USA
www.immunesupport.com/library/bulletinarticle.cfm?ID=4903&PROD=N0149
09-17-2003
By Dr. Charles Shepherd
Following a recent discussion on several UK lists around the controversial subject of thyroid function and the use of thyroxine to treat myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), here are a few key points on which I feel the vast majority of doctors involved in the management of ME/CFS patients would agree:
09-17-2003
By Dr. Charles Shepherd
Following a recent discussion on several UK lists around the controversial subject of thyroid function and the use of thyroxine to treat myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), here are a few key points on which I feel the vast majority of doctors involved in the management of ME/CFS patients would agree:
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For example, people who have autoimmune thyroid disease may present with ME/CFS-like symptoms. And a recent journal report described the disturbing case of an adolescent who had been misdiagnosed as having ME/CFS but turned out to have a severe autoimmune thyroiditis
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7. Thyroxine supplementation always has to be prescribed with great care and carefully monitored as this hormone stimulates activity in various parts of the body, in particular the heart. The problem is that even at very low doses some people are extremely sensitive to thyroxine supplementation and so develop potentially serious (even fatal) heart rhythm disturbances such as atrial fibrillation. There are also a number of potential long-term problems including suppression of the thyroid gland's natural output of thyroxine and increasing the risk of osteoporosis.
8. An additional potential problem in people with ME/CFS, who may already have low levels of the hormone cortisol, is that prescribing thyroxine in this situation can lead to additional stress on the adrenal glands and produce what is called an Addisonian crisis.
So before starting treatment with thyroxine (for whatever reason) people with ME/CFS ought have their cortisol level checked to make sure there is no significant degree of adrenal insufficiency (ref: BMJ, 1996, 313, 427 - 'Adrenal insufficiency should be excluded before thyroxine replacement is started').
Mosken
