Kimorexia: Interesting Reading from Dr. Briffa

Dr. Briffa had an interesting post about thyroid health a few weeks ago:

Low thyroid function may be a factor in weight gain despite ‘normal’ tests

He starts with this - see if it sounds familiar to you!

When I was studying medicine I was even more cynical than I am now and so, I think, were quite a few of my friends. We had all established firmly in our minds the notion that eating few calories than the body ‘burned’ would result in weight loss, so generally had little compassion for individuals who claimed they did not overeat but still could not shift their excess weight. Also, around the time a study was published which claimed that the overweight tend to significantly underestimate the amount they eat. So, if someone claimed that they thought they had a ‘sluggish metabolism’ or had ‘a problem with their glands’ (low thyroid function) then our eyes would usually roll skywards, if not outwardly, then at least inwardly.

Then you had thyroid testing and it was normal, right? Read the whole article to find out more about why normal may not be so normal after all.

Since then, he's written a follow up post about the dangers of ignoring allegedly normal thyroid test results:

More evidence that ‘normal’ thyroid function tests do not necessarily mean that all is well with the thyroid and health

He said

...this study focused on TSH levels in the ‘normal’ range, which the researchers cite as 0.5-3.5 mlU/L. This is interesting in itself, as the lab I usually use for these tests quotes and upper limit of TSH of 4.20, and I saw a patient yesterday who came with some blood test results where the upper limit of TSH was quoted as 5.50! it seems there is a lack of consensus about what the normal range of TSH should be…

Frustrated yet?

Anyway, focusing back on the study, the research looked at the risk of cardiac death in a group of about 17,000 women and 8000 men over a period of something more than 8 years.
They found no significant relationship between TSH levels and cardiac death risk in men. However, in women, it was a different story. Compared to women with a TSH level of 0.5-1.4 (relatively low levels which should mean relatively high thyroid function):
Women with a TSH level of between 1.5-2.4 were found to be at a 41 per cent increased risk of cardiac death.
Women with a TSH level of between 2.5-3.5 were found to be at a 69 per cent increased risk of cardiac death.

Yikes! In the end, Dr. Briffa says:

Quite a few doctors I know express concern at the thought of someone with ‘normal’ test results taking thyroid hormone. They often cite the risk of treatment, including risks to the heart. Obviously, I think it’s a good thing that as doctors we should be aware of the risks associated with thyroid hormone treatment. I just wish more doctors would see the other side: that there can be considerable risks associated with not treating too.