Wednesday, February 15, 2012

Thyroid hormone resistance

Thyroid hormone resistance describes a rare syndrome where the thyroid hormone levels are elevated but the thyroid stimulating hormone (TSH) level is not suppressed, or not completely suppressed as would be expected.


The most common cause of the syndrome are mutations of the β (beta) form (THRB gene) of the thyroid hormone receptor, of which over 100 different mutations have been documented. Mutations in MCT8 and SECISBP2 have also been associated with this condition.


Thyroid hormone resistance syndrome is rare, incidence is variously quoted as 1 in 50,000 or 1 in 40,000 live births.


Sometimes the phrase thyroid hormone resistance is used to identify cases where patients with autoimmune thyroid disorders respond poorly to normal doses of replacement thyroid hormone. This is thought to occur where patients have developed antibodies to thyroid hormones. Antibodies to thyroid hormones quite commonly occur in such disorders, and may interfere with the normal clinical assays used in monitoring such disorders, and in unusual cases may have further independent clinical significance.
So there is a one clearly defined disease called "Thyroid Hormone Resistance", which is caused by genetic mutation and is relatively rare.

And then there is the fuzzy quack "phrase" of some supposed thyroid hormone resistance, that gets thrown around when patients respond "poorly" to thyroid hormone. From the description by Emily Deans (here and here), it would seem like patients who don't respond to thyroid-hormes may actually have health problems that aren't caused by thyroid-hormone resistance in the first place…


  1. Read Mark Starr's book "Hypothyroidism Type 2: The Epidemic." There is a big difference between rare "General" Thyroid Hormone Resistance (RTH) and much more common "Peripheral" tissue Thyroid Hormone Resistance (PRTH). We had 50% infant and child mortality in this country before the turn of the last century and antibiotics became available. What do you think happened to all those children that were saved and went on to reproduce over the last 100 years? We cheated the "Survival of the fittest" protocol. There are repercussions.

  2. There are 3 types of Thyroid Hormone Resistance: (general) Resistance to Thyroid Hormone (RTH), that you cited. Peripheral Resistance to Thyroid Hormone (PRTH), and Partial Peripheral Resistance to Thyroid Hormone (Partial PRTH)
    The last two types are NOT rare. They are due to defective mitochondria, not defective gene transcription, or thyroid transport problems.
    In General Resistance TSH is high in Peripheral Resistance TSH is normal before thyroid treatment and is suppressed with treatment.
    Mitochondrial mutations appear to be largely responsible for metabolic defects at the cellular level, which results in a hypothyroid like condition. Modern thyroid blood tests do not detect this because thyroid hormones levels may be normal, but they are not high enough to stimulate the genetically defective mitochondria into normal activity. The increased basal temperature that results from administering desiccated thyroid is a direct result of enhanced mitochondrial activity.
    Dr. Mark Starr calls the multiple hypothyroid like symptoms resulting from this mitochondrial defect “Type 2 Hypothyroidism.” Type 2 Hypothyroidism therefore cannot be determined by standard Thyroid blood tests since the problem is not hormone related. People with Type 2 Hypothyroidism typically have normal Thyroid blood tests. The term used to refer to defective mitochondria has been “Thyroid Hormone Resistance,” but the new name “Type 2 Hypothyroidism” seems to fit this condition a little better.

  3. Many people have written many books with many claims – because Dr. Mark Starr has done the same doesn't mean much. I may be wrong, but I doubt he provides much data from studies in his book.

    Color me unconvinced.

  4. Many people do not fit into the categories described in science and have to be treated as individuals rather than as "diagnosed" by a book or article. Blood tests don't show everything. If they did, we'd all be "right as rain" in no time. Careful with throwing around harsh words like "quack."

  5. Yes, but is one thing to say:

    "That person has some illness, but we can't figure out what it is with thyroid blood tests"

    or to say

    "Our blood tests tell us nothing, and therefore it must be some medically sounding mumbo-jumbo like e.g. thyroid-hormone-resitance"

    The first one is a sound medical opinion, the second is quackery, don't you agree?

    And the point made above was that supposedly many people fall in this supposed "sciency" thyroid-hormone-resistance category. The point made by these quacks is not that we are "individuals" (as you write). So please, if you argue, argue about the points made – and don't raise strawmen, and don't argue about what you imagine was written.


Comments are most welcome! But please:

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