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T4 Tx of Subclinical Hypothyroidism, Fatal&Nonfatal Cardiovascular events & Mortality


Senior Member
I thought this was interesting. I have heard there might be a higher rate of hypothyroidism or subclinical hypothyroidism in ME/CFS.

Arch Intern Med. 2012 Apr 23. [Epub ahead of print]

Levothyroxine Treatment of Subclinical Hypothyroidism, Fatal and Nonfatal Cardiovascular Events, and Mortality.
Razvi S, Weaver JU, Butler TJ, Pearce SH.

Cellular Medicine (Dr Weaver), and Health and Society (Dr Butler), Newcastle University, and Endocrine Unit, Royal Victoria Infirmary (Dr Pearce), Newcastle upon Tyne, Department of Endocrinology, Gateshead Health National Health Service Foundation Trust, Gateshead (Drs Razvi and Weaver), and Derwentside Community Diabetes Service, Consett (Dr Butler), England.



Subclinical hypothyroidism (SCH) has been associated with ischemic heart disease (IHD); however, it is unknown whether treatment of SCH with levothyroxine sodium will reduce the risk of IHD.

The aim of this study was to investigate the association between levothyroxine treatment of SCH with IHD morbidity and mortality.


We used the United Kingdom General Practitioner Research Database to identify individuals with new SCH (serum thyrotropin levels of
5.01-10.0 mIU/L and normal free thyroxine levels) recorded during 2001 with outcomes analyzed until March 2009.

All analyses were performed separately for younger (40-70 years) and older (>70 years) individuals.

Hazard ratios (HRs) for IHD events (fatal and nonfatal) were calculated after adjustment for conventional IHD risk factors, baseline serum thyrotropin levels, and initiation of levothyroxine treatment as a time-dependent covariate.


Subclinical hypothyroidism was identified in 3093 younger and 1642 older individuals.

For a median follow-up period of 7.6 years, 52.8% and 49.9% of younger and older patients with SCH were treated with levothyroxine, respectively.

There were 68 incident IHD events in 1634 younger patients treated with levothyroxine (4.2%) vs 97 IHD events in 1459 untreated individuals (6.6%) (multivariate-adjusted HR, 0.61; 95% CI, 0.39-0.95).

In contrast, in the older group there were 104 events in 819 treated patients (12.7%) vs 88 events in 823 untreated individuals (10.7%) (HR, 0.99; 95% CI, 0.59-1.33).


Treatment of SCH with levothyroxine was associated with fewer IHD events in younger individuals, but this was not evident in older people.

An appropriately powered randomized controlled trial of levothyroxine in SCH examining vascular outcomes is now warranted.

PMID: 22529180 [PubMed - as supplied by publisher]

LinkOut - more resources
*I've given each sentence its own paragraph.


Senior Member
I think the reason you see the age discrepancy is that in the elderly, subclinical hypothyroidism is actually pretty common and seems to be adaptive and associated with longevity. Not so in the younger crowd.


Senior Member
There was a thyroid webinar last night hosted by Dr. Holtorf and Mary Shomon. (See, http://forums.phoenixrising.me/showthread.php?17656-Webinar-on-Thyroid-Dysfunction-Today-at-6-00-pm-%28PST%29-4-25-2012 ) Target date for releasing a recording of this webinar is Friday, April 27th. I recommend listening to the webinar, if you are interested in understanding how undiagnosed or improperly treated thyroid dysfunction may be contributing to some of the problems seen in illnesses like ME/CFS, MS etc...


Daughters High School Graduation
Upstate SC, USA
I suspect doctors not doing all the necessary test to diagnose plays into this somehow. If an endocrinologist says he wants to check your thyroid function and gives you a script to have a TSH drawn and thats all. Tell him you are leaving and you will not paying and if he has anything else further to say refer him to your attorney!