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Males with hypothyroidism - how are you feeling?
I am a young male recently diagnosed with hypothyroidism (Hashimoto's disease). I have been on Synthroid for a little over a month. Most symptoms are slowly disappearing. I would like to hear other experiences and share mine as well.
Sorry we hijacked your thread. Glad you found something useful in our discussions. Knowing how difficult it can be to locate a good thyroid doctor, I started compiling a list quite a while ago and have gotten from members, names of doctors that they would recommend based on personal experience. I have one from the Westchester, Pa. area and another in Cherry Hill, NJ. If these are of interest to you will be glad to send info by PM.
Gimel and lech I appreciate your opinions on this topic and I am still trying to learn more. Every Endocrinologist I have visited with so far knows less than I do about hypothyroidism and I was diagnosed not even a year ago. I have a strong feeling this is due to the conventional thinking that Synthroid (or whatever laboratory produced substance) is the cure for this condition. I am a STRONG believer in natural cures and eating food as close to the natural state as possible. My way of thinking has brought me to look into natural (or animal derived) thyroid supplements. The doctors I have visited would not even comment on this subject and the pharmacist I pay $25 a month to for Synthroid had no knowledge on the subject.
Is there any community or group of thyroid doctors (not Endocrinologists who state they treat hypothyroidism, but know less than I) that recommend natural thyroid supplements? I am located in the Philadelphia area and could reallllllly use a good referral. My current Endocrinologist will not even call me back and this is through PENN medical. What a joke this American system is...
I look forward to hearing more from you guys and finding a doctor that has an open mind. One not just focused on kick backs from the corrupt corporations that we have allowed to infiltrate medical community.
Is there any community or group of thyroid doctors (not Endocrinologists who state they treat hypothyroidism, but know less than I) that recommend natural thyroid supplements? I am located in the Philadelphia area and could reallllllly use a good referral. My current Endocrinologist will not even call me back and this is through PENN medical. What a joke this American system is...
I look forward to hearing more from you guys and finding a doctor that has an open mind. One not just focused on kick backs from the corrupt corporations that we have allowed to infiltrate medical community.
"I think you believe the basic rules of hypothesis testing and criteria of statistical significance have been created to conspire against unsubstantiated hunches."
No, I believe that the study started with the null hypothesis that adding T3 to a patient's meds does nothing for the patient beyond T4 only. Also, if the study reflects the typical thyroid patient population, many will not have T4 to T3 conversion problems. Accordingly the results will not show any statistically significant improvement with T3, so the study concludes that T3 has no additional benefit over T4. Yet, we know there are patients that have conversion problems, and low FT3 levels, that do benefit from T3 in their meds.
So, as you stated, study results are very dependent on the way the study is constructed and conducted. We see this all the time in new studies that dispute older studies (that disputed yet older studies).
As for throwing around individual studies, to support a position, believe me I can always list numerous references, but I usually only use one, that is clear and conclusive. My intent is not to prove my biased opinion but to discover the facts. From the many studies that I go through I try to determine if there is adequate evidence on one side or the other. That is why I had to question the idea that thyroid hormone suppression, as expressed by TSH level, was primarily related to FT3. The link I referenced was very conclusive, based on the high degree of correlation of TSH to FT4, for each of the three patients evaluated. Since the correlation was based on TSH and FT4 test results, and the study concluded that about 90 % of the variation in TSH resulted from FT4 levels,that leaves almost no room for TSH being affected by other variables. However, the regression line for each patient was different. That is why the correlation between TSH and FT4 becomes poor to fair when you try to extend the results to the total patient population. In order to be really useful, the TSH to FT4 correlation would have to be established by regression analysis for each patient. Obviously not practical.
As noted,when you try to determine the correlation between TSH and FT4 and FT3 for the total population, that becomes very muddled. Due to patient-to-patient variation, test variability and other factors, the correlation seems to be only poor to fair at best, in spite of TSH being touted as the gold standard for thyroid testing. I have searched extensively for data that quantified the relationship of TSH and FT3/FT4, that might justify it being primary. The best info I have found came from the following source. In this study TSH correlated slightly better with FT4 than FT3, but I found the best part of the info to be the graphical presentation of data in Fig. 2, showing the effect of FT4 on TSH and the more variable results of FT3 on TSH.
http://www.clinchem.org/cgi/reprint/55/7/1380.pdf
I guess the only reason I got into this discussion was to question the idea that TSH is affected mainly by FT3. I know you stated, "Most users do not come to such fora to get authoritative knowledge but to confirm their internet-based self-diagnosis." I have no idea how extensive that is, but I think our Forum has a lot of experienced and dedicated members who try very hard to be objective and really help other members. As such, I think we all have an obligation to question and resolve issues. By doing so we can hopefully present the best info available to our members.
Best to you.
No, I believe that the study started with the null hypothesis that adding T3 to a patient's meds does nothing for the patient beyond T4 only. Also, if the study reflects the typical thyroid patient population, many will not have T4 to T3 conversion problems. Accordingly the results will not show any statistically significant improvement with T3, so the study concludes that T3 has no additional benefit over T4. Yet, we know there are patients that have conversion problems, and low FT3 levels, that do benefit from T3 in their meds.
So, as you stated, study results are very dependent on the way the study is constructed and conducted. We see this all the time in new studies that dispute older studies (that disputed yet older studies).
As for throwing around individual studies, to support a position, believe me I can always list numerous references, but I usually only use one, that is clear and conclusive. My intent is not to prove my biased opinion but to discover the facts. From the many studies that I go through I try to determine if there is adequate evidence on one side or the other. That is why I had to question the idea that thyroid hormone suppression, as expressed by TSH level, was primarily related to FT3. The link I referenced was very conclusive, based on the high degree of correlation of TSH to FT4, for each of the three patients evaluated. Since the correlation was based on TSH and FT4 test results, and the study concluded that about 90 % of the variation in TSH resulted from FT4 levels,that leaves almost no room for TSH being affected by other variables. However, the regression line for each patient was different. That is why the correlation between TSH and FT4 becomes poor to fair when you try to extend the results to the total patient population. In order to be really useful, the TSH to FT4 correlation would have to be established by regression analysis for each patient. Obviously not practical.
As noted,when you try to determine the correlation between TSH and FT4 and FT3 for the total population, that becomes very muddled. Due to patient-to-patient variation, test variability and other factors, the correlation seems to be only poor to fair at best, in spite of TSH being touted as the gold standard for thyroid testing. I have searched extensively for data that quantified the relationship of TSH and FT3/FT4, that might justify it being primary. The best info I have found came from the following source. In this study TSH correlated slightly better with FT4 than FT3, but I found the best part of the info to be the graphical presentation of data in Fig. 2, showing the effect of FT4 on TSH and the more variable results of FT3 on TSH.
http://www.clinchem.org/cgi/reprint/55/7/1380.pdf
I guess the only reason I got into this discussion was to question the idea that TSH is affected mainly by FT3. I know you stated, "Most users do not come to such fora to get authoritative knowledge but to confirm their internet-based self-diagnosis." I have no idea how extensive that is, but I think our Forum has a lot of experienced and dedicated members who try very hard to be objective and really help other members. As such, I think we all have an obligation to question and resolve issues. By doing so we can hopefully present the best info available to our members.
Best to you.
"they typically do not find any statistically significant difference, so they accept the null hypothesis, which just happens to be that there is no difference".
I think you believe the basic rules of hypothesis testing and criteria of statistical significance have been created to conspire against unsubstantiated hunches.
This is exactly what you are saying.
"If you follow the money, you begin to believe that many of these studies and the professional organizations that promote T4 only, get a lot of funding from the large pharmaceutical companies that, of course, produce T4 meds."
Forest Labs, the maker of Armour is also a for-profit organization. They also make popular antidepressants, diabetes drugs and what not. Do you think studies and organizations they fund get suppressed by Merck?
I think you believe the basic rules of hypothesis testing and criteria of statistical significance have been created to conspire against unsubstantiated hunches.
This is exactly what you are saying.
"If you follow the money, you begin to believe that many of these studies and the professional organizations that promote T4 only, get a lot of funding from the large pharmaceutical companies that, of course, produce T4 meds."
Forest Labs, the maker of Armour is also a for-profit organization. They also make popular antidepressants, diabetes drugs and what not. Do you think studies and organizations they fund get suppressed by Merck?
Yes, studies such as the one you mentioned in 2004 will prove whatever the null hypothesis is, because they typically do not find any statistically significant difference, so they accept the null hypothesis, which just happens to be that there is no difference. Of course these studies probably did include very many patients that have problems converting T4 to T3.
So that conclusion about the benefit of T3 overlooks the problems that many patients have when they are not converting T4 to T3 adequately and their FT3 level is too low. How can they say that these patients wold not benefit from T3 in their med? If you follow the money, you begin to believe that many of these studies and the professional organizations that promote T4 only, get a lot of funding from the large pharmaceutical companies that, of course, produce T4 meds. Here is a recent article citing a study that says that adding T3 is beneficial for many patients.
http://thyroid.about.com/b/2010/05/17/t3-superior-t4-levothyroxine-hypothyroidism-thyroid.htm
Anyway, we're only preaching to the choir.
So that conclusion about the benefit of T3 overlooks the problems that many patients have when they are not converting T4 to T3 adequately and their FT3 level is too low. How can they say that these patients wold not benefit from T3 in their med? If you follow the money, you begin to believe that many of these studies and the professional organizations that promote T4 only, get a lot of funding from the large pharmaceutical companies that, of course, produce T4 meds. Here is a recent article citing a study that says that adding T3 is beneficial for many patients.
http://thyroid.about.com/b/2010/05/17/t3-superior-t4-levothyroxine-hypothyroidism-thyroid.htm
Anyway, we're only preaching to the choir.
I know, I am only teasing. But you must admit that throwing around individual studies, typically from some patient's "advocacy" site is pure loonacy.
I particularly detest the ritual of citing the Lithuanian study published in February 11, 1999 issue of the New England Journal of Medicine, where it shows that adding t3 to treatment with t4 helps mood and cognition. There are many other, more recent studies showing otherwise. Why would anyone with even rudimentary sanity and decency cite just one source to lay and often desperate audiences, and omit other studies, leading to opposite conclusions and different treatment recommendations?
For example: 2004 study: Clin Endocrinol (Oxf). 2004 Jun;60(6):750-7; Ann Intern Med. 2005 Mar 15;142(6):412-24. The later concludes: "Physiologic combinations of L-thyroxine plus liothyronine do not offer any objective advantage over l-thyroxine alone, yet patients prefer combination treatment."
I particularly detest the ritual of citing the Lithuanian study published in February 11, 1999 issue of the New England Journal of Medicine, where it shows that adding t3 to treatment with t4 helps mood and cognition. There are many other, more recent studies showing otherwise. Why would anyone with even rudimentary sanity and decency cite just one source to lay and often desperate audiences, and omit other studies, leading to opposite conclusions and different treatment recommendations?
For example: 2004 study: Clin Endocrinol (Oxf). 2004 Jun;60(6):750-7; Ann Intern Med. 2005 Mar 15;142(6):412-24. The later concludes: "Physiologic combinations of L-thyroxine plus liothyronine do not offer any objective advantage over l-thyroxine alone, yet patients prefer combination treatment."
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