Diabetes, diabetes, diabetes. Let’s talk about hypothyroid therapy.

Why is diabetes getting all the attention in health care media, and hypothyroidism hardly any?

Let’s brainstorm this together. Let’s see possible reasons why.

Let’s talk more publicly about what Canadians can do about the health inequity and the truly “epidemic” lack of attention and concern for hypothyroidism.

1. PHARMACEUTICAL ATTENTION

Perhaps one reason is the mile-long list of medications for Diabetes. Meanwhile pharma thinks hypothyroidism is entirely fixed by one T4 pill a day.

Medications for Hypothyroidism

Here is a list of thyroid medications and combinations listed in historical order. They are all basically various ratios of T4 and T3 hormone.

• Desiccated thyroid extract (NDT / DTE) in common use 1890 to 1970 contains a ratio of T3:T4 approximately 1:4.2
• Synthetic thyroxine / levothyroxine (L-T4) developed as a pharmaceutical in 1949, which finally became more commonly prescribed in the 1970s
• Liothyronine (L-T3) developed as a pharmaceutical in 1952, which has been used in long term maintenance monotherapy as well as in short-term therapy since then
• Slow-release liothyronine powder (sold in the US and Canada, available from compounding pharmacies.)
• Various combinations and ratios of the above as well as monotherapies of T3 and T4 have been in use since the 1950s.

Medications for Diabetes

Now, here is a list of diabetes medications from a HealthLine article.

Just scroll through them all and let your eyes blur:

Alpha-glucosidase inhibitors
• acarbose (Precose)
• miglitol (Glyset)

Biguanides
• metformin-alogliptin (Kazano)
• metformin-canagliflozin (Invokamet)
• metformin-dapagliflozin (Xigduo XR)
• metformin-empagliflozin (Synjardy)
• metformin-glipizide
• metformin-glyburide (Glucovance)
• metformin-linagliptin (Jentadueto)
• metformin-pioglitazone (Actoplus)
• metformin-repaglinide (PrandiMet)
• metformin-rosiglitazone (Avandamet)
• metformin-saxagliptin (Kombiglyze XR)
• metformin-sitagliptin (Janumet)

Dopamine agonist
• Bromocriptine (Cycloset)

DPP-4 inhibitors
• alogliptin (Nesina)
• alogliptin-metformin (Kazano)
• alogliptin-pioglitazone (Oseni)
• linagliptin (Tradjenta)
• linagliptin-empagliflozin (Glyxambi)
• linagliptin-metformin (Jentadueto)
• saxagliptin (Onglyza)
• saxagliptin-metformin (Kombiglyze XR)
• sitagliptin (Januvia)
• sitagliptin-metformin (Janumet and Janumet XR)
• sitagliptin and simvastatin (Juvisync)

Glucagon-like peptides (incretin mimetics)
• albiglutide (Tanzeum)
• dulaglutide (Trulicity)
• exenatide (Byetta)
• exenatide extended-release (Bydureon)
• liraglutide (Victoza)
• semaglutide (Ozempic)

Meglitinides
• nateglinide (Starlix)
• repaglinide (Prandin)
• repaglinide-metformin (Prandimet)

Sodium glucose transporter (SGLT) 2 inhibitors
• dapagliflozin (Farxiga)
• dapagliflozin-metformin (Xigduo XR)
• canagliflozin (Invokana)
• canagliflozin-metformin (Invokamet)
• empagliflozin (Jardiance)
• empagliflozin-linagliptin (Glyxambi)
• empagliflozin-metformin (Synjardy)
• ertugliflozin (Steglatro)

Sulfonylureas
• glimepiride (Amaryl)
• glimepiride-pioglitazone (Duetact)
• glimepiride-rosiglitazone (Avandaryl)
• gliclazide
• glipizide (Glucotrol)
• glipizide-metformin (Metaglip)
• glyburide (DiaBeta, Glynase, Micronase)
• glyburide-metformin (Glucovance)
• chlorpropamide (Diabinese)
• tolazamide (Tolinase)
• tolbutamide (Orinase, Tol-Tab)

Thiazolidinediones
• rosiglitazone (Avandia)
• rosiglitazone-glimepiride (Avandaryl)
• rosiglitazone-metformin (Amaryl M)
• pioglitazone (Actos)
• pioglitazone-alogliptin (Oseni)
• pioglitazone-glimepiride (Duetact)
• pioglitazone-metformin (Actoplus Met, Actoplus Met XR)

Insulins

Type | Onset of action | Peak | Duration of action

• Lispro U-100 (Humalog) | Approx 15 Min. | 1-2 Hrs. | 3-6 Hrs.
• Lispro U-200 (Humalog 200) | Approx 15 Min. | 1-2 Hrs. | 3-6 Hrs.
• Aspart (Novolog) | Approx 15 Min. | 1-2 Hrs. | 3-6 Hrs.
• Glulisine (Apidra) | Approx 20 Min. | 1-2 Hrs. | 3-6 Hrs.
• Regular U-100 (Novolin R, Humulin R) | 30-60 Min. | 2-4 Hrs. | 6-10 Hrs.
• Humulin R Regular U-500 | 30-60 Min. | 2-4 Hrs. | Up to 24 Hrs.
• NPH (Novolin N, Humulin N, ReliOn) | 2-4 Hrs. | 4-8 Hrs. | 10-18 Hrs.
• Glargine U-100 (Lantus) | 1-2 Hrs. | Minimal | Up to 24 Hrs.
• Glargine U-100 (Basaglar) | 1-2 Hrs. | Minimal | Up to 24 Hrs.
• Glargine U-300 (Toujeo) | 6 Hrs. | No signif. peak | 24-36 Hrs.
• Detemir (Levemir) 1-2 Hrs. | Minimal | Up to 24 Hrs.
• Degludec U-100 & U-200 (Tresiba) | 1-4 Hrs. | No signif. peak | About 42 Hrs.
• Afrezza | <15 Min. | Approx. 50 Min. | 2-3 Hrs.

…. Whew.

I count _ 74 _ medications in this list, 61 of them non-insulin meds.

Do you see what is going on here?

Both thyroid disease and diabetes are serious chronic and often life-long health conditions.

• One is ruled by a monopoly of L-T4 medication, which is kept in place by the tyranny of the TSH test that many doctors very unscientifically believe is an all-knowing indicator of active T3 hormone levels in blood and throughout the human body during thyroid therapy.
• The other is a competing world of pharmaceuticals trying to get attention and sales. Of course it is in the interest of pharmaceutical companies to develop medications and sell their medications to as many people as possible.

If you medicate these people, you have customers for the rest of their lives.

2. NEWS & STATS

Based on the information I can find, more people in Canada have hypothyroidism (9-14%) than diabetes (7.3%).

According to Statistics Canada,

“In 2017, 7.3% of Canadians aged 12 and older (roughly 2.3 million people) reported being diagnosed with diabetes.

Note 1. Between 2016 and 2017, the proportion of males who reported being diagnosed with diabetes increased from 7.6% in 2016 to 8.4% in 2017.

Note 2. The proportion of females remained consistent between the two years.”

If you google “hypothyroidism rates in Canada by province” you get nothing from Stats Canada.

Nothing.

However, if you google “hypothyroidism Alberta” you will eventually find a 2009 CBC article titled thus:

“Thyroid disease highest in Alberta.”

This article says

“A new survey indicates a far higher percentage of people in Alberta suffer from thyroid disease than in any other province.

Fourteen per cent of Albertans who were called during the survey by Harris/Decima Research have a form of thyroid disease, compared with nine per cent of adults nationwide.

“It is a little bit surprising to us,” said Dr. Norman Wong, a professor of medicine at the University of Calgary. “It is a concern. The next step will be to try and do some studies and figure out why we have so many people in the province with hypothyroidism.”

That is where I get the 9% rate of hypothyroidism across Canada.

Well, I cannot find this 2009 survey published anywhere. The news article had no link or reference to it.

I also cannot find any evidence of any further studies of why so many people in Alberta have hypothyroidism.

They dropped the ball. We are that unimportant.

CONCLUSIONS

Hypothyroidism is the orphaned endocrine condition, left in 1970s therapy mode, while Diabetes is the most infamous condition of the 2010-2020 decade to raise public alarm about.

Both chronic conditions are associated with obesity.

Both can contribute to cardiovascular problems.

Hypothyroidism (specifically hypoT3ism) in addition causes psychiatric distress, but all the rage today is to talk about mental health without any reference to thyroid hormones.

Many are saying nowadays that Type 2 Diabetes in many can be reversed by low-carb high-fat diets, but hypothyroidism caused by a missing or antibody-destroyed gland is never curable by diet alone.

Unknown millions of thyroid patients still suffer crippling fatigue and weight gain and depression while on hypothyroid therapy despite normalized TSH. Meanwhile, our medical systems allow this pituitary hormone to tyrannize over all other organs’ supply of T3 hormone. Worship of TSH arrogantly declares brain T3, heart T3 and bone T3 levels irrelevant during therapy, as only pituitary T3 adjusts TSH. The TSH is used to deflect our symptoms and blame them on any and every other health condition under the sun, and we patients also get blamed for our own symptoms — as if “exercise more and eat less” can fix reduced T3.

Can anyone hear the cry of thyroid patients above the din?

Learn more about diabetes and thyroid hormones …

See the Diabetes data set in Anderson’s 2020 article, featured in “Prevalence rates for 10 chronic disorders at various FT4, TSH and FT3 levels.”

SOURCES