People with Mild Thyroid Failure (“subclinical hypothyroidism”) have symptoms of thyroid deficiency, although lab tests may indicate their thyroid function is “normal”. In 2003, the normal range for Thyroid Stimulating Hormone (TSH) was adjusted from 0.5-5.0 to 0.3-3.0 as the American Academy of Clinical Endocrinologists acknowledged that symptoms of hypothyroidism frequently occurred in patients with “normal” lab values. Many patients with thyroid dysfunction have tried synthetic thyroid hormones, such as levothyroxine and liothyronine, and have found that natural thyroid is the only form that works adequately for them. Compounded Natural Thyroid is an option when commercial products are unavailable.
The Division of Endocrinology and Metabolism, Beth Israel Medical Centre, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, reported the successful management of thyrotoxicosis in a seriously ill 47-year-old man with a perforated gastric ulcer in whom oral intake was contraindicated. Specially prepared suppositories containing 400 mg of propylthiouracil (PTU) were administered rectally every 6 hours. PTU was substantially absorbed from the rectal suppositories, with serum levels of PTU maintained within the high therapeutic range for 5 days until the patient was able to tolerate orally administered therapy. The patient improved clinically during this treatment. They concluded that this case strongly supports the rectal administration of PTU in suppository form as an appropriate alternative route in any patient with thyrotoxicosis, including the critically ill patient, when oral administration is not possible.