"Sub-laboratory" hypothyroidism and the empirical use of Armour® Thyroid

Alternative Medicine Review, June, 2004 by Alan R. Gaby

Polycystic Ovary Syndrome (PCOS)

Of 12 girls (ages 9-16) with severe and longstanding hypothyroidism, nine were diagnosed by pelvic ultrasound with PCOS. The cysts resolved rapidly after treatment with thyroid hormone. (22) In another study of hypothyroid patients with PCOS, administration of thyroid hormone was associated with normalization of ovulation. (23) These observations raise the possibility that sublaboratory hypothyroidism is a contributing factor in some cases of PCOS.

Dermatological Conditions

Barnes administered desiccated thyroid empirically to 214 patients with various skin conditions associated with a low basal body temperature. (24) One hundred ninety-eight patients (92.5%) showed marked improvement, 12 (5.6%) showed some improvement, and four(1.9%) did not improve. Conditions successfully treated included acne (n=88). boils (n=20), dry skin (n=14). eczema (n=57), ichthyosis (n=21). psoriasis (n=11). and ulcers (n=3). In those responding to therapy, treatment had to be continued for years, since symptoms recurred within a few months when treatment was discontinued.

Pelkowitz treated 200 patients with psoriasis rising large doses of levothyroxine and an unspecified amount of "essential phospholipids." (25) The initial dose was 100 mcg daily, increased progressively to a maximum daily dose of 400-500 meg. Propranolol was used as needed to control increases in blood pressure and heart rate resulting from supraphysiological doses of thyroid hormone. Typically, a marked improvement was seen after 5-6 weeks on the maximum dose of levothyroxine, although some patients responded to lower daily doses, such as 100-300 mcg. Patients with stable psoriasis and large plaques responded more slowly. After a few months of control, the dose of levothyroxine was reduced to a maintenance dose. Psoriatic arthritis also improved markedly with this treatment, even in patients whose arthritis had been refractory to other treatments. High-dose levothyroxine would not be considered a first-line treatment for psoriasis, because of its potential to cause adverse side effects and the availability of other effective treatments. This author, however, has observed an improvement in psoriasis in several apparently hypothyroid patients during treatment with physiological doses of desiccated thyroid.

Thyroid hormone has also been found to be of value for individuals with chronic urticaria who have laboratory evidence of thyroid autoimmunity. In one study, 10 euthyroid patients with refractory urticaria were treated with levothyroxine. (26) The initial dose was 25-100 mcg daily, depending on the patient's age and medical condition: dosage was increased if a satisfactory response was not obtained. Of seven patients with elevated anti-thyroglobulin and/or anti-microsomal antibodies at baseline, all seven had a complete elimination of hives or marked improvement within four weeks. Two patients required an increase in the levothyroxine dose before a complete resolution was seen. In two others, already on levothyroxine therapy for hypothyroidism, an increase in the dose resulted in a resolution of the urticaria. The highest dose used was 250 mcg daily. The three patients without elevated anti-thyroid antibodies did not improve. Five patients had a recurrence after treatment was stopped, but the symptoms resolved again when treatment was restarted.