Thyroid hormone supplements are among the best-selling medications. It is undisputed: If the thyroid gland does not produce enough of its hormone thyroxine, sufferers need treatment. There is less agreement among experts on the need for therapy in light preliminary stages.
Who should swallow thyroid hormones? No question: If the thyroid gland does not produce enough hormones, sufferers need hormone supplements. There is less agreement among experts on the treatment of cases with slightly noticeable laboratory values. A recent study shows that people over the age of 65 do not really benefit from such an early start of treatment.
##Thyroid hormones:
Thyroid hormones stimulate the cell metabolism of almost all organs; they are therefore vital. To make the hormones, the thyroid needs iodine.
Controlled and, if necessary, stimulated the thyroid activity of a hormone of the pituitary gland, the TSH.
How do I recognize the symptoms of thyroid hormone deficiency?
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Thyroid hormone deficiency leads to a range of symptoms.
Typical: constant tiredness, listlessness, brittle hair, very dry skin, constipation, severe freezing, weight gain
Other possible signs include cold skin, hoarseness, impaired hearing.
Over time, the level of cholesterol in the blood increases, which promotes arteriosclerosis and thus the risk of a heart attack.
Since the physical and psychological symptoms gradually increase, sufferers or even doctors do not initially recognize that there is a disease. You look for other explanations, for example the menopause.
Manifeste Unterfunktion: When the thyroid gland produces too few hormones
When the thyroid gland produces not enough hormones, it is called an overt thyroid underactive. The gland then produces too little T4 (thyroxine) and T3 (triiodothyronine). At the same time the pituitary gland of the brain releases increased amounts of TSH to stimulate the thyroid gland. Up to two percent of the population develop overt thyroid hypofunction. Women are more frequently affected than men, especially women of childbearing age.
A frequent cause is a chronic thyroiditis: Hashimoto's thyroiditis. This is an autoimmune disease whose triggers are unknown. Also, iodine deficiency impairs the function of the thyroid gland.
Only TSH value increased: Also treat subclinical hypofunction?
More often than an underlying hypofunction of the thyroid gland is subclinical hypofunction. This means that the thyroid gland makes enough hormones, and sufferers have no clear symptoms; but: the control hormone TSH of the brain has slightly noticeable values.
Subclinical hypothyroidism is relatively common, according to sources from 3 to 18 percent of adults are affected, especially the elderly, women more often than men.
There seems to be a trend to increasingly treat even these mild subclinical cases. This has been proven by a study for Great Britain. But the practice is controversial.
People with mild hypofunction do not benefit from treatment
A recent international study with Swiss participation comes to the conclusion: study participants with mild subclinical hypothyroidism did not benefit from the intake of thyroid hormones. Conclusion: For TSH values below 10 mU / l, treatment is unnecessary.
Further information
Swiss experts share this view more or less and see exceptions to the rule: especially for unintentionally infertile women and pregnant women. For them, it may be appropriate, according to widespread opinion, to take thyroid hormones.
On the other hand, it is disputed whether higher TSH levels should be tolerated for the elderly.
Some specialists generally advocate treatment attempts, which are checked after a while and if necessary stopped, if they bring nothing.
Laboratory Thyroid Underfunction:
Normal value of the thyroid hormone T4 (thyroxine) in the blood serum.
Normal is a fT4 of 9.9 to 19.3 pmol / l (picomoles per liter).
UNDER means: subfunction
Control hormone TSH in the blood serum:
Normal is a TSH value of 0.4 to about 4.0 mU / l (milliunits per liter)
ABOVE means beginning to pronounced hypofunction
Subclinical hypothyroidism (fT4 normal, TSH elevated):
Very slightly increased TSH value: 4.5 to 10 mU / l
Increased TSH value: 10.5 to 20 mU / l (above = greatly increased)
Thyroid medications: more and more prescribed
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In the last ten years, the sale of thyroid medicines in Switzerland has risen sharply. 680,000 packs were sold in 2007 and more than half in 2017, namely 1.1 million packs. These figures are from the industry association Interpharma. Neither the increase in the resident population nor a change in packaging sizes can explain the sharp increase. In the new Helsana medicine report, thyroid hormones are ranked 14th in the top-20 list of top-selling medications. Also, countries such as Germany, England or the USA have proven that thyroid hormones are prescribed very frequently. The reason for the increase is very different:
General increase of autoimmune diseases, including chronic thyroiditis
Increased treatment of very mild, subclinical hypothyroidism as "trend"
Especially increased treatment in pregnancy