Re: Levothyroxine shows no benefit in elderly patients with subclinical hypothyroidism, trial finds
I agree with Dr Lewis that the evidence on the optimal treatment of hypothyroid disorders is more flimsy than it should be, and that blinded RCTs are required. In the mean time, however, we can only go with the available research. There are clear suggestions that tri-iodothyronine is indeed more effective than thyroxine (1). The main point in my initial response was that, given the dubiety of current evidence, it is illogical to write off the existence of a disorder because it does not respond to a treatment that one expects to be successful. (2) Would we write off the existence of depression because a particular anti-depressant was found to be ineffective?
(1) Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine.
Authors:
Escobar-Morreale, Héctor F.
Botella-Carretero, José I.
Morreale de Escobar, Gabriella
Source:
Bailliere's Best Practice & Research in Clinical Endocrinology & Metabolism; Jan2015, Vol. 29 Issue 1, p57-75, 19p
Publication Year:
2015
(2)The History and Future of Treatment of Hypothyroidism.
Full Text Available
Academic Journal
(English) ; Abstract available. By: McAninch EA; Bianco AC, Annals Of Internal Medicine [Ann Intern Med], ISSN: 1539-3704, 2016 Jan 05; Vol. 164 (1), pp. 50-6; Publisher: American College of Physicians--American Society of Internal Medicine; PMID: 26747302, Database: MEDLINE with Full Text
Rapid Response:
Re: Levothyroxine shows no benefit in elderly patients with subclinical hypothyroidism, trial finds
I agree with Dr Lewis that the evidence on the optimal treatment of hypothyroid disorders is more flimsy than it should be, and that blinded RCTs are required. In the mean time, however, we can only go with the available research. There are clear suggestions that tri-iodothyronine is indeed more effective than thyroxine (1). The main point in my initial response was that, given the dubiety of current evidence, it is illogical to write off the existence of a disorder because it does not respond to a treatment that one expects to be successful. (2) Would we write off the existence of depression because a particular anti-depressant was found to be ineffective?
(1) Treatment of hypothyroidism with levothyroxine or a combination of levothyroxine plus L-triiodothyronine.
Authors:
Escobar-Morreale, Héctor F.
Botella-Carretero, José I.
Morreale de Escobar, Gabriella
Source:
Bailliere's Best Practice & Research in Clinical Endocrinology & Metabolism; Jan2015, Vol. 29 Issue 1, p57-75, 19p
Publication Year:
2015
(2)The History and Future of Treatment of Hypothyroidism.
Full Text Available
Academic Journal
(English) ; Abstract available. By: McAninch EA; Bianco AC, Annals Of Internal Medicine [Ann Intern Med], ISSN: 1539-3704, 2016 Jan 05; Vol. 164 (1), pp. 50-6; Publisher: American College of Physicians--American Society of Internal Medicine; PMID: 26747302, Database: MEDLINE with Full Text
Competing interests: No competing interests