Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
I noticed this very interesting post from Sarah who is a non-medical researcher. She has discovered what other contributors to metabolism.com have, that a serious lack of research exists comparing Armour thyroid to synthetic thryoid hormone in treatment of hypothyroidism. How is it then that the community of endocrinologists who pride themselves on their scientific approach to the practice of medicine, or who claim they follow “evidence based” medical decision making, are so uniformly opposed to the use of Armour thyroid or similar dessicated thryoid products?
Sarah, I believe the vast majority of contributors to metabolism.com including myself, are as astonished and troubled as you are by this apparent lack of insight by the policy makers in the field of endocrinology, in regards to this issue.
Sarah posts the following comments to metabolism.com:
It was very interesting to read these posts. I have never posted to a site such as this but I wanted to contribute my perspectives on this topic. I am a researcher by trade (in a very different line of research). I have been reading general â€œgoogleâ€ information for years on the controversy between synthroid and Armour. I have had trouble with mild symptoms at 88 mcg (synthroid) but 100 mcg brought my TSH to .4. My doctor was not comfortable with a TSH that low. For a number of years I have requested to try Armour and been denied. My main argument for trying Armour has been that if there are not risks with Armour (beyond the typical risks seen with any thyroid meds) why should I not try it. He has responded that the literature does not support Armour or the use of T3. I sat down for a few hours yesterday and looked at primary research articles and was very surprised. First of all there is a serious lack of research with autoimmune related thyroid disease. Second the few clinical trials that looked at Armour vs synthroid products were very poorly designed. Very small sample sizes with high variability in sample populations. The samples involve wide age ranges, multiple ethnicities represented and both genders. These variables would be important to consider but statistically inappropriate with small sample sizes. Of a greater concern was that in many of the studies most of the patients were being treated for hypothyroidism post surgical removal of the thyroid and then had only two patients with autoimmune related hypothyroidism mixed into the sample. They even noted that with the two patients with autoimmune hypothyroidism there were trends toward more positive outcomes related to the Armour. You will not find statistical significant with these kinds of research design (if being responsive is specific for the autoimmune variety) even if differences exist. If anyone could please provide the references for well designed research studies (either pro or con for Armour) I would really appreciate it.