For patients with hypothyroidism, thyroid hormone replacement therapy effectiveness is very important. The more symptom relief they experience, the better they are able to carry on normal activities of work, school and leisure activities. In other words, they will regain the best quality-of-life possible. This is where the importance in securing the best possible doctor for administering the treatment comes in, as well as his or her ability to best optimize that therapy.
Varied Effectiveness of Hypothyroid Treatments
The fact is, that thyroid hormone therapies vary in effectiveness, depending upon the type that is being administered and how well it is being monitored by the treating doctor via repeat blood lab testing. Most hypothyroid patients need dose adjustments to bring their thyroid hormones back to the proper level and eventually finely-tuned further to an optimal level. Each patient has that target level that brings him the most symptom relief or might be called his “set-point”. This level of treatment varies among patients and further demonstrates the importance in a quality thyroid doctor, meaning one who specializes in optimizing treatment for hypothyroid patients.
Finding the Right Type of Thyroid Hormone Dose
Most patients are started on a dose of thyroxine to treat their hypothyroidism, which is a T4 only hormone dose, usually prescribed in the synthetic form. The two major thyroid hormones that regulate the body’s metabolism are the T4 and T3 and we depend on the body’s natural process of converting the needed T3 from the T4. For some patients this does not happen adequately and this problem is referred to as “impaired conversion”. The treating doctor also needs to be aware of these possibilities and to know how to monitor for them. If a patient does experience impaired conversion, the doctor needs to be willing to add T3 hormone to the patient’s replacement therapy. Some doctors start patients on T4/T3 combination hormone doses because they believe it is more effective in some patients than a T4-only dose.
The Importance of Repeat Blood Monitoring
To fully monitor the hormone therapy of newly treated hypothyroid patients, a doctor needs to order full thyroid panels that include TSH, T4 and T3, the “free levels” of the later two being the better versions according to many thyroid specialists and endocrinologists. This more thorough monitoring for at least the first few blood retests will better evaluate the thyroid hormone therapy and help the doctor to know what changes are needed in the dose or type of thyroid hormone that is needed. If this type of specialized treatment is not offered to hypothyroid patients, many may potentially remain in a state of unrelieved hypothyroid symptoms and the opportunity will be missed to restore a better quality-of-life to them.
The Journal of Clinical Endocrinology and Metabolism-Medical Research Article: In Search of the Impossible Dream?
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