I have written several times about the inability of our scientific community to solve the riddles of the treatment of hypo (low) thyroid function. In the most recent study trying to discover the best way to treat hypothyroidism, defective approaches in my opinion, again defeated the good intentions of researchers. The study “Small changes in thyroxine dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life” was published in the prestigious Journal of Clinical Endocrinology and Metabolism.

This study was designed to examine the best doses of thyroid medication for treating hypo (low) thyroid function, and came to some startling conclusions. The first conclusion was that when treating patients with hypothyroidism adjusting the dose of thyroid medication does not affect the symptoms that these individuals had. Even more surprising was the conclusion that hypothyroidism (low thyroid levels) was not causing the symptoms the patients were complaining of.

For those who suffer from hypothyroidism and those whose job it is to treat these people, a study like this comes as a jolt of disappointment. Both groups are left wondering what they are to do next. For the treating physician, further doubt is shed on the rightness of continuing to adjust thyroid medication in response to patients’ complaints.

It is far easier to not find something than to find something. That seems like common sense. In a scientific study of disease treatment, it is far easier to not discover benefits of a new treatment than to find something that helps. There are two main reasons for not discovering something. The first reason is that whatever treatment being tested truly has little or no effect. The second reason is that the researcher is using insensitive methods to observe the effect. For example, even a large telescope will not see the brightest objects in the sky if the lens is dirty.

How do medical studies go wrong? Not having enough people in a study is a common reason. Another reason is using tools which are too insensitive to detect the effect of treatment. In studies of treatment of hypothyroidism like this one, it also seems common to produce a negative outcome by setting up the experiment backwards. Let’s look at these defects as they apply to the latest study.

The most disturbing trend in the study of hypothyroid treatment is using the backward approach to the questions. Most of these studies start by denying the existence of an almost universal observation, which is that patients respond to adjustment of thyroid hormone treatments. Instead, like this study, they start by asking, “Is there a response to thyroid hormone adjustment?” The authors of this newest study admit that not all patients treated with thyroxine (thyroid hormone) feel well. Other researchers have admitted that many of these sufferers respond to changes in thyroid hormone treatments. So why not ask a question like, “What are the differences between responders and non-responders in thyroid hormone treatment?” When studies using poor techniques can find no effects of treatment changes they deny the experience of patients and doctors alike. When these results become the medical gospel it causes doctors to be skeptical of their patients’ complaints and to feel that treatment adjustment is useless.

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