A study by researchers at Kaiser Permanente in Denver, Colorado evaluated the stability of thyroid stimulating hormone (TSH) in patients using synthetic medication versus those using desiccated thyroid products to treat hypothyroidism. The results showed no difference in TSH stability over a three-year period between patients taking desiccated thyroid products and those on synthetic levothyroxine, an unanticipated finding given concerns about variability among batches of desiccated thyroid, which is prescribed much less frequently than synthetic levothyroxine.
In an accompanying editorial, Jill Schneiderhan and Suzanna Zick argue in favor of a patient-centered approach as opposed to relying primarily on laboratory results when determining the best way to manage hyperthyroidism. Emerging evidence shows that for many patients taking levothyroxine, symptoms persist despite lab results indicating normal TSH values. Further, these patients may feel invalidated and not in control of their treatment decisions. Schneiderhan and Zick conclude, “[k]eeping desiccated thyroid medications as an option in our tool kit will allow for improved shared decision making, while allowing for patient preference, and offer an option for those patients who remain symptomatic on levothyroxine monotherapy.”