Most people don't want to be hyperthyroid OR hypothyroid but to be
euthyroid.
I'm not sure how being hypo helps the case that T4 alone is sufficient!
Using OTC supplements as well as desiccated thyroid can inadvertently lead to hyperthyroidism and/or similar symptoms.The endocrine system is very sensitive and works in a delicate balance. A change in one part can change the others which can not only be harmful to health but mess up the reading on Thyroid tests thus possibly leading to treatments that do not relate to what health problem are actually present. These problems can be caused by the dessicated thyroid as well as OTC supplements.
It's always important to use supplements with the guidance of a skilled practitioner. This is true for all supplements, not just thyroid.
Most thyroid supplements contain amino acids and/or iodine which are very unlikely to cause any great long-term harm.
Desiccated thyroid supplements are widely used worldwide and have a very good safety profile unlike many other of the drugs that we are subjected to. I bet there are fewer deaths from natural thyroid products than from Tylenol.
This article discusses the safety and benefit of combination therapy and provides a rebuttal to the flawed and biased studies showing otherwise:
http://www.thyroidscience.com/Criticism/lowe.3.16.09/lowe.bta.rebuttal.3.16.09.pdf
There are lots of problems with the study posted showing that there was supposedly no benefit to T4/T3 only therapy. The dosages were not equivalent, the FT4 was allowed to drop, the TSH was allowed to rise, the dosing of T3 was not appropriate once a day, the measurement of FT3 24 hours after a dose is totally inaccurate due to the short half life...the list goes on and on.
But most tellingly, the study itself quotes a handful of other studies that show that there WERE benefits to patients of combination therapy but then invents excuses as to why THOSE were flawed and not their own study!
Unfortunately, they then have to conclude that half the patients on combination therapy improved whereas half did not. While this proportion is probably not entirely accurate, it does show that nearly 50% of people on T4 do better with the addition of T3 to their thyroid medication regimen. Funny how they didn't choose to highlight that finding but instead attributed it to chance.
Contrary to popular believe on the web, endocrinologists do treat subclinical hypothyroidism and there is a systematic way to dianose and treat this disorder.
It's true that subclinical hypothyroidism is studied in the literature. It's also true that a certain subset of people with subclinical hypo may not benefit from thyroid hormone replacement. But since a certain number of people DO benefit, and there is very little risk for a trial of thyroid hormone, it seems very silly to write it off. There is little possibility for harm and great possibility for benefit. Seems like a no-brainer to me!
And the truth of the matter is that endos in general do not recognize and/or treat subclinical hypothyroidism. They BARELY treat overt hypothyroidism when they are reliant on the TSH only.
I saw 6 endos before I found one in this area that was familiar with the concept. She was one of the most senior faculty members of the state school of medicine. She acknowledged the problem of subclinical hypothyroidism but had no explanation for why it was not taught in the medical school. Endos are NOT taught about this issue currently in the way that they should be taught. They are taught to treat to the TSH alone so that is what they do.
If treating patients as lab results worked, we would have no need for doctors and could just go to see computers. A skilled clinician should have judgment that is more valuable than a lab report and that is how it was throughout history.
Medicine was every bit as much of an art as a science. We have lost that now and the population's health reflects this trend.
Spend 5 minutes in the waiting room of any typical endo and you will see the fattest, sickest people you would ever want to meet. It's a crying shame and it should be criminal.
You REALLY need to vet your sources a little more closely!
Read a little bit more about the Executive Editor of sciencebasedmedicine.org and then post anything from that blog here with a straight face.
ETA: There are reports that his affiliation with Yale may not be all it is made out to be. I don't know for sure if this is true, but I have no reason to doubt it.
http://www.bolenreport.com/feature_articles/Doctor's-Data-v-Barrett/novellahumiliation.htm
"Novella claims to be a neurology professor at Yale University, and throws the name "Yale" around like he was throwing seed to the morning chickens - but, to me, that is an
outright fabrication.
Novella, evidence shows, works for a medical center that "rents" the name "Yale" from the University, who then, assuming the monthly payments are up to date, gets to claim that all their staff doctors are, in fact, professors at Yale (insert bad smell here).
In short, Novella is just another justifiably self-disappointed crap-career loser...
The reality of Novella,
easily found, is that
he testifies for insurance companies, and that seems to be the extent of his practice. I get a picture of Novella saying
"that hatchet imbedded in Mr. Smith's head by his employer is causing no neurological damage, and it is clear that Mr. Smith is faking his claims of pain... His employer was right to fire him when he didn't show up for work the next day. Mr. Smith clearly self-inflicted his injury... and has previously demonstrated his social recalcitrance when he failed to institutionalize his autistic child, actually claiming that the autism started after a series of 152 vaccinations were given in one day by a pediatrician. It is clear that Mr. Smith, and his wife, caused the autism themselves, in that they are clearly genetically defective... blah, blah, blah..., blah, blah, blah..., blah, blah, blah..., blah, blah, blah..., blah, blah, blah..., blah, blah, blah..."
You know - the
usual quackbuster testimony."
As far as Armour being more natural, pigs are not people and have a different ratio of T4 and T3 than levothyroxine. So in this case synthroid is more natural as it is tailored to how the human body works. T3 is unstable with a very short half life. T4 in most cases will convert to the right amount of T3.
Yes, pigs are not people and that is why Armour doesn't work well for some people and they do better on a synthetic bioidentical T4 + T3 therapy so that they can control the proportion.
But the actual thyroid hormone is the same (and bioidentical) regardless of the source whereas the same cannot be said for the conjugated estrogens in Premarin. Those are not bioidentical and do not work the same way. The only difference in the thyroid hormone is the proportion, not the content.
T3 is not unstable just because it has a short half life. That's just biased writing to make people fearful. Scary things are unstable so if T3 is unstable it must be scary too! Just fear-mongering, pure and simple.
I have lots of trepidation with the practice of using symptoms to only using symptoms to diagnose, as other health conditions may be overlooked. The symptoms cited by the alternative webpages are vague and can mimic other diseases. Increasing your dose by symptoms only is IMHO not appropriate medical practice, may have dangerous health consequences and a form of self medication.
Funny, because that is how hypothyroidism was historically treated for years with many fewer problems. It's your choice to remain hypo as you stated in your first paragraph.
No one is saying not to have expert clinical guidance or advocating self medication. I am advocating learning the actual facts, speaking to patients who have been through it and coming to your own conclusions.
The TRUTH of the matter is that some people do great on T4 only therapy. Some people do not and benefit from the addition of T3 to their regimen. This results in a greatly improved quality of life and very few risks when appropriately monitored by a doctor who is not a slave to the TSH and actually bothers to monitor your free thyroid hormone levels.
Ema