100,000 older people missing thyroid treatment - study

BBC News Health

24th January 2011

bbc.co.uk/news/health-12252813

"Around 100,000 older people in the UK are missing out on thyroid medicine that could improve their lives, according to a study.

The Journal of Medical Screening study examined women over 50 and men over 65 - and found 8% had underactive thyroids.

But many were not getting treatment for symptoms, including lethargy and weight gain.

Researchers, at the Wolfson Institute, said screening would improve lives."

Read the rest of the BBC article here:

bbc.co.uk/news/health-12252813

Read the abstract of the actual study referred to here:

A randomized double-blind crossover trial to investigate the efficacy of screening for adult hypothyroidism

jms.rsmjournals.com/cgi/con...

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5 Replies

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  • dont see the point in screening ,even with medication ,if you can get your doctor to realise that just because you're bloods come back in range doesnt mean youre symptoms have gone away or that you feel like a normal human being with no brain fog ,that you can stand to look at yourself because of weight gain ,and you dont feel like you have run two marathons when you only walked the dog .why add to that with no hope in the main of ever feeling well again ,and they ask if you're depressed......... er yeah. ps [havin a bad day ,could you guess?]i think more research into treatment of patient not response to blood tests needs to be done ,dont label people with no hope of help .

  • Despite how it may seem, not all doctors are unsympathetic and many do listen to their patients. If your GP isn't working with you, then maybe it's time to take action. A second opinion from a different doctor, or a referral to an endocrinologist perhaps.

  • hello,thanks for your reply,this wasnt a direct critisizm of the gp,but if this web site and speaking to other hypo patients are anything to go on ,once you are in range thats it .most other conditions are dealt with by a specialist in that field but it doesnt appear to be the case with this ,blood tests once a year ,unless you feel ill [which you invariably do ]you get sent then ,but if alls in range you are back to square one . i have a friend who is hypo has been for 30yrs ,she has never seen an endo ,never been offered ,still has symptoms .should we have to ask to be referred? or go private ?if we had diabetes we would be treated differently,regular checks ,not a repeat prescription .when i was diagnosed 18months ago ,i got my results ,was told it can be serious ,take these tablets every day for life,come back every year ,i found information out for myself . with regards to a second opinion i only have one gp in my practice ,and again we are treated by results not symptoms ,i have read on this site about endos being less than supportive as well ,is it any wonder we get brain fog we dont know where to turn ,well i dont anyway,anyone else feel the same ?

  • If the thought of a screening programe does not bring forth the required result from the majority then perhaps our GP's would benefit more from having CPD (Continuing Professional Development), training and further education in both alternative methods of diagnosing thyroid disorders and in the clinical signs that should not be ignored. As they are our first port of call when we are poorly it is paramount that we are directed by them to the correct consultant.

    Wellwisher

  • The following is from the GP's journal Pulse. I see this as potentially a huge issue.

    Screening considered for thyroid disease

    28 Jan 11

    By Christian Duffin

    Screening for hypothyroidism could lead to early detection and treatment for about 100,000 patients in the UK, leading screening experts have concluded.

    Their findings emerge as the UK National Screening Committee told Pulse it has launched a review into a possible screening programme for thyroid disease, and would consider the research as part of its decision on whether to launch a pilot scheme.

    The study, led by epidemiologists at the Wolfson Institute of Preventive Medicine and published in the Journal of Medical Screening, showed that about 1% of people screened would benefit from treatment with thyroxine – more than 100,000 people in the UK.

    A thyroid-stimulating hormone (TSH) measurement was performed on 341 women aged 50 to 79 and men aged between 65 and 79 attending a BUPA clinical for a general health assessment

    Those with ‘high’ TSH levels – above 4.0 milliunits per litre (mU/L) – were invited to join a randomised double-blind crossover trial, which involved taking thyroxine for four months followed by placebo for four months, or vice versa.

    49 women and 7 men completed the trial. Among the 15 patients with a repeat TSH measurement above 4.5mU/L, 11 reported feeling better on thyroxine than on placebo, while none reported feeling better on placebo than on thyroxine.

    There was no significant difference among the 41 individuals with a repeat serum of TSH of 4.5mU/L or less ten who took thyroxine or placebo. Overall patients reported improvements in tiredness and memory loss, and the researchers found no evidence of harm.

    Lead researcher Professor Malcolm Law, professor of epidemiology and preventive medicine at Queen Mary University of London concluded: ‘The results indicate that screening for hypothyroidism would be worthwhile. Approximately 1% of people screened would be expected to benefit from screening and subsequent thyroxine therapy. Pilot screening programmes for adult hypothyroidism are justified.’

    He added: ‘The number of participants on whom our conclusions are based is small, but the discordance of 11 improving on thyroxine and none on placebo provides compelling evidence of efficacy.’

    Professor Law told Pulse: ‘It could be done in general practice. But if there was a pilot it would be a funded programme – you wouldn’t just say to GPs: “Go out and do it.”.’

    Professor Nicholas Wald, director of the Wolfson Institute and co-author, said: ‘It is rare to be able to find chronic diseases in adults that can be identified by screening. We need to focus preventive medicine more on improving quality of life whenever this is achievable at a reasonable cost. The UK National Screening Committee can now consider pilot screening programmes.’

    Dr Anne Mackie, director of programmes for the UK National Screening Committee told Pulse: ‘The committee is in the process of conducting its own review into thyroid disease. The UK NSC has not made a recommendation to screen for hypothyroidism, however we welcome all research that will aid our review of current recommendations.’

    J Med Screen, published online 24 January 2011

    pulsetoday.co.uk/story.asp?...

    Rod

    Rod

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