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Is Thyroid Disease Really So "Easy to Treat?"

Hypothyroidism and hyperthyroidism diagnosis and treatment


Updated May 16, 2014

Is Thyroid Disease Really So
A recent spate of high-profile media coverage on thyroid disease has been promoting two key messages:
  • more people should be tested for thyroid disease, because there are millions of people in the U.S. who are undiagnosed.
  • once diagnosed, thyroid disease is easy to treat.
These ideas were most recently disseminated in an April 10, 2000 Associated Press (AP) story, "Specialists Urge Thyroid Testing," and Dr. Isadore Rosenfeld's April 2, 2000 Parade magazine article, "Could It Be Your Thyroid?"

In Parade, Dr. Rosenfeld states, "All you need to do to treat your hypothyroidism is replace the missing hormone. It's easy -- just a pill a day." In the AP article, writer Lauran Neergaard says, "Thyroid problems are easily treated, with a daily pill or, for hyperthyroidism, sometimes removing the gland."

The "daily pill" these writers are talking about is levothyroxine (brand names: Synthroid, Levoxyl, Levothyroid), a thyroid hormone replacement that contains a synthetic version of the thyroid hormone T4 (thyroxine). Levothyroxine is considered the mainstream treatment for hypothyroidism in the U.S.

Efforts to raise visibility of thyroid symptoms and to increase thyroid testing in the U.S. should be applauded. It is particularly important, given recent findings that an estimated 10 million people have undiagnosed thyroid conditions -- not 5 million as previously thought. These findings were discussed in a recent article here at the site.

This recent public relations campaign to increase the number of people aware of and diagnosed with thyroid disease in the U.S. is, however, doing a disservice to some patients. The campaign is seriously downplaying the complexities of thyroid disease treatment and the difficulties many patients encounter in living with the hypothyroidism -- underactive thyroid condition -- that is usually the result of most thyroid disease and thyroid treatment. This was the subject of a Patient Response to AP Wire Story Press Release in which I presented arguments on behalf of hypothyroidism patients.

These writers' continued assertions of how easy it is to treat thyroid disease are not only propagating old ways of thinking, but they are contradicted by major medical organizations involved in thyroid disease, and recent journal findings. . . and particularly by patients themselves.

Is Hypothyroidism Easy to Treat With One Little Pill?

The patient foundations and medical journals don't think so.

Research from the now defunct Thyroid Foundation of America, a thyroid patient organization, found that among patients who were hypothyroid due to treatment for Graves' Disease, the majority did not feel well despite daily treatment with a thyroid hormone replacement pill.

Groundbreaking research reported on in the February 11, 1999 issue of the New England Journal of Medicine also found that levothyroxine treatment alone was not enough for many patients, and found that, for the the majority of patients participating in their study, "treatment with thyroxine plus triiodothyronine improved the quality of life for most [hypothyroid] patients." Triiodothyronine is more frequently referred to by the term T3, and one brand name, Cytomel, is available in the U.S. Some compounding pharmacies also produce a time-released version of T3.

Is Hyperthyroidism Easy to Treat?

The primary treatment for hyperthyroidism in the US is not, as stated in the AP article, removing the gland surgically, but rather, is a treatment know as radioactive iodine, or RAI. Surgery of the thyroid would not typically be described as an easy treatment, nor can RAI be considered easy. RAI involves ingestion of a radioactive iodine liquid, and in some cases, is followed by as much as a several-day isolation from other people to avoid radiation contamination of others. The RAI slowly deteriorates the thyroid's ability to produce hormone. Eventually, most people who have received RAI become hypothyroid, and require lifelong thyroid hormone replacement treatment. And, as noted above, according to the Thyroid Foundation of America, the majority of these patients, subsequently complain of continuing symptoms.

RAI treatment also increases the risk of thyroid eye disease complications and exacerbation of the condition.
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