DTE stands for “desiccated thyroid extract” which is made up of thyroid hormones refined from pig thyroid and used to treat people with hypothyroidism (low thyroid hormone). This is possible because human and pig thyroid are very similar in the types of thyroid hormone they contain. For over 100 years, DTE had been used successfully to treat hypothyroidism.
T4, also known as levothyroxine, is the most abundant of the 4 thyroid hormones and synthetic levothyroxine has almost completely replaced DTE treatment since the 1980’s. There is no scientific evidence however, that synthetic T4 is better than DTE for treating hypothyroidism. The almost universal switch to levothyroxine and away from DTE appears to be due to a shrewd worldwide marketing campaign by the makers of brand synthetic T4.
Due to this marketing, Synthroid, the major brand of synthetic T4, became the most widely prescribed medication in the U.S. Only in recent years has the medical community begun to recognize the benefit of using DTE treatment for individuals suffering with persistent symptoms of hypothyroidism, despite what appears to be satisfactory amounts of thyroid hormone replacement with T4. Could this benefit be due to the higher concentration of the active thyroid hormone, T3 (liothyronine) , provided by DTE compared to T4? This is the subject of on-going studies by medical scientists at this time.
For decades doctors have recognized synthetic thyroid hormone known as levothyroxine or brand name Synthroid, as the undisputed choice for treating hypothyroidism (low thyroid function). By virtue of hypothyroidism being extremely common levothyroxine has been the most prescribed medication in the U.S.
According to key medical organizations in this country, the only acceptable treatment of hypothyroidism is the use of levothyroxine alone. Using any other form of therapy is not recommended. Pointing to a significant number of patients receiving levothyroxine who continue to complain of symptoms of hypothyroidism health advocates have been calling for recognition of alternative treatments. One such alternative with a small but enthusiastic following is extract of pig thyroid (desiccated thyroid extract). All of the major organization of endocrinologists fail to recommend this form of treatment but in particular the American Association of Clinical Endocrinologist or AACE in the US has flatly stated this form of therapy should never be used. Physicians and their patients remain deeply divided on this issue.
In the spring of 2017 the American Thyroid Association (ATA) convened a symposium on treatment of hypothyroidism and determined that â€œit is important to describe the patient perspective regarding hypothyroidism treatment and to share itâ€ with the medical community. Now, after an enormous expenditure of time and effort, the results of their survey of patients being treated for hypothyroidism were published on-line. The full report in print will become available in the coming months. Here are some to the highlights of the ATA analysis of over 12,000 participant responses.
Overall satisfaction with the present choices of thyroid hormone treatment is 5 out of a possible 10Treatment satisfaction with desiccated thyroid extract (DTE) such as Armour and NP Thyroid was highest at 7 out of 10.
Lowest satisfaction was with levothyroxine or Synthroid alone at 5 of 10
Treatment with levothyroxine plus t3 (Cytomel, tri iodothyronine) was next best at 6 out of 10
Patients taking DTE were less likely to report problems with weight management, fatigue, mood and memory as compared to levothyroxine alone or levothyroxine plus t3
The authors conclude, â€œa subset of patients with hypothyroidism are not satisfied with their current therapy or their physiciansâ€ and â€œhigher satisfaction with both treatment and physicians is reported by those patients on DTEâ€.
After decades of dispute among physicians themselves about the best ways to treat hypothyroidism, patient are finally having their say. Some readers of this blog may have been among the participants in the survey and deserve great credit for sharing their experience with the medical community. It is hoped that this survey will mark a turning point in the discussion about treatment of hypothyroidism and help to forge a change in the way physicians approach this very common and often disabling condition.