An excellent updated (November 2011) article on what is known about Hashimoto's thyroiditis. Written by endocrinologists, there's a lot of material here, everything from diagnosing, to symptomology, to treating, to research, and lots of good stuff in between.
It's a good update on what is known now and recommendations for treatment. The only comment I would make, from personal experience, is that there is still an overreliance on lab values, and failure to listen to patient symptoms.
The authors state that only one of nine studies showed an advantage to adding T3 to levothyroxine. That is where I think endocrinologists need to be willing to open their minds and give it a try. If the patient is still reporting symptoms despite a "normal" TSH and Free T4, in the absence of cardiac problems, a little trial of T3 might be a good idea! They state that T3 is more popular with patients than with physicians.
Hmmm. I wonder why that is?
Addition of a little T3 can require cutting back on the amount of levothyroxine, but if it works for the patient and doesn't cause any abnormal labs or symptoms, hello...
I'm not saying T3 is for everyone, or the magic answer, but quality of life is a big issue with thyroid patients. Endocrinologists need to remember they are treating PEOPLE. People who have lives, and don't feel good when they are constantly plagued wth fatigue and brain fog.
If you're looking for an endocrinologist, do a little research. Find out if they have a genuine interest in thyroid disorders. Have they attended any conferences or participated in any research on thyroid diseases? How do they balance the patient's symptoms vs. lab values when treating?
If you're having problems getting back to feeling like your normal self, "come back in a year" is not the right answer.
Just food for thought.
Thanks for providing such a great blogspot. I am from Australia and have Hashimotos and I have been lucky enough to have one of the few doctors that will readily prescribe T3.(She too has Hashimotos). I have experimented going on and off T3 for the last 6 years and without it I cannot function at a normal level. In addition I have also for the most part been able to train and run ultras again. It is expensive here but well worth it to me.
ReplyDeleteThank you Elouise. I rely on T3 to feel functional. It made such a difference in my life, I can't imagine being without it. It is worth it, to be able to fully live your life. I wish all doctors could empathize with that. So often it seems like only the ones who have been sick or have had thyroid problems themselves really understand. Congratulations to you on being able to run ultras and train again. Keep going!
ReplyDeleteHi Louise can you please tell me the name of the endocrinoligist.
ReplyDeleteThankyou
Arlene, I have been a serious Cyclist; from short races to long endurance MTB races… This fall I have been diagnosed (finally) with Hashimoto's. This past year everything has been falling apart. I'm started on T4 only… and would like to connect with another athlete who is experiencing this syndrome! Is there hope or are my bike racing days over… RG
ReplyDeleteYes there is hope!! It can be a challenge to get to feeling good again with Hashimotos but once I did, I performed as well or better than ever.
DeleteI too am an endurance athlete and have felt my performance spiraling downhill all year. Training runs were at 8:30 minute miles but are not at 10 minute miles. My bike races have gone from first place to being lucky to get 3rd, but I'm getting slower and slower. I was just diagnosed less than 2 weeks ago with Hashi's. My T4 and TSH are both within the normal limits so my Dr said no need to do anything. I don't know anything about optimal levels so I went with what she said. I raced again yesterday and it was a disaster. Last place and today my back hurts and walking up the stairs is wearing me out. I've lost a lot of muscle this year too and it seems fat has replaced it.
DeleteUnfortunately there isn't that much you can do at this point other than checking your labs frequently and going by your symptoms. Wherever your TSH T4, T3 are now, they will be changing if you have Hashis. There is a new recommendation that is being pushed to do a thyroidectomy on people with Hashis but be careful because this has not been standard practice and I fear it could do more harm than good in many people. I am going to be posting an update here soon on the latest talk on Hashi's. Do not give up though. You will most likely have periods of time when you have better function, but the Hashis is going to dictate that. Everyone is different. I know that's not much help. When you are really exhausted, if you can just keep moving and do some physical activity even on the worst days, at least you keep from losing any more muscle mass. More on this in a near future post...
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