Successful Withdrawal of Thyroid Hormone in Nursing Home Patients
The authors of this article went to four nursing homes and identified patients on thyroid hormone therapy; many were believed to be put on the therapy inappropriately or had only needed it temporarily. Many had been on the hormones since they were younger. Half of the patients that met the criteria for the study were successfully weaned from the hormones. This article raises many interesting issues. First, I believe we handle thyroid disorders very poorly. There are so many patients out there who are put onto thyroid hormone replacement for one main reason only — abnormal lab findings. If those labs are normal, you’re normal. If they’re abnormal you’re put on thyroid hormone. Yet, many, many times on the hormones, the patient’s bloodwork comes back to normal but their symptoms are still present!! Two possibilities: subclinical hypothyroidism (us docs need to stop using labs and use our brains-LOOK at the patient for a change–not the bloodwork!!) and lack of effect of thyroid hormone. Glandulars typically work cheaper and more effectively than synthetic hormones.
J Am Board Fam Pract 13(6):403-407, 2000 Studies of community-dwelling patients have indicated that substantial numbers of patients might have had thyroid hormone therapy prescribed inappropriately and that thyroid hormone therapy in some can be discontinued without adverse effects or evidence of clinical hypothyroidism. We wanted to find out whether thyroid hormone therapy in selected nursing home patients could be withdrawn without adverse effect. Thyroid hormone therapy was successfully withdrawn from one half of the nursing home residents studied. Previous studies conducted in community-dwelling patients have shown similar findings. Many older patients began taking thyroid hormone therapy when younger either for inappropriate reasons or for what turned out to be transient hypothyroidism. If the findings of this study are generalizable for other nursing home residents, there are important implications for health and health care costs.