Dr. Gary Pepper and Dr. Paul Aoun discuss recent findings about thyroid hormone treatment at the 15th International Thyroid Congress
According to experts, 10 to 20% of hypothyroid individuals fail to respond completely to T4-only (levothyroxine, Synthroid) treatment. Dr. Anthony Bianco, the president of the American Thyroid Association, and his associates believe this is due to genetic variations in the way thyroid hormone is converted in the body from T4 into T3. T3 is the much more potent form of thyroid hormone and unless the cells of the body receive enough T3, normal function cannot be achieved and symptoms of low thyroid such as fatigue, mental fogginess, constipation, muscle aches etc, persist. Based on the research conducted by Dr. Bianco and colleagues it is thought that in those with the genetic trait making T4 treatment ineffective, blood tests would show low T3 levels. (more…)
Update from the 15th International Thyroid Congress, Orlando Florida, October, 2015 By Gary Pepper, M.D. Â Â Â Â I just returned from Orlando, Florida, where I attended the 15th International Thyroid Congress and want to provide a report of my experience, to readers of metabolism.com. This was truly an international event with an estimated 50% of the attendees from outside the U.S. Organizers of this event describe it as, â€œRenowned experts in thyroid function and biology, diagnosis and management of thyroid disease, and novel therapies for treating thyroid cancer are gathering at the 15th International Thyroid Congress (ITC) to present, discuss, and debate the latest advances in thyroidology. Held every five years, the ITC is a collaborative meeting of the four world thyroid associations; the ATA (American Thyroid Association), Asia-Oceania Thyroid Association (AOTA), European Thyroid Association (ETA), and Latin American Thyroid Society (LATS).â€ I was particularly excited to be attending this conference this year since my colleagues, Drs. Paul Cassanova and Kathryn Reynolds and I were presenting our study on the use of combination T3 plus T4 for the treatment of underactive thyroid (hypothyroidism). Here are some papers I found to be of particular interest; (more…)
Why Patients Arenâ€™t Receiving the Most Effective Treatment for Hypothyroidism By Gary Pepper, M.D.
For the past 3 to 4 decades endocrinologists worldwide have adhered to the belief that only synthetic T4 (the most abundant of 4 thyroid hormones produced by the thyroid) is appropriate therapy for a sluggish thyroid even though it is known that a substantial number of those treated with T4 only continue to suffer from persistent symptoms of the disease. This may be because under normal conditions the thyroid produces two principle hormones T4 and T3. In 2013 an NIH study showed that 50% of those with hypothyroidism preferred treatment which includes T3 and our group reported that 78% of a subgroup of patients preferred T3 containing medication to treat hypothyroidism . (more…)
Early in May 2014 a patient being treated with Armour Thyroid (desiccated thyroid) for hypothyroidism reported that her pharmacy service would not refill her prescription for Armour Thyroid because it was an “illegal” drug. We were both very distressed to learn of this, but for different reasons. My patient was rightfully concerned that she might be receiving a wildly inappropriate medication, while I was concerned that I might not be able to prescribe a medication I knew to be extremely helpful and safe. (more…)
I am often asked by patients with hypothyroidism (low thyroid hormone levels), â€œWhat is the right thyroid hormone dose for meâ€.Â Of course, a physician wants to find the appropriate dose of medication to treat each condition a patient has. When it comes to thyroid disease however, this can be a complex question. Not only is there an issue of whether T4 alone or combination T3 and T4 will be required to treat a particular individual but the therapeutic window of these hormones must also be considered. (more…)
The mission of the The Thyroid Project is to encourage sharing of information and experience between the public and the medical community about the treatment of hypothyroidism (low thyroid function). For at least the past few decades there is a growing awareness of â€œsomething missingâ€ in the way suffers of hypothyroidism are treated for their disease.
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.
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