Conflicting opinions and heated debates come with every election cycle. In a similar fashion, appropriate treatment of underactive thyroid, or hypothyroidism, can also cause significant discourse in the medical world. Oddly enough, this election season causes politics and thyroid health to intersect. The former First Lady, and presidential candidate for 2016, Hillary Clinton has made available her medical information, as is customary for those running for president. Interestingly, not only was it shown that Mrs. Clinton has hypothyroidism, but she is also using Natural Desiccated Thyroid (NDT), which is not considered to be part of standard care by many physicians.
This news is particularly interesting because hypothyroidism can seriously impact one’s memory and cognitive ability as well as promoting fatigue, depression, and a bevy of other symptoms. Although these are negative attributes to have in a potential leader, with proper treatment the risk of these maladies is negligible. In regards to Mrs. Clinton’s medical records, her doctor, Lisa Bardack, MD stated that, “Mrs. Clinton is a healthy 67-year-old female whose current medical conditions include hypothyroidism and seasonal pollen allergies…” and concerning treatments, “Mrs. Clinton’s current medications include Armour Thyroid…” It is interesting that a person of such recognition is not only hypothyroid, but is also using a lesser utilized treatment. Hopefully her notoriety will bring greater awareness to thyroid condition and treatment options.
Why is this Important?
Armour Thyroid, the treatment used by Mrs. Clinton, is a brand of natural desiccated thyroid (NDT) that is derived from the dried thyroid glands of pigs. This substance contains calcitonin as well as other natural elements found in the thyroid. Most importantly, NDT holds two critically significant thyroid hormones, T4 (thyroxine, the stored from of the hormone) and T3 (triiodothyronine, the active form of the hormone). This is significant as it differs from the most commonly prescribed treatments, which usually contains just T4. Unfortunately, many physicians improperly treat one’s thyroid condition with exclusively T4 medications which can leave them suffering from any or all of the following symptoms of hypothyroidism:
- Weight Gain
- Sensitivity to cold
- Muscle or joint aches
- Brain fog, including poor memory and poor concentration
- Non-refreshing sleep
- Brittle hair and nails
- Shortness of breath (often called “air hunger”)
- Thinning hair
- Sensitivity to cold
- Significantly calloused heels
- Chronic yeast infections
- Low libido (sex drive)
It is important to treat each patient for their unique needs, be it T4 deficiency, T3 deficiency, conversion from T4 to T3, etc. A healthy thyroid primarily produces T4, which is eventually converted into T3. In part this is why levothyroxine, synthetic T4, is the most common method of treatment. However, T4 is not always converted to T3 effectively, which does not show up on standard tests. A number of factors such as chronic stress, depression, insulin resistance, PMS, iron deficiency, and many others, can inhibit conversion. This is why NDT, which contains both T4 and T3, as well as other beneficial cofactors, may be a better option for those with hypothyroidism.
Natural desiccated thyroid (NDT) is not commonly prescribed for hypothyroid patients even though there is research available that shows the positive impact of this treatment. Unfortunately, misinformation and myths have been proliferated throughout the medical world causing many to believe NDT is unsafe or inferior to levothyroxine. In some cases, doctors may not even suggest, let alone prescribe, NDT even though a patient is not responding well to the standardized treatment. This is unfortunate because one’s condition that is left unresolved by levothyroxine (synthetic T4 thyroid, which includes brands such as Synthroid, Tirosint, Unithroid and Levoxyl) may never be fixed. More often than not, this is because one’s physician incorrectly believes NDT is substandard and therefore not a viable treatment option.
Fact and Fiction
There are a number of false beliefs that continue to circulate in the field of endocrinology such as: NDT can transfer diseases from animals to humans, the ratio of T3 to T4 is too high, there is a lack of research showing its efficacy, it causes heart conditions etc. All these statements have been found to be false yet they are still perceived as truth by many practitioners.
The root of this issue may be found in a controversial statement made in the 2014 Hypothyroidism Guidelines, produced by the American Association of Clinical Endocrinologists (AACE) and the American Thyroid Association (ATA). As stated in the guidelines, “There is no evidence to support using natural desiccated thyroid hormone — i.e., Armour, Nature-Throid — in preference to levothyroxine in treating hypothyroidism…therefore desiccated thyroid hormone should not be used for the treatment of hypothyroidism.” Interestingly, this statement was made without presenting any research proving levothyroxine’s superiority over NDT nor did it present any research showing any additional risks in taking NDT.
A significant piece of research that was neglected to be brought up in these guidelines was a study conducted by Thanh D. Hoand, DO, who presented his research at the Endocrine Society Annual Meeting in June of 2013. Dr. Hoang’s research showed that NDT such as Nature-Throid, WPThyroid, Armour Thyroid, and the generic natural thyroid drug (NP Thyroid) are viable alternatives to levothyroxine. In addition to these findings, nearly half, 49 percent, of the 70 patients preferred natural desiccated thyroid treatment compared to the 19 percent of patients who preferred levothyroxine. Additionally, those who were administered NDT reported weight loss of up to three pounds within the 16-week period of the study. Those who took levothyroxine saw no weight change.
As confidently stated by Dr. Hoang in Endocrine Today, “We now know that once-daily desiccated thyroid extract is a safe alternative treatment for patients with hypothyroidism who are not satisfied with levothyroxine treatment. It’s an option for them to try, and also desiccated can cause moderate weight loss in these patients as well.” It is clear that not only is NDT viable, but there is a significant level of ignorance in the medical field regarding its efficacy.
Regardless of how this election cycle concludes, the medical community, specifically those involved in thyroid health, benefits from the widespread recognition that a prominent figure in our culture is utilizing NDT in treating hypothyroidism. Hopefully this will coax physicians to be more open in utilizing NDT and lead to increased availability. At the very least NDT is another option for treating patients who are not getting the results they need from levothyroxine and may in fact be a better treatment option overall.