British Medical Journal Publishes New Clinical Practice Guidelines for Subclinical Hypothyroidism
The British Medical Journal this month has published new clinical practice guidelines which are set to change the way conventional medicine deals with subclinical hypothyroidism (SCH).
These new clinical practice guidelines strongly recommend against the use of thyroid hormone therapy for most patients with subclinical hypothyroidism. They have been put together by an expert panel of clinicians, methodologists and patients, taking into account the results of a systematic review which included 21 trials and 2192 participants. This review included a large and new trial specifically in older people with SCH.
“The panel concluded that almost all adults with SCH would not benefit from treatment with thyroid hormones. Other factors in the strong recommendation include the burden of lifelong management and uncertainty on potential harms. Instead, clinicians should monitor the progression or resolution of the thyroid dysfunction in these adults.”
Outline of the new clinical practice guidelines
Adults with subclinical hypothyroidism would not benefit from treatment with thyroid hormones. This guideline:
What is subclinical hypothyroidism?
Subclinical hypothyroidism is defined as elevated levels of thyroid stimulating hormone (TSH) and normal free T4 (thyroxine) levels. A diverse range of symptoms may accompany SCH. Find out more on subclinical hypothyroidism here
So what does this mean for patients with subclinical hypothyroidism?
In short, the expert panel have found that there is no benefit in thyroid hormone therapy in most patients with SCH; which means an alternative approach needs to be considered.
What’s also important to consider is that SCH may be an early warning sign that the thyroid is struggling and this shouldn’t be ignored.
So how can you take a natural proactive approach to protect & support your thyroid function?
Thyroid health is complex and fascinating. There are many factors involved in the production, conversion, distribution and regulation of thyroid hormones in the body. It’s a complicated process, but this also means that there’s lots you can do to naturally support a struggling thyroid. From a nutritional perspective, subclinical hypothyroidism is often viewed as an opportunity to dig deeper and get to the bottom of why the thyroid is struggling. It’s rather like an early warning sign, and it’s important to take action to support your thyroid at this point.
Thyroid hormone conversion
One particularly important factor to consider is the conversion of thyroid hormones. The thyroid gland produces mainly thyroxine (T4) but this must then be converted into tri-iodothyronine (T3) – the most active form of thyroid hormone that the body can use. Read more about supporting healthy thyroid hormone conversion here.
Gum guggul supports healthy thyroid hormone conversion
Gum guggul is a natural resin extracted from the mukul myrhh tree. Research shows that this natural plant extract can help to support the healthy production of T3, the active form of thyroid hormone that the body can use.
Gum guggul contains guggulsterones which have been shown to support the healthy conversion of thyroid hormones in the body. It was back in 1984 that the positive effects of gum guggul on thyroid function were first noted,2 and further research has since confirmed and clarified these findings: gum guggul extract increases the conversion of T4 into active T3.3,4
In addition, gum guggul has been found to support healthy cholesterol and triglyceride levels. More specifically, gum guggul may help to balance LDL cholesterol and decrease lipid peroxidation.5-7 This is an important benefit as hypothyroidism, even subclinical hypothyroidism, and elevated cholesterol may commonly co-occur.
Key thyroid takeaway
The takeaway message here is that if you have been diagnosed with or suspect subclinical hypothyroidism (SCH) do not ignore this early warning sign that your thyroid may need a little extra help. The new clinical practice guidelines published in the British Medical Journal have found no benefit in thyroid hormone therapy in most patients with SCH but that doesn’t mean you can’t be proactive with natural support for this important gland.
1. Bekkering GE, Agoritsas T et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. British Medical Journal 2019; 365:I2006
2. Tripathi Y.B; Malhotra O.P; Tripanthi S.N. Thyroid stimulating action of Z-guggulsterone obtained from Commiphora mukul. Planta Med, 1984 (1): 78-80
3. Panda S; Kar A. Gugulu (Commiphora mukul) induces triiodothyronine production: possible involvement of lipid peroxidation. Life Sciences, 1999; 65 (12): 137-141
4. Panda S, Kar A. Guggulu (commiphora mukul) potentially ameliorates hypothyroidism in female mice. Phytother Res 2005 Jan; 19(1): 78-80
5. Singh R, Mohammad AN et al. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovascular Drugs Therapy. 1994; 8: 659-664
6. Nityanand S, Kapoor NK. Hypocholesterolemic effect of Commiphora mukul resin (Guggal). Indian J Exp Biol 1971;9:367–77.
7. Deng R. Therapeutic effects of guggul and its constituent guggulsterone: cardiovascular benefits. Cardiovasc Drug Rev. 2007 Winter; 25(4): 375-90
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