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Mary Shomon

Slightly Underactive Thyroid May Make You Depressed, Overweight, at Risk of Heart Disease and Chronically Ill

By June 12, 2009

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Sometimes, thyroid news makes me furious....and today is one of those days. You might see or hear a news story over the next few days saying: "A slightly underactive thyroid may help you live longer," or "Hypothyroidism may be a plus" -- you get the idea. Those are the headlines coming out of a presentation at this week's Endocrine Society meeting. But unfortunately, as is all too common when it comes to thyroid disease, things are getting garbled, and that always means patients end up getting the short end of the stick.

So, what do we know? We know that at the Endocrine Society annual meeting in Washington this week, Dr. Martin Surks, a professor of endocrinology at Albert Einstein College of Medicine in New York, gave a presentation titled "Genetic Predisposition to Elevated Serum Thyrotropin is Associated with Exceptional Longevity."

According to Dr. Surks, researchers took a group of 100-year old 236 Ashkenazi Jews -- along with their 70-something children -- and measured their thyroid stimulating hormone (TSH) levels. They found that the centenarians and their children had slightly elevated levels of TSH -- and 40 percent of the centenarians had TSH levels above 2.5.

So the scientists have decided that, though they don't know why, a slightly slower metabolism might promote longevity.

Before we get worked up...it's just a theory, right? And before anyone could assume that the hypothyroidism was somehow a positive, you'd have to look at all the various factors --especially genetic similarities in Ashkenazi Jews, and an unusual variant in their TSH receptors that they shared -- that might predispose them to longevity. Right?

Well, you might think it's just a theory, but here's what study co-author Martin Surks, MD had to say: "This is sort of a revolutionary finding. A year or two ago, higher TSH was thought to be a disease that might warrant treatment. These findings in this very select population suggest the opposite. Higher TSH could actually benefit you."

Yes... one of the nation's leading endocrinologists DID in fact say, "a year or two ago, higher TSH was thought to be a disease that might warrant treatment."

Then you have Dr. Jacob Warman, chief of endocrinology at the Brooklyn Hospital Center in New York, who added his two cents: "I see a lot of people with this elevated TSH, and I usually do not treat all of them unless I see the TSH levels going up to above 10." (Before we remind Dr. Warman that the American Association of Clinical Endocrinology recommends that doctors consider treatment for TSH levels above 3.0, in his defense, he did suggest that people with elevated TSH levels also get antibodies testing for Hashimoto's thyroiditis, and recommended treatment because Hashimoto's hypothyroidism usually worsens over time.)

But still....they don't treat until TSH levels are over 10???

Is it not enough that millions of people have thyroid problems that are undiagnosed? Now, it seems that doctors are actively looking for yet more reasons to NOT treat people with thyroid problems?

What about the hundreds of peer-reviewed, double-blind medical journal studies that show that borderline, subclinical and mild hypothyroidism is associated with a laundry list of health challenges, including heart disease, high cholesterol, infertility, miscarriage, prematurity, metabolic syndrome, obesity, depression, Alzheimer's disease, and cognitive and developmental problems in the offspring of affected mothers? What about the fact that most of us are NOT Ashkenazi Jews with changes to our TSH receptors?

Yes, it's interesting that this small group of centenarians had a thyroid similarity. But when researchers present their findings without the context of all the knowledge we have about subclinical hypothyroidism, and the media start pumping out the "Slightly Underactive Thyroid May Be a Plus" stories, you just know thyroid patients are going to suffer.

It's just another level of misinformation that is doing a disservice to the millions of people who are in the limbo of a TSH level above 3.0 and who can't get diagnosed or properly treated.

So this group of folks lived to be 100, with mildly hypothyroid TSH levels. Here's the question I would ask. Did they have to spend the better part of those 100 years exhausted, overweight, depressed and with a nonexistent sex drive in order to make it to 100?

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Comments
June 13, 2009 at 12:29 am
(1) Lily says:

Okay, so 60% of Centenarians had a TSH under 2.5, right? So why isn’t the take away message that people should have a TSH below 2.5 if they want to live that long?

Don’t even get me started on the fact that correlation is not causation, but if they are going to make faulty associations, why can’t they make the association between LOWER TSH and longevity?

June 13, 2009 at 10:58 am
(2) Judith Franklin says:

a big thank you to Mary for a first rate site.
I now know more than most doctors and also most
endo`s. but what is the good in that if my doctor or endo cannot diagnose my hashimoto`s
or even treat me with concern.how do we get them to see the trees in the woods when they only see the woods, and not all the different
leaves.

June 13, 2009 at 12:20 pm
(3) Donna M. says:

So, does having an elevated TSH increase the chance of living past 100 in that particular genetic population, or does living past 100 increase the chance that the TSH will be elevated? One could argue the second option as easily as the first. I think Dr. Surks drew the wrong concusion.

June 14, 2009 at 11:43 am
(4) Terry Alan says:

In the past I went to a new Dr. — had to change because of insurance reasons. I told him I was cramping up. I couldn’t turn my head to back up my truck without my neck muscles cramping.
I told him I hadn’t had a blood test in over a year, I had no thyroid and the T4 only drug was not only not working but was not enough 125 mcg.
My TSH was 7. something. My cholesterol levels was through the roof. Signs that even a novice doctor could recognize as hypothyroid.
He said I wasn’t hypothyroid and would need some cholesterol lowering drugs and didn’t think much of my cramping up at all.
I thanked him for his professional medical opinion, paid my co pay and never went back to that Doctor.
Now I have a surpressed TSH which is like a bounty over my head with docs just itching to cut my thyroid meds and bring my TSH levels up

This news will make things just that much more difficult.

Being a man with thyroid problems is enough of a hindrance. Most docs don’t really know how the adrenal & sex hormones work in conjunction with the thyroid, and what they do study is how female sex hormones interact, if they pay any attention to it all

Male

thyroidless

June 15, 2009 at 2:59 pm
(5) gina says:

this tripe “research” is beyond infuriating!

since t3 and t4 levels weren’t measured, they don’t even know if they were in fact hypothyroid anyway. maybe their “slightly elevated” tsh levels (btw, since when do endo’s call 2.5 elevated??) meant that their thyroid hormones were actually elevated as well.

also, even if 100% (instead of only 40%) had tsh over 2.5, what does that have to do with not treating until tsh exceeds 10?!

also, as lily pointed out, “correlation is not causation”, yet one of the docs asserts confidently that “this is beginning to get us some answers for what is important for that degree of longevity.”

the endo’s quoted in this article would flunk a junior high logic class, yet they’re all hospital department chiefs – crazy!!

June 16, 2009 at 4:02 pm
(6) Donna says:

I am a hypothyroid Ashkenazi jew and I would bet that every woman in my family had high tsh. All the bubbies were overweight, very sarcastic to compensate for their depression, and never made it off the couch. Don’t get me started on the sex drive thing. The symptoms of hypothyroidism are the cultural norm in this group. The women all lived long and the men died early (the joke is because they wanted to). Their lives might have been happier if they were treated.

June 19, 2009 at 4:37 am
(7) Denise Belgacem says:

In the face of the dismissive attitudes and ridicule I faced in trying to get treated. I have to wonder what they have to gain. Personally I think it’s politics and until money is taken out of the equation I can not see any improvement any time soon.

June 19, 2009 at 5:17 am
(8) Anne says:

You are all missing the most obvious point…
Who, in their right mind, whether a thyroid patient or not, really wants to live to be 100?

Have a “wunnaful” day!

XOXO
Anne

June 19, 2009 at 8:40 am
(9) Anna says:

I hear you Anne that was my thought

June 19, 2009 at 9:05 am
(10) Deb says:

My thoughts follow the last 2 posts – especially with the obesity/low sex drive/depression/heavy periods – why would anyone want to live that long? Yea! I get to suffer even longer with all the symptoms, Woo Hoo?!

June 19, 2009 at 9:14 am
(11) Norine says:

What were the TSH’s at 90 years, 80 years, 40 years of age, etc? Maybe there was a change because of old age. Levels might have been better when they were younger. My father lived to 98 and was healthy until about 96. Then things deteriorated rather suddenly. These people could have been normal until the day before they were tested. This reminds me of the old saying,”Figures fool when fools figure”. Blessings to all. N.

June 19, 2009 at 9:52 am
(12) Dianne says:

Anybody can have a theory, so here’s mine. I am one of the thousands of thyroid patients whose “numbers” respond well to treatment, but not my symptoms. “Problem” patients like me, who, for whatever reason don’t respond well to treatment must be a source of extreme frustration for doctors. And why not? We defy what they were taught AND logic. PLUS, we are a drain on their energy and time when our TSH is fine, yet we complain.

Now make that magic number for treatment a “10″, where most people would be close to immobile, sky high cholesterol “zombies”, and patient response, even with moderate improvement, would seem like a miracle.

In my opinion, don’t try to DISPROVE what is already medical fact, (hypothyroid does need to be treated at levels between 3.5 — 5.0) BUT research better methods of treatment! (How long since a new drug has been introduced into the hypothyroid world?)

NEW research on THE PROBLEM…not trying to REDEFINE the problem.

June 19, 2009 at 10:30 am
(13) Rhonda says:

This is a good example of how studies are twisted. In addition to what has already been stated:

#1 without having followed these people their whole life, it’s impossible to draw conclusions (ie maybe their thyroids were normal for the majority of their life but as they aged their TSH raised–as is common in many elderly people) #2 what is their quality of life? Their longevity by itself means nothing without knowing their overall health status.

Most likely there were other problems with the study design as well.

June 19, 2009 at 11:56 am
(14) Suzanne says:

Thank you Mary! This is ridiculous! Maybe true, but who wants to trade in being miserable for a longer life?!

June 19, 2009 at 12:12 pm
(15) MK Ray says:

Wow above 2.5 is hypothyroid! that will be the big news about this study to a lot of doctors and labs!

June 19, 2009 at 12:20 pm
(16) K. Christensen says:

Shocking morons. Thanks Male Hypothyroid for leaving a comment–much appreciated. I can’t help but think if this disease were mostly suffered by men, instead of 80% women, that none of this nonsense would be taking place.

June 19, 2009 at 5:25 pm
(17) Valetudinarian says:

First, Dr. Surks: While I am really glad he is attempting to study the thyroid and applaud his efforts, I am curious as to his MOTIVATION for testing 100 year olds? Is he trying to find the key to longevity (the fountain of youth) or to find out how the endocrine system functions? The TSH can not be the only thing tested on those 100 year-olds! What else was tested? What were the findings? Perhaps what we consider normal now, we may find out in decades that there was a pattern. Was there a similar study done on 100-year old Ashekenazi Jews done 5, 10 or 20 years ago? What were those findings? Are there no comparative studies on this population?

I wonder, is Dr. Surks happy with what the media is grabbing onto?

Secondly,Dr. Jacob Warman: Has anyone asked him to thoroughly explain WHY he does not treat until the TSH reaches 10? A thorough explanation from him seems in order and would certainly be helpful. Dr. Warman, would you please explain?

I think just about every one of my professors in college preached “correlation is not causation”. I will never get that phrase out of my head….!!

June 20, 2009 at 4:14 pm
(18) Anna says:

I would have thought that, instead of reaching that ripe old age because of slightly suppressed thyroid function, centenarians end up with slightly suppressed thyroid function because they have reached that ripe old age. There’s a big difference.

June 20, 2009 at 10:32 pm
(19) Evelyn says:

I can’t get a dr to increase a dosage when my tsh won’t go below 5.14 without deciding that I’m a hysterical old woman with mental problems, and they want to tell me this is a good thing? I don’t think so. I’m just the foggy headed, dry skinned, achy, moody b!+(# who will tell them how crazy they really are.

June 21, 2009 at 8:12 pm
(20) Thalia says:

More bad research.

A TSH of 4 might be great if you are 100. Any TSH at the age of 100 is a bonus as so few of us get that far we don’t know what is normal for that age group anyway.

We do know anything over 2.5 from age 0 – 80 is associated with heart disease, infertility, obesity, high Cholesterol, economic inactivity, depression and many, many other things and as that is the average lifespan, that’s what matters to most of us.

They are just trying to sell more statins, heart drugs, anti-depressants etc.

June 21, 2009 at 8:18 pm
(21) Thalia says:

Where’s this new magic number of 10 come from?

First the British Thyroid Association, who’s anti-patient care bias was so well summed up in the immortal article “Whose thyroid is it anyway?”, and now this chap.

The thing to do is find the common denominator.

It’s a maths thing.

June 23, 2009 at 4:41 am
(22) Ciara says:

If they found that 40% of women at 100 years old, had slow growing lesions or tumours, would they concur that having lesions led to a longer life.
Two posters summed it up corelation is not causation and there is nothign to suggest that it was being 100 years old that cuased the TSH – NOT the other way round.
As for a TSH of 10!!!!!!! Well I wouldn’t be costing the medicla system a fortune in treating heart disease, depression and obesity – as I’d be DEAD.

July 12, 2009 at 4:05 pm
(23) Melanie Decker says:

My TSH is a 17 but my doctor did not want to share any levels with me so I do not know my T3 or T4. While I may or may not have some symptoms of an under active thyroid I certainly do not have the usual ones. Thursday I got up at 6 am mowed my yard, watered outdoor plants, moved the paint scaffold inside because I just finished scraping and painting my house last week, wahsed some clothes, washed my kitchen floor and then went to a teacher workshop that started at 9 am. I was there until 3:30 came home and took a 30 minute nap and then I went and edged and worked in my flower beds for about 3 hours. Does this sound like someone with an underactive thyroid? I am like this all the time and my friends always say underactive sounds like overactive. I have lost 30 pounds in the last year . Yes, I worked at it but it was not impossible. I have always had a hoarse sounding voice and I have always been colder than other people. I bounce through life, do not have dry skin nor is my hair falling out. All my doctor wants to do is to put me on medication but something just is not fitting in this picturem,

August 5, 2009 at 6:37 pm
(24) kim says:

I just has my tsh level & other labs taken today to see if I have an underactive thyroid…but I could sleep forever, and I have gained 50lbs in 2yrs..I am so tired,it`s all I can do to stay awake thru an 8hr work day..I also have depression & constipation along with being wore out…. & ACHES & PAIN!! I would not want to live to be 60 like this,let alone 100.I am 44 yrs old at this time!

December 14, 2009 at 7:44 pm
(25) Michael Cignarella says:

O.k. I’ve got a Headache, Depressed, Angry at times, No sex drive where in a year prior It was overactive, My eyes hurt, Feels like I have a lump in the back of my throat that I want to swallow but never goes into my stomach, I go through ALL emotions Hourly, Hungry some days Other days I don’t want to eat at all No hunger what so ever, PALE white as a ghost where I used to have nice color, I’m shedding, Never had dry skin before now I scratch my head it looks like it’s snowing. They put me on .5 of levothyroxine took care of the body aches that’s about it. Hospital said 3 weeks ago my lvl’s were .83 Today my PHP said my lvl’s were at 44 ? ? ? I take my meds EVERY day.. All my other symptoms are the same or worse I feel like they are missing something I used to be a happy lovable person. Now I’m depressed all the time and can barely play with my son.

June 27, 2010 at 12:18 am
(26) karen says:

Does hypothyroid make your heart flutter?

December 17, 2010 at 4:15 pm
(27) liza says:

above michael just about summed it up..my results today were 37, and had to beg for more thyroxine…i said i will self medicate.

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