Does Synthroid Do Anything?

I’m just full of questions today. Maybe it’s a sign that it’s one of those rare days in which I’m clicking on all cylinders. For example, this New York Times article on a study of the effects of levothyroxine in the treatment of subclinical hypothyroidism made me wonder if anybody’s actually studied drug interactions of the pharmaceutical in patients who were taking many different drugs?

As to the meat of the article I know at least one endocrinologist who won’t prescribe the most commonly prescribed version of of levothyroxine because he doesn’t think it’s as effective. They’re all supposed to be bioequivalent so I have no idea.

2 comments… add one
  • steve Link

    This drug is one of my pet peeves. My personal theory is that every fat lady, and a lot of the men, want something to blame it on other than their eating habits. Hence, they have low thyroid and have an excuse. (Remains amazing to me how many people I see that are on 15 daily meds or more.)

    Steve

  • CStanley Link

    There’s a lot to unpack here.

    Is the drug not helping because of misdiagnosis? Elevated TSH alone doesn’t necessarily equal hypothyroidism, especially if it’s only mildly elevated.

    Then there’s the fact that T4 is a prohormone that has to be converted to T3. Plenty of people argue that hypothyroid individuals need supplementation with both, although I don’t think the literature backs that up.

    As for the bioavailability issue that Dave mentions, very true that there are variations but really that shouldn’t matter. If a generic formulation has a higher or lower bioavailability, the dosage will just be adjusted up or down and as long as a consistent brand is used the effects for the patient should end up being the same.

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