The article points out the fact that many patients who are on hormone replacement therapy for hypothyroidism, do not always experience significant symptom relief. The article points out a variety of reasons for this problem of unsatisfactory results from thyroid medication used to treat hypothyroidism. It also points out the fact that some patients are treated with T-4 only thyroid medications, when some might benefit more from a combination T-4 and T-3 medication. It makes mention of the fact that some patients may be under-treated by their Doctors with their hypothyroid medications in general.
While it is a very interesting study, I feel some mention of the fact that if hypothyroidism has "thyroid autoimmunity" as its cause, the disease itself has potential to cause symptoms apart from hormone levels. There are medical research studies out there that confirm this fact as well.
There is another article entitled; "Chronic autoimmune thyroiditis and rheumatic manifestations." (PubMed). In this article from the National Institutes of Health/National Library of Medicine website, "rheumatic Manifestations" (joint & muscle pain) in relation to Hashimoto's thyroiditis (common cause of hypothyroidism) is addressed. Here we have a medical research article that attributes this symptom problem to the underlying autoimmune disease and not to hormone levels only. In other words a treated hypothyroid patient can achieve a euthyroid state (normalized thyroid hormone levels) but can potentially still experience rheumatic symptoms from the underlying thyroid autoimmunity. The important point this articles makes, is the fact that correcting hypothyroidism, in some patients, will not always resolve their joint and muscle aches completely.
Doctors who believe their treated hypothyroid patients are imagining (psychosomatic) their unrelieved rheumatic symptoms, need to read this article.
Another article I wish to refer to, is entitled; "A case control study on psychiatric disorders in Hashimoto disease and euthyroid goiter: not only depressive but also anxiety disorders are associated with thyroid autoimmunity"
This article points out that Hashimoto's thyroiditis or the type of thyroid autoimmunity that causes hypothyroidism has the potential to cause "anxiety disorders" in addition to depression. They distinguish between hormone levels and the disease itself as a cause of emotional disorders.
Some Doctors tell patients their emotional symptoms are not related to their thyroid disease but these type research articles say differently. A number of other research articles confirm this same conclusion.
The next research article i wish to refer to, is entitled; "Association between thyroid autoimmunity and fibromyalgic disease severity" (Journal Clinical Rheumatology):
In this article found in the Journal of Clinical Rheumatology, an association between thyroid autoimmunity and fibromyalgia is noted. This is only one of many research articles that connect thyroid disease to fibromyalgia. Other articles make a connection specifically of "TPO antibodies" (one of the antibodies that causes Hashimoto's thyroiditis) to fibromyalgia and that people with fibromyalgia commonly have sub-clinical hypothyroidism, rather than full blown or overt hypothyroidism. There are many more research articles in addition to this one that connects thyroid disease to fibromyalgia.
The next article I wish to pint out, is entitled; "Modifications of the Immune Responsiveness in Patients with Autoimmune Thyroiditis: Evidence for a Systemic Immune Alteration".
This research article concludes that a degree of "peripheral immune deficiency" is present in patients with "Hashimoto's thyroiditis", the most common cause of hypothyroidism. The importance of this article in my opinion is in recognizing that autoimmune hypothyroid disease has a "systemic" (system-wide) effect on these patient's immune systems. This may help explain why patients with thyroid autoimmunity have a higher susceptibility for developing other autoimmune diseases and health disorders of many kinds. It also can help to explain why all symptoms are not relieved in all patients on hormone therapy for autoimmune hypothyroidism because correction of the hypothyroidism may not necessarily mean correction of the disease affecting the immune system as a whole.
Here's an interesting one I wish to pint out as well, entitled "Fibromyalgia and Thyroid Function" Genova Diagnostics:
In this article published by "GDX", in regard to the association between thyroid dysfunction and fibromyalgia, the article cites other studies and mentions the statistics from studies that report that up to 80% of fibromyalgia patients may suffer from some form of subclinical hypothyroidism.
This last article I wish to refer to is entitled; "Assessment of Anxiety in Sub-clinical Thyroid Disorders" (Science Links Japan):
This article was published in an Endocrine Journal in Japan and also added to the links on the Science Links Japan website and is on the subject of "anxiety" as it manifests in sub-clinical thyroid disorders.
The conclusion in this medical study is that anxiety can develop in sub-clinical thyroid disorders whether hyperthyroid or hypothyroid. This lends toward correcting the misperception by some in the medical community who believe only hyperthyroid states cause anxiety symptoms. It is also in opposition to some opinions that state only full blown thyroid dysfunction causes emotional symptoms. This article points out that patients with sub-clinical thyroid dysfunction can potentially experience anxiety symptoms.
