Are underactive thryoids being over-treated?

An underactive thyroid can go hand in hand with a diagnosis of Complex Regional Pain Syndrome, with around 33% of those who have the illness also going on to develop hypothyroidism or Hashimoto’s disease (the technical names for an underactive thyroid).

Hypothyroidism can cause problems including low mood, weight gain and tiredness. To combat these symptoms, the illness is normally treated by taking a synthetic version of the thyroid hormone to bring levels back to the normal range. I myself have been on levothyroxine now for several years.

New research has been published

Today, though, research has been published in the British Medical Journal suggesting that for some people, this medicine isn’t really helping. The scientists behind the research have looked into whether synthetic thyroid hormones are helpful to people with mild underactive thyroid in controlling three common symptoms of the illness: tiredness, weight gain and low mood.

They looked at the results of 21 clinical trials with 2192 participants. By looking at the results of lots of different trials, they were able to build up a wide-ranging picture of how thyroid medication affects people with hypothyroidism.

Their studies ultimately suggest that if you have a mild underactive thyroid, there’s little evidence that the medicine will help you. Also, given that it’s generally a life-long illness so needs to be treated with medicine until death, there’s not enough known about the possible side effects of levothyroxine or levothyronin to state with total confidence that they do more good than harm.

What should I do if I take medicine for an underactive thyroid?

Firstly, don’t panic and definitely don’t stop taking your prescribed medication. The doctors behind the study have taken great pains to make it clear that these findings only apply to those with a very mildly underactive thyroid so for many of us this research will be irrelevant.

If you’re concerned that you may be taking medicine that you don’t really need, the best thing is to make an appointment with your GP to discuss. They can do a blood test to see how your thyroid gland is working and how much thyroid hormone is in your blood so you can have an informed conversation about the best options for you. It’s a good idea to do this every few months or so anyway, as our bodies can fluctuate and your thyroid function can change over time, meaning that your medication may need to be tweaked anyway.

At the moment this is merely research that suggests the possibility of changing the guidelines; it’s hit the news because hypothyroidism is a problem that affects lots of people, but nothing has been decided yet.

Ultimately, the scientists suggest that the most important factor in deciding whether someone needs thyroid hormones is how you feel; the doctors recommend that if you do have an underactive thyroid, it’s probably worth trying tablets for a few months to see if they make you feel any better. If they do then that’s great. If they don’t, well, perhaps this is one medication you can do without. Certainly CRPS patients often feel like a walking pill bottle so I imagine most of us wouldn’t mind giving one up if it’s really not helping.