Guest Author - Jim Lowrance
I just completed the reading of a wonderful book on the subject of hypothyroidism by “C Phillips and D Roach”, twin sisters, who developed hypothyroidism during childhood and have now entered the age of their 40s (born in 1968). The book is entitled; “Hypothyroidism in Childhood and Adulthood”.
These two women have kept diaries since youth, detailing their hormone therapy treatments for hypothyroidism and their information in my opinion should be used by medical research groups in studying and improving thyroid hormone replacement therapy for hypothyroid patients, both youths and adults.
When these women were young girls, they were treated with synthetic T-4 hormone replacement and dosed with the medication, to suppress their TSH levels. Thyroid Stimulating Hormone (TSH) is the pituitary hormone that reflects thyroid hormone levels and decreases to a lower level when thyroid hormone levels increase in the body. Their treatment as youths placed their TSH levels at undetectable levels but at the same time, greatly relieved their hypothyroid symptoms. This is supposed to be the goal of treatment however, during a blood retest of their TSH, a treating GP decided to reduce their dose out of fear that their suppressed TSH levels reflected the possibility that they would experience osteoporosis (a possibility with over-treatment). This dose change at youth began an incredible journey for both of these girls.
Following their dose decrease, they fell into severe hypothyroid symptoms but were told the symptoms were actually from the need for that dose decrease. When the symptoms were not relieved after several months, the girls insisted upon reevaluation of their treatment. Their symptoms had become so, severe as to make them disabled and also required that they see other specialized doctors for severe joint pain (mainly in their arms, hands and backs). A new private doctor they were referred to at one point increased their thyroxine/T-4 level but to a level still below the dose-level that brought them much better symptom relief. Their doses were eventually returned to that original level but unlike the results they had at their earlier ages, at the hands of a pediatrician they did not experience significant symptom relief of their hypothyroidism although they were much improved. Their newer treating doctor began a trial of T-3 therapy (triiodothyronine), added to their T-4 and began to wean them off the T-4, eventually replacing them with T-3 only. The girls again experienced a significant degree of symptom relief but were still in need of much more improvement from their hypothyroid symptoms.
The girls who became women, were eventually administered a combination T-3 and T-4, hormone replacement medication, porcine derived (processed pig thyroid glands), called “Armour Thyroid”. This is in fact the brand of thyroid medication I take and they saw the most significant relief of their hypothyroid symptoms since childhood. I take from their final chapters of their book that they still have room for improvement but they have regained much of the activities important to life. Both of them have also achieved Bachelor Degrees of Science and are now better able to attend family events and live more satisfying lives since experiencing their much-needed improvement. You’ll note in some of my own articles, I point out the fact that some patients see more improvement on T-3/T-4 combination hormone therapy and this book is another confirmation of that.
This book is greatly interesting and the ladies have photographs included in the book, showing the difference between the girls, when one first experienced hypothyroidism, before the other. The stunted growth this caused in the twin that first became ill is remarkable but this twin caught up with her sister in development, once treated with thyroid hormone therapy. They also include symptom and lab test graphs that detail their treatments over the years.
I commend these women for a book that so intelligently details the treatment of their hypothyroidism and how they detail much of this in a medical study type format. I feel the important message this book sends includes the importance in doctors not treating patients using the TSH-only test. I also believe it conveys the importance in doctors not overreacting to possibilities such as the development of osteoporosis from over-treatment because this can be monitored (as it was in their case) using lab testing as well. If patients are experiencing significant symptom relief their thyroid hormone dose should not be adjusted with decreases in dose unless absolute proof of over-treatment is presented. An imbalance caused by radical dose changes, can cause an imbalance that is ongoing and not easily correctable.
This book is a great read for thyroid patients and doctors alike!