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Thursday, 12 September 2013

Benefit of Treatment of Low-Normal Thyroid Function

September 10, 2000

Finally, conventional medicine is recognizing what those of us in "Natural" medicine have known all along.

A new double-blind placebo-controlled trial has demonstrated that symptoms of hypothyroidism can be improved in patients receiving the synthetic thyroid hormone, levothyroxine, despite the fact that they didn't quite meet the current guidelines to be considered hypothyroid (subclinical hypothyroidism).

This may be one of the first studies indicating that thyroid replacement therapy can benefit patients with subclinical hypothyroidism.
  • Researchers from Switzerland conducted a 12-month, double-blind, placebo-controlled study to investigate the clinical and metabolic effects of levothyroxine replacement in patients with different degrees of subclinical hypothyroidism.
  • Sixty-three women (avg. age 57 years) with subclinical hypothyroidism
  • Patients, having an average TSH (thyroid stimulating hormone) of 12.7 mcU/mL (range 4.5-50) were randomized to receive either levothyroxine (mean dose 83 mcg/day) or placebo and TSH levels were monitored.
  • In the levothyroxine group, mean TSH decreased to 3 mcU/mL and total cholesterol and low-density lipoprotein (LDL) cholesterol improved significantly.

Although the researchers admit that additional studies are needed in patients with milder hypothyroidism, they feel that in general, there seems to be increasing evidence towards treating these patients as well because of possible beneficial effects on cardiovascular function, lipids, and symptoms.

82nd Annual Meeting of the Endocrine Society Boston, Mass. August 2000.

Dr. Mercola's Comments:


This is one of the first studies that documents the validity of using a lower TSH value for the diagnosis and treatment of hypothyroidism. I have written extensively about this in the past and have been interviewed about this by Mary Shomon at About.com. It is encouraging to see this actually documented in the clinical literature.
     
This is a European study and they use a slightly different reference range than we do in the US, as the normals here are 0.4 to 5.5. However, if one were to transfer their findings over to our measurements they are calling anyone over 1.0 positive. I think that this is a bit too low to treat with thyroid replacement however.
     
My concern is that one would likely have to commit the patient to a life long replacement of thyroid. My preference is Armour thyroid, but it is far better to identify and resolve the cause of the thyroid problem rather than treat it with a natural hormone. My experience is that thyroid impairment is frequently due to adrenal dysfunction.

So some simple lifestyle changes to address to normalize thyroid function before considering hormone replacement would be to:
  • Get to bed before 10PM (9PM in the winter)
  • Have some mechanism to cope with emotional stress
  • Eat a good diet, especially excluding soy which can harm the thyroid
  • Don't smoke

Some supplements that might be helpful:
  • Iodine
  • Selenium
  • Lipoic Acid
  • Zinc
  • Vitamins E, C and B12
Related Articles:
Pesticides Targeting West Nile-Carrying Mosquitoes May be a Thyroid Danger
Chemical in Water May Damage Thyroid
Diagnosis of Hypothyroidism
Treatment of Hypothyroidism
New Thyroid Screening Recommendations
 http://articles.mercola.com/sites/articles/archive/2000/09/10/hypothyroid.aspx