I am attempting to put together a science-based argument to show a doctor that desiccated thyroid is a viable treatment choice for a specific individual.
The argument that desiccated thyroid is natural and therefore better is off the plate. Synthetics work for some people and the desiccated works for some people. This isn't about which is better overall. What works for one person may not work for another.
I'm hoping the science people here can help me fine tune my argument and keep me away from anything that doctors consider to be woo woo and give me an idea of what science-based arguments a doctor might present to dissuade the use of desiccated thyroid.
When it comes to hypothyroidism, optimally the medication should make the patient feel better, not worse and should at least halt or slow the progression of maladies associated with hypothyroidism. Treat the patient, not just the numbers.
I'm pulling some of the basic arguments against dessicated thyroid from the
Quackwatch.com.
quote:
1. During the 1960s, science-based physicians stopped using it because its potency can vary from batch to batch, which would make it harder to optimize the patient's thyroid hormone levels.
According to the Federal Register
August 14, 1997 (Volume 62, Number 157), it seems the synthetics didn't maintain consistency over time. I can't say whether they did initially or not.
Food and Drug Administration [Docket No. 97N-0314]
SUMMARY: The Food and Drug Administration (FDA) is announcing that orally administered drug products containing levothyroxine sodium are new drugs. There is new information showing significant stability and potency problems with orally administered levothyroxine sodium products. Also, these products fail to maintain potency through the expiration date, and tablets of the same dosage strength from the same manufacturer vary from lot to lot in the amount of active ingredient present. This lack of stability and consistent potency has the
potential to cause serious health consequences to the public.
Armour Thyroid, which seems to be the one most targeted and was grandfathered in as was Syntrhoid, are thyroid tablets, USP (
United States Pharmacopeia).
There are standards for both thyroid treatments, but companies making both have had reprimands to maintain consistency. (Sort of like admins trying to keep people on topic.) Fillers vary by company on both sides.
I don't see inconsistency as a good argument against using desiccated thyroid.
quote:
2. While desiccated thyroid contains both T4 and T3, the balance of T4 and T3 in animals is not the same as in humans, so the hormones in animal thyroid pills aren’t necessarily natural for the human body.
Desiccated thyroid tablets carry a T4 to T3 ratio of 4:1. From what I can find, the ratio in humans is either 14:1 or 20:1 depending on who you read.
Study Finds Patients Prefer Combination T4/T3 Treatment
The above study compared the synthetic thyroids and the patients preferred the T4/T3 in the 5:1 ratio which is closer to the desiccated thyroid ratio. They didn't prefer the higher ration of 10:1 which is closer to the human ratio.
The double-blind, randomized, controlled clinical trial looked at 141 patients with primary autoimmune hypothyroidism, who were broken into groups who were treated with T4/T3 in a ratio of 5:1, 10:1, as well as a group that continued with their previous T4-only treatment. After 15 weeks, the study showed a clear preference on the part of the patients for the combination treatments, and in particular, the 5:1 treatment featuring a higher level of T3, versus the T4-only treatment.
quote:
3. Doctors who prescribe desiccated thyroid typically diagnose "hypothyroidism" (underactive thyroid gland) in people with normal thyroid function. Many of these doctor base their diagnosis on "low" temperature readings determined by placing the thermometer under the armpit. This is not a valid test of thyroid function. Proper diagnosis requires blood tests that measure thyroid hormone levels.
I couldn't find much on whether the basal body temperature (BMT) has been compared with lab readings on people without whiplash.
The comparison in
this study does not invalidate the use of the BMT and I haven't found any science-based info to support that the practice is not science-based, obsolete or quackery.
Before we get into the absence of double blind studies, I found this study on observational studies to be interesting.
A Comparison of Observational Studies and Randomized, Controlled Trials
Conclusions
We found little evidence that estimates of treatment effects in observational studies reported after 1984 are either consistently larger than or qualitatively different from those obtained in randomized, controlled trials.
There are two schools of thought when it comes to treating hypo or hyperthyroidism. Dr. Broda Barnes is the grandfather of the school of thought that doesn't rely solely on the blood work. His theory is that the blood tests can't always tell us if treatment is successful. I don't know who ushered in the lab work only school of thought.
Bottom line: The T4 only treatment isn't working in the patient. Since the standard treatment hasn't accomplished anything more than making the test scores look good for the last ten years, I see no science-based reason not to try the desiccated thyroid or FDA approved synthetic T4/T3, which oddly enough is made by the same lab that makes Armour Thyroid.
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