DEAR DR. GOTT: Quite a while ago, you published a letter from a person who inquired about whether he or she should be treated for hypothyroidism with a TSH level of 6.7.
Hypothyroidism is rampant in my family. I think it is important to identify the consequences of untreated hypothyroidism, which include a greater likelihood of high blood pressure, high cholesterol, diabetes and early-onset dementia.
Also, it is worthwhile to note that the European standards for diagnosing hypothyroidism are much narrower than in this country. In Europe if a person’s TSH is higher than two, he or she is diagnosed with hypothyroidism. If it is between one and two, the person may have it. If it is less than one, the person definitely does not have it.
The American Association of Clinical Endocrinologists issued a paper in 2002, stating that anyone with a TSH of three or higher should be treated.
And then there is the issue of treating with a natural source of thyroid, such as Armour thyroid, versus treating with a synthetic form, such as levothyroxin. In a study done in another country, 60 percent of people with hypothyroidism felt better when taking both T3 and T4, compared to taking just T4.
Thank you for the helpful information in your column.
DEAR READER: Hypothyroidism (underactive thyroid) can be a somewhat complex issue. The area about which you have written, subclinical thyroid disease, is particularly complicated. Until adequate scientific studies have been performed, it will continue to be difficult to determine at what levels treatment should be given when levels fall within those gray areas.
You are correct in that there are very real and sometimes serious consequences in not treating hypothyroidism. These can include heart disease, goiter (enlarged thyroid gland), infertility, peripheral neuropathy and myxedema (cold intolerance, drowsiness, profound lethargy and unconsciousness). These are most commonly associated with long-term uncontrolled hypothyroidism. Women with untreated hypothyroidsm who are pregnant, have a higher risk of having child with birth defects. The child may also be more likely to have serious developmental and intellectual problems. Babies born with hypothyroidism who go untreated past the first few months of life are at risk of serious mental and physical development problems.
