Hypothyroidism Treatment History

• The first hypothyroidism treatment
• Synthetic medications until the present
• The standardization hoax
• Links to more information

The first hypothyroidism treatment

One of the early methods of treating hypothyroidism was to fry sheep's thyroid glands and eat them with currant jelly¹ or brandy.² This was considered preferable to the late-1800s treatments of grafting sheep's thyroid glands beneath the skin of thyroid patients or injecting thyroid extract.³ The first desiccated (dried) form of animal thyroid gland was placed on the market in 1894, and was further standardized a few years later.⁴

The first patient with myxedema (severe hypothyroidism) to be successfully treated with thyroid extract began treatment in 1891 in the UK. She was a 46-year-old woman with advanced symptoms of hypothyroidism. In her case history in the British Medical Journal,⁵ we read that "The experimental nature of the treatment was explained, and the patient, realizing the otherwise hopeless outlook, promptly consented to its trial." Within three months of starting treatment, her symptoms had almost disappeared. She remained in good health until shortly before she died at age 74.

According to The Annals of Internal Medicine,⁶ a woman in the US was first treated for hypothyroidism with thyroid extract in 1896. She began taking it when she was 39 years old, and continued treatment for the rest of her life until she died at age 91.

The successful treatment of both of these patients was based on symptoms only.

Synthetic medications until the present

Desiccated thyroid in pill form continued to be the main treatment for hypothyroidism until the 1960s. Its use diminished after Synthroid, the first synthetic medication, arrived on the market in 1958. There were no problems with desiccated thyroid even at high doses, and it was known as one of the safest drugs available. Synthetic T4, on the other hand, has had a long history of manufacturing and reliability problems.

The advent of the TSH test in common use in about 1974 was the beginning of diagnosis according to lab results rather than symptoms. Why rely on how a patient feels when symptoms can be unmeasurable and vague, and one number on a piece of paper clearly indicates "yes" or "no"? From a medical point of view, hypothyroidism diagnosis and treatment had just become easier. Simply give the patient one hormone that the pharmaceutical companies assure you is all that the patient needs, and don't bother with multiple confusing tests that might tell you otherwise.

Synthroid is now the industry leader and is among the top-selling prescription drugs in Canada and the US. Synthetic T4 is successful in alleviating symptoms of hypothydism for many patients, but for many others, it isn't. In medical schools today, treatment with synthetic T4 is generally taught as being the only necessary treatment for hypothyroidism. If symptoms persist, most doctors try to treat them with other medications, if at all.

The standardization hoax

Numerous doctors have told thyroid patients that they don't prescribe desiccated thyroid because (according to them) it isn't stable, and they say that synthetic T4 medication is. Yet batch after batch of synthetic T4 has been recalled due to potency problems, while recalls of desiccated thyroid have been fewer and more likely to be because of mislabelling or non-standard pill sizes.

Doctors get their information about drugs mainly from university and from pharmaceutical companies, and the use of desiccated thyroid has hardly been taught in medical school classes since about 1975. The question arises about how these doctors got the impression that desiccated thyroid is unstable.

The following quote from the bible of thyroid treatment, Goodman and Gilman's the Pharmacological Basis of Therapeutics, provides some light on this question:

A few years ago [1963], a large batch of material came into the hands of a number of distributors in the United States and Europe and, although of proper iodine content, it later proved not to be thyroid [extract] at all. This episode gave thyroid a bad name because several publications about the unreliability of thyroid appeared before the hoax was uncovered.⁷

Decades later, the myth persists.

Links to more information

Thyroidhistory.net
Excerpts about thyroid conditions from medical journal articles and books from the past century and more can be found at this site.

An account of early references to cretinism, goitres, and myxoedema is in "Thyroid Insufficiency in General Practise" (by J. Parlane Granger, published in The Practitioner, Jan. 2, 1915). Parts of this article are online at Thyroidhistory.net. (Click on the Thyroidhistory.net home page link first, and then the other pages at this site will open.)

"Prescription Drug Products; Levothyroxine Sodium" (FDA 1997 notice)
"Almost every manufacturer of...orally administered levothyroxine sodium [synthetic T4] products, including the market leader, has reported recalls that were the result of potency or stability problems."

Thyroid-Related Lawsuits and Recalls at thyroid.about.com
A listing of thyroid medication recalls was started on this page in 2001.

Synthroid Lawsuit, News & Controversy at thyroid.about.com
A long list of links to articles about the Synthroid lawsuit.

Footnotes