If Hypothyroid and Unhappy, Which Came First?
By Gary Pepper, M.D.
Medical specialists increasingly accept that some patients being treated for hypothyroidism continue to be symptomatic and “unhappy”. The degree to which patients experience this problem while on conventional treatment for hypothyroidism with levothyroxine (Synthroid, Levoxyl, Unithroid, T4) has motivated many specialists to look for other approaches to treatment such as adding T3 (Cytomel, liothyronine) or switching to desiccated thyroid extract (Armour, WPthyroid, Westhroid
Not all experts are convinced looking for new treatment options for hypothyroidism is the right approach. At the 2017 meeting of the American Thyroid Association in Orlando, Florida another train of thought appeared to be gaining ground. The question raised is, are patients with hypothyroidism unhappy because their medication is at fault, or rather is it that unhappy people receive thyroid hormone treatment since physicians and patients prefer blaming the symptoms on a medical problem instead of a psychiatric one. Several meeting attendees point out that the number of patients in the UK receiving thyroid medication has grown rapidly and out of proportion to the number of people with hypothyroidism in the population. This suggests that doctors are using thyroid hormone to treat non-thyroid conditions. Could depression be one of these? The conclusion is offered that if thyroid hormone is used inappropriately to treat disorders of mood then it is no surprise that so many patients on thyroid medication remain unhappy and dissatisfied.
Is Hypothyroidism the New Chronic Fatigue Syndrome?
A similar attitude is exhibited by medical professionals when dealing with Chronic Fatigue Syndrome (CFS). This diagnosis is used to explain persistent symptoms of fatigue, body pain, loss of motivation, which are also symptoms of depression. Many physicians do not believe CFS is a real syndrome but is a smoke screen used to avoid confronting a patient with the statement “it’s all in your head”. Is this the attitude physicians take when dealing with patients with hypothyroidism who continue to complain of fatigue, mental fog and lethargy? As of now it seems endocrinologists will remain divided until new scientific insight helps them decide if the problem is with conventional thyroid hormone treatment or is it actually a CFS-like phenomena.