Page 36 - Summer2009

is accurate. The companies making the other two QR EHQH¿W +RZHYHU WKHVH VWXG\ SDWLHQWV¶ 7
brand names, Levoxyl (King Pharmaceuticals, DQG 7 VHUXP OHYHOV ZHUH HYHQ OHVV RSWLPL]HG
which also makes Cytomel, the leading T3-only than those of the 33 patients in a 1999 paper by
brand) and Levothroid (Forest, which also makes Bunevicius and others, published in the New
Armour Thyroid and Thyrolar, the natural and England Journal of Medicine, which had found
V\QWKHWLF UHVSHFWLYHO\ 7 7 FRPER SURGXFWV VLJQL¿FDQW EHQH¿WV —and which these newer
33
DUH QRW LQYROYHG LQ WKH 7 RQO\ FDPSDLJQ DV papers were obviously intended to counteract.
WKH\ KDYH GLYHUVL¿HG WKHLU SRUWIROLRV WR LQFOXGH In addition, the patients in the 1999 study often
T3-containing products. These have been both ended up on a lower total daily intake of thyroid
VFLHQWL¿FDOO\ DQG FRPPHUFLDOO\ EHQH¿FLDO GHFL- KRUPRQH 7 DQG 7 FRPELQHG WKDQ WKH\ KDG
VLRQV RQ WKHLU SDUW 7KH 7 RQO\ FDPSDLJQ KDV RULJLQDOO\ QHHGHG ZKHQ 7 RQO\ ZDV WKHLU WUHDW-
been almost totally successful in keeping T3 ment.
DQG 7 7 FRPER SURGXFWV RXW RI PDQ\ RWKHU Using patients with suboptimized serum T3
countries, including Australia, Israel and Spain DQG 7 OHYHOV LV QR ZD\ WR WU\ WR SURYH WKH IXWLOLW\
(despite the Escobar-Morreale research team in of T3 treatment—not only for primary hypothy-
Madrid, which showed that the addition of T3 roidism patients but even less so for patients who
WR WKH 7 WUHDWPHQW ZDV QHFHVVDU\ WR UHVWRUH WR have one of the other types of hypothyroidism,
normal the brain function of rats whose thyroid either as the sole cause of their hypothyroidism or
glands had been removed or destroyed). 21 as an additional cause of their total hypothyroid
The best In spite of the fact that neither Boots nor picture. There is no way to justify withholding

approach, Knowles is in business any longer (at least under the addition of T3 to secondary, tertiary and NTI
those names), due to public outcry, the medical hypothyroidism patients, because in them the T3
one I have profession is still largely in the Synthroid camp is the lower of the two thyroid hormones.
used very with regard to brand names—and has even al- In these latter types of hypothyroidism there

successfully ORZHG LWV VFLHQWL¿F MXGJPHQW WR EH VNHZHG RQ is a strong tendency for the free T3 level (deter-
WKH LVVXH RI 7 RQO\ WUHDWPHQW E\ WKLV SKDUPD mined by the dialysis method) to lag behind the
since 1989 in industry giant. GLDO\VLV IUHH 7 OHYHO GHWHUPLQHG E\ WKH GLDO\VLV
over 5,000 :KHQ , ¿UVW VWDUWHG WUHDWLQJ K\SRWK\URLG- method). This is partly because of the lack of
patients, ism, in 1989, there were several very bad generic 76+ ZKLFK GULYHV WKH FRQYHUVLRQ RI 7 WR 7
products on the market that produced inferior but may also be due to peripheral interference
does not results and blood levels. That is no longer the ZLWK WKH ¶ GHLRGLQDVH HQ]\PH¶V FRQYHUVLRQ

advocate any case. This is one area where some praise for the GHLRGLQDWLRQ RI 7 WR 7 ZKLFK RFFXUV LQ 17,
one FDA is in order, though they went overboard in hypothyroidism. It is telling that the Kaplan
banning Euthroid—and may go overboard again, editorial indicated a marked note of despair that
prescription LQ D PXFK ZRUVH ZD\ EDQQLQJ DOO QRQ 7 RQO\ an ideal treatment for all the symptoms of hypo-

medication products, if Sidney Wolfe, MD, the misguided thyroidism will ever be found! Considering the
for all cases Public Citizen advocate, attains a high enough ÀDZHG DVVXPSWLRQV RQ ZKLFK WKH HGLWRULDO DQG
position in it to impose his view on the organiza-
the articles were based, it is not at all surprising
but has the tion. to me that optimal treatment is an elusive goal
goal of to these researchers and opinion-makers!
If practitioners would simply switch their
optimizing 386+,1* 7+( 7 21/< $3352$&+ focus from “optimizing” TSH to truly optimiz-
TO TREATMENT
the free Toward the end of 2003 a rash of papers LQJ WKH GLDO\VLV WHVWHG IUHH 7 DQG IUHH 7 VHUXP
serum levels appeared in the October issue of the Journal of levels, they would achieve, as I have, this laud-
of both the Clinical Endocrinology and Metabolism, along able goal in virtually all their patients!
31
with an editorial by Kaplan and others, and an
Fortunately, the pendulum has already
T3 and T4 article in the December issue of the Journal of started to swing back toward evidence for the
thyroid the American Medical Association, showing HI¿FDF\ RI WKH DGGLWLRQ RI 7 WR 7 WUHDWPHQW ,Q
32
hormones. WKDW WKH VXEVWLWXWLRQ RI 7 IRU VRPH RI WKH 7 LQ 2002, an “old guard” resister of the combination
7 RQO\ WUHDWHG K\SRWK\URLG SDWLHQWV SURGXFHG approach, the same Anthony Toft who originally
34 Wise Traditions SUMMER 2009