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Research Articles and Papers on:

Natural Desiccated Thyroid

 

Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study

Thanh D. Hoang, Cara H. Olsen, Vinh Q. Mai, Patrick W. Clyde, and Mohamed K. M. Shakir

DOI: http://dx.doi.org/10.1210/jc.2012-4107
Received: December 05, 2012
Accepted: March 07, 2013
Published Online: March 28, 2013
http://press.endocrine.org/doi/full/10.1210/jc.2012-4107

Abstract

Context:
Patients previously treated with desiccated thyroid extract (DTE), when being switched to levothyroxine (l-T4), occasionally did not feel as well despite adequate dosing based on serum TSH levels.
Objective:
Our objective was to investigate the effectiveness of DTE compared with l-T4 in hypothyroid patients.
Design and Setting:
We conducted a randomized, double-blind, crossover study at a tertiary care center.
Patients:
Patients (n = 70, age 18–65 years) diagnosed with primary hypothyroidism on a stable dose of l-T4 for 6 months were included in the study.
Intervention:
Patients were randomized to either DTE or l-T4 for 16 weeks and then crossed over for the same duration.
Outcome Measures:
Biochemical and neurocognitive tests at baseline and at the end of each treatment period were evaluated.

Results:

There were no differences in symptoms and neurocognitive measurements between the 2 therapies. Patients lost 3 lb on DTE treatment (172.9 ± 36.4 lb vs 175.7 ± 37.7 lb, P < .001). At the end of the study, 34 patients (48.6%) preferred DTE, 13 (18.6%) preferred l-T4, and 23 (32.9%) had no preference. In the subgroup analyses, those patients who preferred DTE lost 4 lb during the DTE treatment, and their subjective symptoms were significantly better while taking DTE as measured by the general health questionnaire-12 and thyroid symptom questionnaire (P < .001 for both). Five variables were predictors of preference for DTE.

Conclusion:

DTE therapy did not result in a significant improvement in quality of life; however, DTE caused modest weight loss and nearly half (48.6%) of the study patients expressed preference for DTE over l-T4. DTE therapy may be relevant for some hypothyroid patients.


 

Conversion to Armour Thyroid from Levothyroxine Improved Patient Satisfaction in the Treatment of Hypothyroidism

Gary M. Pepper* and Paul Y. Casanova-Romero
Gary M. Pepper, Palm Beach Diabetes and Endocrinology Specialists, University of Miami "Leonard M. Miller" School of Medicine, USA

Published: 11 September 2014

Abstract

The use of Armour Thyroid (desiccated thyroid) in the treatment of hypothyroidism has generated debate among endocrinologists although there is evidence that a significant percentage of patients prefer this medication to T4-only replacement strategies. In this retrospective analysis we investigate the preference for replacement therapy of patients with persistent subjective symptoms of hypothyroidism on T4-only treatment who subsequently switched to Armour Thyroid (AT).

Methods: 450 consecutive patients being treated for hypothyroidism were screened. Of these, 154 had been switched from either generic or brand T4 replacement to AT for treatment of persistent symptoms of hypothyroidism. Patients undergoing treatment for thyroid cancer or on suppression therapy for nodular thyroid disease were excluded. Patients were instructed to have their blood sampled for thyroid function testing in the morning after taking their medication. After a minimum of 4 weeks on medication patients were asked to compare AT treatment versus T4-only treatment using a 5 point satisfaction rating scale. Results are reported as mean ± SD.

Results: On a 5 point Satisfaction Rating Scale with “5” indicative of the highest level of satisfaction, 117 (78.0%) patients gave a score of greater than “3” in preference for AT. Three patients treated with AT and one treated with LT4 reported adverse events, all minor. TSH was 1.30 ± 1.9 mIU/L and T3 1.81 ± 0.78 pmol/L on L-T4 monotherapy while TSH was 1.27 ± 2.2 mIU/L and T3 2.31 ± 1.33 pmol/L on AT (NS for TSH and p<0.003 for T3 ). T4 to T3 ratio on L-T4 monotherapy was 8.45 ± 3.7 while it was 4.70 ± 2.0 (p<0.001) on AT. There was no significant change in weight after switching to AT.

Conclusion: AT treatment was preferred over LT4 replacement therapy by 78% of patients with hypothyroidism in the sub-group with persistent subjective complaints while on T4-only therapy. No serious adverse events were noted while on AT treatment including 30 subjects aged 65 yrs or older. AT could be a reasonable alternative choice for treating this sub-group of patients with hypothyroidism.

www.jscimedcentral.com/Endocrinology/endocrinology-2-1055.pdf

 


Improvements in quality of Life in Hypothyroid Patients taking Armour thyroid

Abstract taken from :
Endocrine Abstracts (2008) 15 P359
DH Lewis, J Kumar, P Goulden & DJ Barnes
Maidstone and Tunbridge Wells NHS Trust, Tunbrige Wells, Kent, UK.

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.

Aim: To assess changes in symptoms of hypothyroidism in patients treated with Armour.

Methods: Forty patients (38 female) who had been prescribed Armour between 2005 and 2006 were identified using hospital Pharmacy records. A simple questionnaire was sent to these patients to assess changes to quality of life whilst they were taking Armour.

Results: Thirty-five patients (88%) returned the questionnaire. All patients had been prescribed either T4 and/or combination T4/T3 therapy before commencing Armour. Twenty-nine were still taking Armour at the time of the questionnaire. Three of these twenty-nine patients did not answer the quality of life questions, one of whom was unable to tolerate T4 and T3 due to nausea.

Of the patients still taking Armour, 72% found improvement in energy levels, 52% dry skin, 52% hair loss and 55% cold intolerance. There was no difference in constipation, arthragia, myalgia or ability to lose weight. Most patients (62%) had improvements in 3 or more symptoms of hypothyroidism.

In the 6 patients who were no longer taking Armour, there were no significant improvements in any parameter.

Conclusion: In appropriately selected hypothyroid patients, Armour appears to improve the quality of life in patients who have either had an inadequate clinical response to conventional T4/T3 therapy or are unable to tolerate such therapy.


Does synthetic thyroid extract work for everybody?

Gautam Das, Shweta Anand & Parijat De, Diabetes & Endocrine Unit, City Hospital, Birmingham, United Kingdom.
Endocrine Abstracts (2007) 13 P316

The researchers of this study state that thyroxine is the treatment of choice for hypothyroidism and that it is safe, effective and generally well tolerated. They state, however, that some patients cannot tolerate it.  They describe 3 patients who were successfully treated with Armour thyroid after being intolerant to L-Thyroxine.

A 35yr old lady, having been put on thyroxine for autoimmune hypothyroidism found that, even though she was on 150mcg thyroxine and her TSH was in the mid-normal range of 2.62, she still suffered from tiredness, poor memory, headache, and mood swings. She had a Short Synacthen Test (SST), which was normal and her thyroid auto-antibody test was negative.
She was started on Armour thyroid and within a few weeks her symptoms improved significantly. Within 2 months of starting Armour, her FT4 was 15 and TSH 0.67 and she was continued on Armour thereafter.

Another lady, 63 years of age, was diagnosed with hypothyroidism and was started on 25 mcg thyroxine by her GP. She became dizzy, felt nauseous, and had headaches. She had a short synacthen test, which was normal and she had negative thyroid antibodies. She suffered from tiredness and her TSH was 9 mIU/L. She was given some T3 but she couldn’t tolerate this either. She was subsequently started on Armour thyroid, which led to considerable improvement in her symptoms within a few weeks and her TSH normalized to 4.03  and normal FT4 of 9  in three months time.

A 40yr old female was diagnosed with autoimmune thyroiditis and was started on 25 mcg of L-Thyroxine, which was gradually increased to 100mcg. Over the years her symptoms of tiredness, mood swings, poor memory persisted and she claimed to feel more and more unwell and stopped taking her L-Thyroxine. Her thyroid function deteriorated with a TSH of 31.49  within 6 months. She was put on Armour thyroid
extract and within a few months she became biochemically euthyroid and was completely symptom free.

The researchers inform us that, “Currently it has to be imported from the US where it has been used successfully and safely for some time. Although L-Thyroxine remains the treatment of choice in the majority, a trial of Armour could be considered in patients who have not responded to this conventional treatment and who remain symptomatic with raised serum TSH levels.”
http://www.endocrine-abstracts.org/ea/0013/ea0013P316.htm


Changes in Basal Metabolism, Serum-Protein-Bound Iodine and Cholesterol During Treatment of Hypothyroidism with Oral Thyroid and L-Thyroxine Sodium

J. DOUGLAS ROBERTSON, M.D., D.Sc., F.RC.P. F.R.I.C., D.P.H.,Director
and H. F. W. KIRKPATRICK, PhID., B.Sc., F.R.I.C., Chemical Pathologist, Department of Clinical Investigation, the London Clinic

MARCH 22, 1952

It has been generally established that in patients with untreated hypothyroidism the serum-protein-bound iodine (P.B.I.) is consistently below the normal range of 4 to 8 pg. per 100 ml., and the literature has been re- viewed by Rapport and Curtis (1950). Further, Winkler, Riggs, and Man(1945) claimed that serum iodine is not only a valuable aid in the diagnosis of hypothyroidism but a useful criterion of the adequacy of treatment with thyroid substance, for its return to within the normal range with adequate treatment isa better indication of the thyroid status of the patient than the basal metabolic rate (B.M.R.), the latter becoming stabilized at a slower rate than the serum iodine.

In support of this statement Winkler et al. described their findings...

www.ncbi.nlm.nih.gov/pmc/articles/PMC2023211/pdf/brmedj03486-0020.pdf