More about DCM

This new (August, 2021), very well-written paper, entitled
“Thyroid Hormones—An Underestimated Player in Dilated Cardiomyopathy?“,
comes very close the truth of T3’s influence on heart health and function.
The authors have managed to review all the important facts on the subject, up to and including a mention of reverse T3, without coming to the conclusion that full thyroid testing might disclose functional hypothyroidism and by so doing, permit the prescription of Triiodothyronine for cure of this almost universally fatal disease (many DCM subjects, even those treated by heart transplant, die).

J Clin Med. 2021 Aug; 10(16): 3618. Published online 2021 Aug 16. doi: 10.3390/jcm10163618PMCID: PMC8397026PMID: 34441915, Karolina Zawadzka,¹Radosław Dziedzic,¹Andrzej Surdacki,² and Bernadeta Chyrchel^2,*
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397026/

ABSTRACT:
Dilated cardiomyopathy (DCM) is the most prevalent cardiomyopathy, typified by left ventricular dilation and systolic dysfunction. Many patients with DCM have altered thyroid status, especially lower levels of free triiodothyronine (T3) and elevated levels of thyroid-stimulating hormone. Moreover, growing evidence indicates that even subtle changes in thyroid status (especially low T3) are linked with a worse long-term prognosis and a higher risk of mortality. Notably, recent discoveries have shown that not only local myocardial thyroid hormones (THs) bioavailability could be diminished due to impaired expression of the activating deiodinase, but virtually all genes involved in TH biosynthesis are also expressed in the myocardium of DCM patients. Importantly, some studies have suggested beneficial effects of TH therapy in patients suffering from DCM. Our aim was to discuss new insights into the association between TH status and prognosis in DCM, abnormal expression of genes involved in the myocardial synthesis of TH in DCM, and the potential for TH use in the future treatment of DCM.

MESSAGE:
(1) A “Thyroid profile”, including TSH, T4, T3 and rT3 (with T3/rT3 calculation) should be part of the “workup” for all major diseases and conditions.
(2) When the T-profile shows functional hypothyroidism, treatment with slow-release T3, to correct the functional hypothyroidism, should be given in addition to whatever specific therapy is recommended for the condition (excepting that if T4 is recommended, T3 should be given instead).