Thyroid Hormone Therapy..new Studies

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SOME INTERESTING FACTS FROM THE ENDOCRINE SOCIETY!

Combination Hormone Therapy Does Not Benefit Hypothyroid Patients, Says New Study
Combining two hormone therapies to treat the psychological affects of hypothyroidism may not be more effective than using a single therapy, according to new research articles published this month in the Journal of Clinical Endocrinology & Metabolism (JCEM). Two new studies and an editorial question whether a combination of thyroxine (T4) and T3 is superior to T4 alone for the treatment of patients with hypothyroidism...

The new findings will be of great importance to the five to 10 percent of Americans who suffer from hypothyroidism, which occurs when the thyroid gland does not produce enough thyroid hormone. Symptoms of hypothyroidism can include fatigue, weight gain, thinned hair, decreased cardiac function, menstrual irregularities, sluggishness, dry skin, and constipation.

One study, which was led by researchers from McMaster University in Ontario, Canada, specifically examined whether a combination of T4 and T3 therapy improved mood and sense of well being in hypothyroid patients who also suffered from depressive symptoms. In the prospective, double-blinded, randomized controlled trial, forty patients were randomized to receive either T4 therapy alone or a combination of T3 and T4 therapy. The results showed that when compared with T4 alone, the combination therapy did not improve either mood or personal sense of well being in the patients. The 15-week study was longer than any previously published studies on this subject.

"Data do not support the routine use of T3 in addition to T4 to maintain euthyroidism in hypothyroid patients who are on stable doses of levothyroxine hormone, but who complain of depressive symptoms. Until a future large, multicenter, blinded, randomized, controlled trial proves otherwise, there is insufficient evidence to support changing the current approach of routinely using T4 alone to maintain euthyroidism in hypothyroid individuals," explained Dr. Anna Sawka, the first author on the study.

A second study published this month in JCEM also compared a combination T4 and T3 therapy with T4. In the second study, which was a double-blind, random order, crossover trial, researchers from Sir Charles Gairdner Hospital in Perth, Australia compared the impact of the two treatments on quality of life, cognitive function and subjective satisfaction in 110 hypothyroid patients. In this study, approximately one-half of the subjects received T4 therapy for 10 weeks and then T4 and T3 therapy for 10 weeks. The other half of the subjects received the combination therapy first.

Once again, the researchers found no significant benefits for combination therapy compared to T4 alone. However, they did find that anxiety and nausea were significantly worse for patients on the combined therapy.

"At the conclusion of our trial, we found no benefit of combining T4 and T3 therapy on quality of life, hypothyroid symptoms, cognitive function, subjective satisfaction with therapy or treatment preference," notes Dr. John P. Walsh, the senior author on the study. "Furthermore, we could not identify a specific subgroup of patients who benefited from the combined therapy. Based on these findings, we believe that T4 alone should remain the standard treatment for hypothyroidism."

In addition to the two new studies, the October issue of JCEM also includes an editorial by Drs. Michael Kaplan, David Sarne and Arthur Schneider, which discusses the use of T4 and T3 therapy to treat hypothyroid patients. In the editorial, the authors discuss the two new studies as well as previous research that examined T4 and T3 therapy. The authors write that based on past and current research, "evidence is fading that adding T3 to T4 is beneficial in the long-term treatment of hypothyroid patients with autoimmune thyroiditis."

JCEM is one of four journals published by The Endocrine Society. Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Endocrinologists are specially trained doctors who diagnose, treat and conduct basic and clinical research on complex hormonal disorders such as diabetes, thyroid disease, osteoporosis, obesity, hypertension, cholesterol and reproductive disorders. Today, The Endocrine Society's membership consists of over 11,000 scientists, physicians, educators, nurses and students, in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit the Society's web site at www.endo-society.org

Source: Endocrine Society Press Release