Sub-clinical Hypothryoid - trial project

Sub-clinical Hypothryoid - trial project

Here is an international trial (TRUST) for Sub-clinical hypothryoid folks over 65 , not sure if it has started yet sorry, but if you are in Glasgow or Cork maybe you know more. (trial mentioned in Dr Linder's letter to Scottish Parliament).

trustthyroidtrial.com/index...

For one definition of Sub-clinical (2008) and a bigger version of the flowchart, see here

bmj.com/content/337/bmj.a80...

link to Scottish Parliament petition, letters of submission here

scottish.parliament.uk/Gett...

Jane :D

10 Replies

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  • I hate the definition of calling people with a high TSH but T4 within reference range "subclinical hypothyroid". The word "subclinical" means "no or few symptoms".

    I was diagnosed as subclinical, a term I refuse to accept as I had so many symptoms that I was becoming housebound. It does make a difference to how a doctor treats you if s/he sees the word "subclinical".

  • I'm 'sub-clinical' too - no treatment despite definite symptoms - even borderline is not an accurate word - however it is encouraging to see in actual black and white that:

    'TRUST is a new research project from five European universities investigating current treatment practices for people who suffer from a mildly underactive thyroid gland.

    "Sub-clinical (mild) with TSH 5-10 If patients have symptoms consistent with hypothyroidism and the increase in thyroid stimulating hormone persists, then a therapeutic trial of levothyroxine for three to six months is a reasonable approach. If the patient feels improved by therapy—as a third to one half do—it is reasonable to continue treatment." (BMJ clinical review 2008) ...........hope! J :D

  • I still don't get this trial business. It can take some patients years to feel better, what is six month going to do? So if they don't feel better after six months, what is going to happen to them? Taken off the meds and left to rot? It just doesn't make sense to me.

    Grey

  • well for folks like me it's hope and better than being ignored, I'll cross that bridge if and when I come to it (& hope i'm in the third to a half that improve!) J :D

  • Well, I hope so for you, but it still seems very hit and miss to me. Not very scientific. And not very fair.

  • life ain't fair!

    I was the 'ratling' girl with 4 older brothers - but who was up the top-rung of the double ladder painting? - me, to prove I'm just as good - better! and we all deserve to get well! lol! J :D

  • Well, yes, I get all this. But the point is, if for any reason your trail fails - and as FloB pointed out very well below, there are many many reasons why this might fail - you are going to be worse off than before. That's all I'm saying. I'm not saying you don't deserve to get well. Of course you do. We all do. But this, in my opinion, is more likely to be a step backwards than a step forward.

    And wether life is fair or not, we could at least try and be fair to each other - most importantly, doctors to their patients. That's all.

    Grey x

  • These tests will be flawed if the subjects aren't given a thorough physical check beforehand. e.g.

    1)Will they be tested to make sure they are converting T4 to T3 correctly because if they aren't it won't work?

    2) Will they have a full adrenal test to establish a good adrenal status. Untreated Hypo T can cause adrenal fatigue and the trialwon't work if this is the case?

    3) Will they have a thorough vitamin & mineral panel to make sure these are in a good place because untreated hypoT can cause these deficencies, and the trial won't work?

    4) I'm assuming they will be given the smallest amount of thyroxine which will not work for some people who may meed more.

    I'm sure you folks can add some more.What do others think?

    Flo B

  • Sorry but my thinking is if you have NO treatment then that it's worth a try

    - and the TSH 10 'limit' has been halved to 5 - so I'm asking for a trial (second link/flowchart)

    and hopefully this will help a few folks in a similar "sub-clinical' situation - it doesn't mean no symptoms just 'mild' or borderline - we have to educate them! (yes it's a wrong definition but it's a start) J :D

  • The link has gone?

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