupied academics, clinicians and patients for decades, and is a controversial topic in thyroidology. Persistent symptoms are at the heart of this discourse and, contrary to scientific evidence, liothyronine use is increasingly common. Aetiologies and interventions beyond thyroid dysregulation and pharmacological approaches must be pursued.

Over the past 20 years, prescriptions for thyroid hormones, including liothyronine, have increased (1), which mirrors a downward trend in the threshold of thyroid-stimulating hormone (TSH) levels at which thyroid hormone therapy is commenced (2). The majority of people being treated for hypothyroidism either have mild (subclinical) hypothyroidism or were euthyroid before starting treatment. One of several reasons for the inclination to treat people who are euthyroid is the misconception that symptoms that are compatible with hypothyroidism are more reliable than thyroid function biochemistry in the diagnosis of hypothyroidism (2). If symptom relief is the goal, then therapeutic failure and disappointment is assured for this group of patients.

Drivers for these increases in diagnoses and treatment include misinformation (especially internet-enabled misinformation) about symptom attribution and ‘direct-to-consumer’ thyroid function tests, which circumvent professional clinical assessment and facilitate indiscriminate biochemical screening for thyroid dysfunction. Physician-related contributors include a lack of appreciation that common hypothyroid-like symptoms (such as fatigue, brain fog, mood swings and weight gain) are associated with a low pretest probability of detecting overt hypothyroidism, pressure from patients to perform unnecessary tests and to be treated with thyroid hormones, and a willingness to prescribe levothyroxine for people who are euthyroid for non-evidence based-indications (2). Unexplained persistent symptoms are at the centre of diagnostic and therapeutic inflation.

The suggestion that combination treatment (levothyroxine and liothyronine) might be an antidote to persistent symptoms comes from evidence extrapolated from some elegant rodent experiments. This low tissue tri-iodothyronine (T3) hypothesis has been tested in patients with hypothyroidism in a large number (n = 19) of randomized controlled trials(1). Systematic reviews and a meta-analysis have concluded that combination treatment is not better than levothyroxine monotherapy in alleviating patient symptoms and impaired quality of life (1). Yet, liothyronine is still prescribed and its advocates justify it by citing real-life experiences.

Individual testimonies from patients who are treated with liothyronine contrast with findings from randomized controlled trials. Transformative recoveries following treatment with liothyronine are regularly reported(3). However, these reports need to be interpreted with caution. Surveys have shown that a large proportion of people who are treated with liothyronine continue to be symptomatic and to have a poor quality of life(1). Those with good responses might represent true examples of low tissue T3, adequately addressed by liothyronine. In our experience, many patients receiving liothyronine are overtreated and might experience an enhanced sense of wellbeing as a result of overuse and misuse of liothyronine (4) Patients treated with liothyronine have usually been repeatedly denied it by their physician and have completed an arduous journey before accessing such medication. In such cases, belief perseverance might prevail when the result is disappointing.

There are at least two additional contributors to the extraordinary phenomenon of the use (and misuse) of liothyronine continuing to rise, despite robust evidence of non-superiority of combination treatment over levothyroxine monotherapy. First, published guidelines by professional organizations have produced ambiguous recommendations on this topic, which are widely open to interpretation(5,6). Second, some influential experts are focused on combination treatment as the principal remedy for persistent symptoms, and allow little room for exploration of other approaches.

Overtreatment with levothyroxine (and probably liothyronine), leading to low (and particularly suppressed) serum levels of TSH, is associated with increased risks of cardiovascular morbidity, osteoporosis, dementia and death (2). Use of liothyronine often leads to low serum levels of TSH3. A study published in 2022 has highlighted an excess risk of heart failure and stroke in patients treated with liothyronine (7). In this retrospective, propensity-matched study in Korea including 1,434 people taking liothyronine and 3,908 taking levothyroxine alone (34.7% and 40.1%, respectively, had a history of thyroid cancer), the use of liothyronine was associated with increased incidence of heart failure and stroke in patients with a longer duration of liothyronine use and a history of thyroid cancer. The risk of stroke was also higher in people taking liothyronine who did not have a history of thyroid cancer and had ≥52 weeks of liothyronine treatment, as compared with people taking levothyroxine alone (7). The potential consequences of failing to address all possible root causes of persistent symptoms and offering a treatment that could be no more effective than what patients are already receiving raises additional ethical concerns.

The non-superiority of combination treatment over levothyroxine should not surprise us, as there is no consistent correlation between serum levels of T3 and persistent symptoms (8). Furthermore, the symptoms that combination treatment aims to address are exceedingly common and widely experienced by the non-hypothyroid population and people with other morbidities. Titrating thyroid hormones against symptoms that often fluctuate widely and unpredictably is inherently problematic. Therefore, it is necessary to consider alternative possibilities. Exclusion of comorbidities (such as other autoimmune diseases) is recommended by guidelines and is probably done effectively by most physicians. However, the role of ‘medically not yet explained symptoms’ (MNYES) is often unappreciated (2).

Endocrinologists usually do not receive training in recognizing and managing MNYES. Yet, up to 30% of patients attending internal medicine outpatient clinics have MNYES2. A large international survey of people treated with thyroid hormones has revealed a high prevalence (58.6%) of probable somatic symptom disorder, a diagnosis that is closely related to MNYES9. The same survey showed that type D personality (a vulnerability factor for general psychological distress related to somatic symptom disorder and MNYES) was present in 54.2% of respondents (10). Both somatic symptom disorder and type D personality were associated with the perception that symptoms were poorly controlled by thyroid medication and with dissatisfaction with care and treatment.

The diagnosis of MNYES is reached by excluding other causes of symptoms. An empathetic approach during the medical consultation and reassurance that there is no underlying serious cause (a skill set that should be in the toolbox of every physician) can help most people presenting with MNYES. For more difficult cases, collaboration with primary care physicians and sometimes input from other healthcare professionals is needed (2).

In summary, the conundrum of unexplained persistent symptoms in people treated with thyroid hormones poses a considerable challenge for both patients and physicians. This hypothyroid controversy has featured in every annual meeting of the European and American thyroid associations over the past decade. Consensus has not been reached, and progress is limited by the narrow view that it can be fixed by finding an elixir with the right mix of levothyroxine and liothyronine. In our view, the negative randomized controlled trials do not invalidate the low tissue T3 hypothesis. However, the evidence suggests that it is much rarer than has been proposed. If MNYES is the true elephant in the room, then low tissue T3 is the mouse in the corner. Both live in the echo chamber of the hypothyroid controversy.

Limiting the overuse and misuse of liothyronine requires an honest and unbiased consideration of both elephant and mouse.

Published online: 24 October 2024

References

1. Hegedüs, L. et al. Primary hypothyroidism and quality of life. Nat. Rev. Endocrinol. 18, 230–242 (2022).

2. Hegedüs, L. et al. Medically not yet explained symptoms in hypothyroidism. Nat. Rev. Endocrinol. 20, 685–693 (2024).

3. Michaelsson, L. F. et al. Treating hypothyroidism with thyroxine/triiodothyronine combination therapy in Denmark: following guidelines or following trends? Eur. Thyroid J. 4, 174–180 (2015).

4. Perros, P. & Hegedüs, L. Enhanced well-being associated with thyrotoxicosis: a neglected effect of thyroid hormones? Int. J. Endocrinol. Metab. 20, e127230 (2022). 5. Bianco, A. C. & Taylor, P. N. Optimizing the treatment of hypothyroidism. Nat. Rev. Endocrinol. 20, 379–380 (2024).

6. Biondi, B., Celi, F. S. & McAninch, E. A. Critical approach to hypothyroid patients with persistent symptoms. J. Clin. Endocrinol. Metab. 108, 2708–2716 (2023).

7. Yi, W. et al. Heart failure and stroke risks in users of liothyronine with or without levothyroxine compared with levothyroxine alone: a propensity score-matched analysis. Thyroid 32, 764–771 (2022).

8. Medici, B. B., la Cour, J. L., Michaelsson, L. F., Faber, J. O. & Nygaard, B. Neither baseline nor changes in serum triiodothyronine during levothyroxine/liothyronine combination therapy predict a positive response to this treatment modality in hypothyroid patients with persistent symptoms. Eur. Thyroid J 6, 89–93 (2017).

9. Perros, P. et al. Hypothyroidism and somatization: results from E-Mode Patient Self-Assessment of Thyroid Therapy, a cross-sectional, international online patient survey. Thyroid 33, 927–939 (2023).

10. Perros, P. et al. Hypothyroidism and type D personality: results from E-MPATHY, a cross- sectional international online patient survey. J. Clin. Endocrinol. Metab. doi.org/ 10.1210/clinem/dgae140 (2024).

Nature reviews endocrinology Volume 21 | January 2025 | 3–4 | 4

[tattybogle]

they are getting desperate aren't they , our friends from the dark ages .

ahh diddums ......

" how dare some influential endocrinologists not agree with us , we've explained repeatedly and it's quite simple .... if the TSH isn't humungous, there's nowt wrong with em , simples , no point treating 'em cos they always be moaning about something , it's just who they are ...sad attention seeking moaners.....

oh darn it ~ we can't use 'somatic symptom disorder' cos there's no evidence they have it , so we'll change that to 'probable somatic symptom disorder' call it PSSD and hope no one notices that it's 'not actually a thing'.... and then we'll conveniently forget to include 'probable' for the rest of the page .

and darn it some more , those pesky patients realise that MUS means 'we think it's all in ya hed'..... so we'll have to change that to MNYES ..... Crikey , we're running out of stupid patronising acronyms , we'd best order some more from Simon at head office "

thanks Tara .... i've filed it where it belongs , under Petty Minded Garbage

think there was a post where we discussed this particular piece of garbage a few wks ago , if i find it i'll add a link later.

EDIT :adding links to related posts :

healthunlocked.com/thyroidu...... (Elephant -or-mouse? ~ an earlier post about the same article )

healthunlocked.com/thyroidu... hypothyroidism-and-somatization-results-from-e-mode-patient-self-assessment-of-thyroid-therapy~ a post form 2 yrs ago, on the origins of some of the 'research' this article references .

[JGBH in reply to tattybogle]

Hear! Hear! How accurate an analysis. How obnoxious these people are!

[tattybogle in reply to JGBH]

Methinks it's time we started to think up some SPADT

(Stupid Patronising Acronyms to Describe 'Them')

[JGBH in reply to tattybogle]

Absolutely ! What is the problems with such people, not wishing to help patients? Not that intelligent..

[tattybogle in reply to JGBH]

'What is their problem', .......yes exactly that,

if they don't want to get involved in helping a group of patients they see as 'unhelpable' , fine , they could jog on ,and leave those who are interested to get on with it .... i really can't see what drives their need to try and put a stop to anyone who thinks something can be done and is trying stuff out with good results for some people , or is doing intelligent research on how thyroid hormones work best in individuals...

why are they so afraid to contemplate anything outside their little "Janet and John Ladybird Book of TSH " ?

maybe they should talk to someone about thier insecurities , it could be a subconscious fear of being found to be wrong , or that one where you end up at school in your pyjama's and all the clever kids are laughing at you ...... i'm sure they have friends who sell CBT , maybe they could get a few sessions at mates rates .

[JGBH in reply to tattybogle]

They probably have friends with benefits from Big Pharma.. the more unwell people become the more drugs to ‘correct’ the problems will be prescribed by GPs.. and still more drugs to help with secondary effects etc. Moi, a touch cynical….

[TSH110 in reply to tattybogle]

Sadism? Misogyny? Psychopathy? Ageism? Or more likely all four

[Rapunzel in reply to tattybogle]

I will forever fail to understand that whilst endocrinology is in its infancy, so many bare assertions are made about inefficacious T4

'T3 is dangerous, causes strokes and heart disease and anyway T4 is better.' is the basis of what this states. None with the condition were consulted, because that's never necessary.

Good job this is digital - the binmen come tomorrow...

[sparkly in reply to tattybogle]

Tatty, you really are on form tonight 🦸‍♀️ Do think you could run for Prime Minister please? 💪😃👌

[tattybogle in reply to sparkly]

no

[TSH110 in reply to tattybogle]

Who’d want to take hold of such a poison chalice? And when everyone else thinks they or even their deceased cat could do a better job of it. Id like to see them try. or perhaps not….especially the dead cat

[tattybogle in reply to TSH110]

"..not the dead cat " lol .... i'd be happy to let Larry the cat have a go ..., i think he'd do well.

[TSH110 in reply to tattybogle]

They throw them out everywhere to distract but as for taking the reins it’s a new on one me it would be very effective as a diversionary tactic I guess imagine the rumpuss (😁)

Larry will have seen and heard a thing or two over the years for sure

[Pandora777 in reply to sparkly]

She will do a better job than our present one!

[Sparklingsunshine in reply to Pandora777]

My cat could do a better job than any of them and I dont even have a cat anymore.

[Tina_Maria in reply to Sparklingsunshine]

😂

[JoJoloveschocolate in reply to Sparklingsunshine]

😂😂

[JGBH]

Thank you Tara. So it never ends. These people are so full of themselves. Ignorami

[helvella Administrator]

Aetiologies and interventions beyond thyroid dysregulation and pharmacological approaches must be pursued.

Is resistance to thyroid hormone/impaired sensitivity to thyroid hormone a form of thyroid dysregulation?

I suggest that, in the biochemical approach this paper seems to go towards, RTH is not a form of dysregulation. After all, someone can have what appear perfectly good TSH/FT4/FT3 results, yet suffer from the inability of the thyroid hormone to have the required effects on thyroid hormone receptors.

And just what approach beyond "pharmacological" could be expected to work?

Do they really think that diet and exercise, talking therapies, etc., could ever be appropriate for RTH?

[tattybogle in reply to helvella]

oh you mustn't worry about that hel ... they already told you , that's soooo rare you don't have to think about it ... cos they said so .

[TSH110 in reply to helvella]

It’s argybarble speak for fatuous nonsense

[TSH110 in reply to helvella]

just talk that tired old thyroid out it and tell it to pull up its socks - sorted

[TSH110 in reply to helvella]

The walk, chomp and chat it better brigade about sums them up completely out of their depth suggesting puerile solutions to something they have no real comprehension of. Charlatans

[helvella Administrator]

Liothyronine treatment for some patients with hypothyroidism has preoccupied academics, clinicians and patients for decades, and is a controversial topic in thyroidology.

On the one hand, they are saying that patients are preoccupied with the issues of liothyronine. To some extent rightly recognising that many patients do what they can to understand the science, to keep up with the subject, and to look after themselves as well as they are able.

They then see fit to publish papers such as this - which I consider vital for patients to be able to read - behind a paywall which makes them inaccessible!

Effectively, paywalls preclude patient access to most papers through the standard approaches. Having to plead with journals, make contacts, or use potentially dodgy links is not acceptable.

[helvella Administrator]

I've just posted in relation to this post:

When two papers go to war

healthunlocked.com/thyroidu...

[arTistapple]

Same old rubbish being trotted out again. No shame at all. He does love the word somatoform. He does spitefully like to ensure no patient might be having an “enhanced sense of well-being”. What is that anyway? If I experience anything remotely in that ballpark, I can be pretty sure I pay dearly for it later. My enhanced sense of well-being tends to be spent changing my bedclothes, or washing my hair, or dealing with my tax bill (usually under great duress) so I don’t go to prison.

[waveylines]

Ahhhhh these little men with nothing better to do than malign let's be honest us women with jumped up complete pseudo babble nonsense......that they think we won't be able to see it for what it really is- junk!! Or maybe they were worried we'd see right through so hid it behind a pay wall!! Cowards! How dare we figure out what we need without their pretty heads with their massive over inflated egos fake superiority complex over us mere women. Their, their boys you need some in depth long term psychotherapy with a good smattering of those psychtropic drugs to calm you down and sort out your dillusions of grandeur, bring you back into reality and to process through your suppressed anger towards assertive FEMALE patients.

[TSH110 in reply to waveylines]

How about chemical castratration? They don’t need all those sex hormones and claims they do is nonsense it’s all in their heads.

[waveylines in reply to TSH110]

😂🤣😂 don't get me started!!

[TSH110]

😡🤬🤯

[Zephyrbear]

Is there no way all of us patients who have recovered large chunks of our former health by the use of Liothyronine can get together and put together some sort of publication to highlight the positive effects associated with it? Hell… maybe we could become a significant part of that “elegant rodent” echelon!

Why don’t they ever ask those of us who are actually on the receiving end of the treatment??? Or are they that afraid of the answers they will get?

[waveylines in reply to Zephyrbear]

I think you answered your own question Zephyrbear. They are of a certain ilk.....& am telling you, you can't change illogical madness. The one I did battle with told me he was personal friends to another in that group. This Endo told my ICB that NDT is "dangerous " for me. Exact words ICB quoted. Even though I'd been on it for 17yrs and it had taken me through rigorous long cancer treatment and countless consequential operations sucessfully!! The evidence flies totally against his allegement.....and the very same person could not provide me with any research evidence to back his proclaimations as he hinself said there isn't any research!!. He was oblivious of the research that came out in May of this year in favour of ndt. Despjte all of this ignorance and the fact his unsubstantiated view flew in the face of four other nhs endos who said yes I need NDT the ICB still decided it was dangerous because he said so!!

This IS the madness we are all up against. No amount of reasoning/science will disuade them because their opinions are not rational and science based at all but fantasy and conjecture. Can't reason with a madman.....or in this case madmEn

[sparkly]

In our experience, many patients receiving liothyronine are overtreated and might experience an enhanced sense of wellbeing as a result of overuse and misuse of liothyronine

In my experience over the 12 years I've been on T3 only. This sums up what the medical profession think T3 is..a drug we get a kick off.

Three times by 2 different endocrinologist and a GP i have been told " anyone would feel good if they took T3" like it was an illicit drug I am taking.

We who suffer now low tissue T3 does very much exist. Why can't they?!!

[waveylines in reply to sparkly]

They're very proud and egocentric! Such people don't conceded even when presented with strong evidence that what they're saying is wrong they wont back down. Their weapons one is to generate more bunkem to support the bunkem they're alleging. And do it goes on.....lol

[mrskiki in reply to sparkly]

I’d quite like an ‘enhanced feeling of wellbeing’, for a while, thinking about it, it doesn’t even have to be enhanced!

[waveylines in reply to mrskiki]

Isn't that a description of a "high" Think they've got confused with narcotics......am not aware of its link to heroine or opoids!!!

[Sparklingsunshine in reply to sparkly]

They make T3 sound like LSD or magic mushrooms, not a substance we normally produce ourselves. God knows what they make of Dopamine, Serotonin and Endorphins, instruments of the Devil probably.

The thought of patients having " an enhanced sense of wellbeing" isnt that the whole point of being a doctor, to make people better?

[sparkly in reply to Sparklingsunshine]

Absolutely!

[waveylines in reply to Sparklingsunshine]

Maybe they don't think you have Hypothyroidism unless you are suffering......after all apparrantly it's now normal to feel unwell with this condition when it's well managed with your TSH in range according to a nhs endo.......and like that I will be safe from harm! Based on what evidence if no "harm" he wasn't clear. Some GPs think that means up to a TSh of 10 on treatment is still fine. One despairs.

In reality it's medieval torture without a physical rack.....and sadly it does cause harm.

[TSH110 in reply to Sparklingsunshine]

It’s nothing like LSD or magic mushrooms or any mind altering drugs - but they do dish those out like smarties in the form of antidepressants, without so much as a bat of an eye.

It’s unbelievable they bad mouth a necessary hormone but are happy to ram mind altering garbage into people, about which we really know very little.

[arTistapple]

Aplogies and thanks Tara. For some reason I thought helvella had put this one up. So apologies to him too.

[Gruij]

The final author listed in this article works in the Newcastle Hospital Trust along with the “esteemed” Professor with the TSH obsession. Nothing of value to see here boys and girls.

[helenshubby]

Well, if our experience with even a tiny amount of of T3 (2.5 mcg) daily has shown an improvement in Helen’s wellness and improved thyroid hormone levels and reduction in Cholesterol, ferritin etc is anything to go by, this article is a complete load of bollox!

Am I right in thinking this bunch of idiots have done nothing but read and interpret a load of other studies without actually doing any research themselves?

It would be good to see the authors join the ranks of the autoimmune hypothyroid to see how they cope on mono therapy when for whatever reason their bodies fail to convert T4 to T3. Too many heads in the clouds here.

[tattybogle in reply to helenshubby]

m I right in thinking this bunch of idiots have done nothing but read and interpret a load of other studies without actually doing any research themselves?

no unfortunately it's worse than that .. they are the one's doing the *bleep* 'research' in the first place : then repeatedly referencing their own *bleep* research in further articles to prop up their equally *bleep* opinions :

(don't go here if becoming cross will spoil your day)

healthunlocked.com/thyroidu... hypothyroidism-and-somatization-results-from-e-mode-patient-self-assessment-of-thyroid-therapy

healthunlocked.com/thyroidu...... elephant-or-mouse...

[waveylines in reply to tattybogle]

That's the name of the game tattyboogle. Then what's even better for them they have more published research which gains them more prestige and recognition.....you're not considered active unless you keep.publishng even if you are reiterating your own bogus results repeatedly so someone can use all those published papers as evidence it is the case. This is the nonsense of research evidence laid bare. Lol....

[Pandora777 in reply to waveylines]

A few years ago I visited a consultant gynaecologist because I had fibroids. I took my husband to back me up because he was a hospital manager and was used to dealing with doctors in his job. The man we saw came from south Africa and was a large black man. I explained to him about my heavy bleeding and asked if there was anything I could take to treat it. He then started to lecture me on how the women in his country never complained and would walk miles to give birth and never asked for help. Well my husband listened patiently to him and then replied. “Well we are not in your country are we? We are in the UK so can you please treat my wife and stop lecturing to her and me about what your women put up with because it has nothing to do with us!” I came away with some tablets to help with the bleeding 😀

[HowNowWhatNow]

eh?!!

“Misconception that ..” (not very scientific way to show your bias on your sleeve.)

[HowNowWhatNow in reply to HowNowWhatNow]

Who needs symptoms and medication to address them when you can have doctors telling you it’s all in your mind?

Amirite, ladies?

[helenshubby in reply to HowNowWhatNow]

It's not only lasses getting gaslit! The more I read of research medics misdemeanours the less confidence I have in their understanding. The influence these miscreants peddle is far too excessive and ignores experienced symptoms.

[HowNowWhatNow in reply to helenshubby]

yes. I am saying the ladies bit because thyroid hypo-ism is primarily on women and because the the sort of patronising - little women - short shrift given to patients feels gendered. If it was a male condition would they all be written off so fast?

[tattybogle in reply to HowNowWhatNow]

thyroid disease is a male condition too, less men get it than women, but this forum is for both , and some of our valued contributors are male. We see regular posts/ replies from men of all ages whose problems with thyroid disease diagnosis and treatment have been written off by their doctors / endo's.

i put it to you that if you developed a disease that was predominantly suffered by men , and when you went to support groups , you found they were mainly populated by men some of whom constantly made comments along the lines of 'you have had it easier than we do because you are female ' .... you would not be ok with that ?

[HowNowWhatNow in reply to tattybogle]

Hi

The quality I have received for conditions that are only or that are mainly suffered by adult women has in general been markedly worse than those which all humans can be afflicted by. I haven’t had any male-only conditions, this is true.

On leaving the hospital after I had our first child - feeling lucky to be alive after the paucity of help I had had - my husband turned to me and said “if men had babies, their care wouldn’t be anything like this”. Ie. It would be much better.

We can disagree on the facts and stats, we can disagree on our experiences, we can even disagree on our opinions and the way to express them. Such is the nature of public forums.

If acting out of concern for how women are treated in medicine eventually helps men who are badly affected by suffering from a condition that mainly affects women, would that not be a very helpful thing for them too?

[TSH110 in reply to HowNowWhatNow]

When I was in Africa the tribe l lived with told me if men had babies humanity would long ago have died out! That was the men speaking not the women.

[janeroar in reply to HowNowWhatNow]

Completely agree with you.

This report reeks of misogyny. It’s not anti-male to say that. I think a lot of us are on this forum because thyroid issues aren’t being properly treated because they are largely suffered by women. As a consequence males with these conditions are also being badly neglected.

[Pandora777 in reply to janeroar]

What gets me is when I worked in a hospital pharmacy the pharmacist did not take into account that women react differently to men when it comes to drugs

I also noticed how Viagra is sold over the counter in most pharmacies. It’s A Man’s Man’s World as the song title states so flipping true imho!

youtu.be/ClhBXVygWbc?si=TMx...(Not working as expected?)

[TSH110 in reply to tattybogle]

But the latest research has shown considerable gender bias in things like treatment for heart attack with men receiving prompt appropriate treatment and women having symptoms belittled and sent home to die. The general state of affairs pertaining to women’s health in the main has been on a trajectory downward, iron infusions stopped except for those who are almost dead, child birth deaths the highest in Europe , ditto mothers dying in childbirth, thyroid hormone treatments withdrawn lock stock and barrel and on and on it goes. The targeting of provision for women’s health not to mention the great pension theft, to save money has been actively and knowingly decided upon and is accepted almost unquestioned by a society that is still deeply misogynistic. The hypothyroid men probably bear the brunt of this prejudice too it’s hard to see how they’d get better treatment given the appalling level of ignorance displayed by the medical profession in its diagnosis and effective treatment, with options bar Levothyroxine removed, ridiculously high bars to jump before getting treatment despite a growing body of evidence showing the detriment to health by this stupid watch and wait till TSH is over 10 two or three times in a row protocol now being adhered to.

It’s just getting worse and worse. The mysogyny behind it has to be called out surely?

[tattybogle in reply to TSH110]

i agree with all you say there ~ that wasn't the reason for my comment (which was intended as a request to be more considerate towards the men on the forum)

[TSH110 in reply to tattybogle]

I hope I always am, it’s no fun for anyone having a thyroid disorder especially with the medical incompetence we have to face.

[HowNowWhatNow in reply to TSH110]

“Women’s history is the primary tool of women’s emancipation”

The state of maternal healthcare in the U.K. is at such scandalously bad and life-threatening levels that it should be being debated weekly in the House of Commons and life-saving improvements funded to boot.

It doesn’t help any men who have thyroid conditions that thyroid care is perceived as being such a low-order health problem, beneath diabetes and all other endo issues. It doesn’t help the male children of the women who have these conditions either.

We can all agree that thyroid healthcare is in a parlous state in the U.K.. Things need to change. Whether we achieve that via a greater awareness of the gender imbalances or through an awareness of the economic loss it causes or through any optic lens matters less to me than the fact that change happens and soon.

[TSH110 in reply to HowNowWhatNow]

Couldn’t agree more

[waveylines]

At some point some "new " research will pop up with the effects of undertreatment or no treatment on the heart. Antheroclerosis will be rediscovered as a consequence though the statins pharma will do their best to suppress this as they will be benefitting from all the people on them due to rising cholesterol & heart disease. Of course this is not new at all been known about for decades.....just got lost in the noise of it's " all in your mind " research..... they'll also rediscover BP goes up with under or no treatment for hypothyroidism.....

eventually.

I probably won't be around for the "big reveal......" but eventually full circle will happen.

[Judithdalston]

What a difficult read, think my GP must have had a preview as 2 months ago or so threatened me with DEATH as my TSH is 0.02 on T4 100/T3 15 combo. It was one of those authors as a clinician who 20+ years ago poo-pooed my symptoms when newly diagnosed overt hypothyroidism and 150 mcg levo.wasn’t doing much, perhaps because the FT3 was 3% in range, insisting fatigue, brain fog, weight etc were not thyroid related and went on to develop lots of other problems ( diabetes, gall bladder etc). Quality of life deteriorating early in Hypothyroidism as had to resign teaching job, and no attempt at identifying MNYES…. Stupid, they are not even saving the NHS money by insisting our troubles must be seen by other specialists…

[TSH110 in reply to Judithdalston]

I’d have like to have told him I’m choosing death thanks mate because feels rather good to me and a hell of a lot better than your idea of life, you incompetent ass 🕳️ and walked out.

Poor you having to suffer a complete fool like that destroying your health for decades and proud of it. These people should be struck off for gross negligence and squandering of public funds