Ineffectively Treated Hypothyroidism

The T4 Only Versus T4 and/or T3 Replacement Therapy Debate

Having an underactive thyroid can cause debilitating symptoms. The thyroid gland, positioned in the neck, is an important part of the endocrine system and helps drive energy levels along with many other important biological functions. An underactive thyroid can cause fatigue, depression, constipation, dry skin, hoarseness, infertility and many other problems. Long-term untreated hypothyroidism can even lead to heart disease and premature death.  Having incorrectly diagnosed, or ineffectively treated, hypothyroidism is ruining the quality of life for many people.

                                     Thyroid and Parathyroid GlandsCredit: Wikimedia.org

Hypothyroidism is treated differently in different countries. For example, patients in the United States are diagnosed with hypothyroidism when producing considerably lower thyroid hormone levels than patients using the National Health Service in the United Kingdom. Treatment also varies and some patients feel there underactive thyroid condition is being treated ineffectively.

Professional opinion sometimes dictates that patients need a treatment program involving T4 replacement therapy alone. Others think that this is inadequate for some patients who cannot convert the T4 hormone to the more active T3 hormone. In these cases some experts think patients need replacement therapy including either both the T4 and T3 hormones, or T3 hormone replacement therapy alone. This can leave patients confused and with, what they feel to be, inadequate treatment.

Private health care providers in the United Kingdom will sometimes provide treatment programs including either one, or both, thyroid hormones and American doctors are likely to offer both kinds of treatment. Many NHS patients in the UK, however, feel that they are not being correctly diagnosed when they have an underactive thyroid. Others feel, having been diagnosed with the condition, that the treatment they receive is inadequate and does nothing to relieve their symptoms.

Campaign groups like Thyroid Patients Advocacy UK and Thyroid UK give out information about self-testing kits and ways to receive different thyroid replacement treatments, either privately or through medication bought online. Self-medication is always risky, however, and is not advisable. It is always best to be monitored by a health professional.

Some hypothyroidism patients prefer synthetic hormone replacement therapies, while many others claim they receive better results from natural thyroid hormone replacement treatments. These medications are usually made from desiccated porcine thyroid glands and proponents reason that the hormonal content ratio is more naturally balanced, hence the supposedly superior symptomatic relief. Natural thyroid supplementation was used extensively in the UK until synthetic products took over in popularity.

Modern medical opinion in the UK favoring the T4 only approach has seen NHS patients being prescribed this synthetic hormone replacement on its own. The rationale being that all patients convert the T4 to the active T3 hormone internally, therefore do not need T3 hormone replacement therapy either alongside, or instead of, treatment with T4 hormone replacement medication.

Many British hypothyroidism patients feel that the NHS diagnostic test is inadequate in itself as it tests the thyroid stimulating hormone, rather than actual thyroid hormone levels. TSH levels rise in an attempt to stimulate more thyroid hormone production when the thyroid gland is underactive. A blood test looks at how high the TSH level is and, if it is over a certain level, the patient is diagnosed with hypothyroidism. TSH levels can vary widely throughout the course of just one day, however, and many think that analysis of actual thyroid hormone levels is a more accurate test.

The TSH test also disregards what quantities of which particular thyroid hormones are present in the blood stream. There are actually four hormones (T1, T2, T3 and T4) which are produced by the thyroid gland. Also, individual biology means that varying levels of TSH levels are required to stimulate different quantities of thyroid hormones, depending on the person.

One way patients can get an idea of whether they are suffering from an underactive thyroid disease is to measure their basal body temperature before getting out of bed each morning over a period of time. Hypothyroidism sufferers have a lower basal temperature than non-sufferers. Usually their temperature is at least 1 degree less than normal. To take the basal temperature test people who think they may have an underactive thyroid place a thermometer under their armpit for a few minutes each morning for several days. They record the resulting temperature and, if it is consistently lower by 1 degree or more, they ask their doctor to test them further for the condition. Some demand to see an endocrinology specialist if their doctor is unwilling to help.

Underactive thyroid disease sufferers who are correctly diagnosed and treated can start to lead more normal lives, while those left with poor treatment find themselves hampered in many ways. They are often unable to work and are sometimes inappropriately diagnosed with depression or Chronic Fatigue Syndrome. It’s important for people feeling unwell with underactive thyroid symptoms to eat as healthily as possible and maintain good nutritional levels, including the use of appropriate supplementation use.

Some sufferers claim that selenium, zinc and/or iodine supplementation helps, while others find that supplements like cortisol, designed to support insufficient adrenal function, give them some relief. Others sufferers find that including coconut oil in their diet helps their underactive thyroid condition and also aids them lose weight. Deficient adrenal function can lead to problems with low thyroid hormone production. Therefore, if the underlying problem is addressed, sometimes the underactive thyroid symptoms also decrease.

It is always advisable to seek help through your general medical practitioner before taking any health matter into your own hands. Private treatment may be an option for those who can afford it, or you can always ask your doctor to send you to an endocrine specialist at your local hospital. The specialist may at least offer you more comprehensive testing, including readings of actual individual thyroid hormone levels. They may also test you for adrenal insufficiency problems.

Although it may seem like a lot of effort, especially when you probably already suffer from low energy levels, ineffectively treated hypothyroidism could be dragging you down unnecessarily. Appropriate medication could make you feel dramatically better in a very short time.

The Thyroid System
Credit: wikipedia.org