special equipment. Is it likely that these companies will continue to fund researchers who constantly come up with negative findings? The best studies are those that aren’t connected to specific companies, but knowing which studies don’t have such connections is sometimes hard. So don’t be surprised if today’s magic cure-all turns out to be tomorrow’s source of major side effects. Even with no observer bias, results that are excellent when a drug is tested on a few hundred or thousand people may be very different when hundreds of thousands of people begin to use the drug. As I write this chapter, researchers are studying just about every aspect of thyroid disease, with articles in every medical journal andnew findings that are getting ready to join the thousands of studies before them. Being up to the minute in a book isn’t possible given the constraints of a publishing deadline and the amount of information coming out. If you have a particular problem that concerns you or a loved one, don’t hesitate to use the enormous amount of free resources at your disposal. Go to the PubMed Web site (www.pubmed.gov), or check out your local bookstore and hospital library. And be sure to utilize the references you find in Appendix B of this book.
Treating Subclinical Hypothyroidism One of the great debates in thyroid management is what to do about subclinical hypothyroidism, condition in which the patient’s TSH level is slightly elevated (say to 6 or 7), the free T4 level is normal, and the patient has some nonspecific symptoms that can be the result of hypothyroidism or something else. Doctors have been studying these patients, looking for signs of low thyroid function or a response to thyroid medication, because they aren’t sure whether treatment is necessary. One study from Italy, published in the Journal of Clinical Endocrinology and Metabolism in March 2001, looked at the function of the heart in 20 people with subclinical hypothyroidism, all of whom showed some abnormality in heart activity. Half of the study participants were given thyroid treatment, and the other half were given a placebo. The study found that people given the thyroid-treatment drug showed an improvement in heart function, while those given a placebo showed no change. The study concluded that people with subclinical hypothyroidism have measurable abnormalities that thyroid treatment improves. Another study from Germany, published in Thyroid in August 2000, looked at heart disease and heart attacks in patients with subclinical hypothyroidism. The author of the study found that these