Dr. Gerdes’ Heart Failure Therapy

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In the world of doctors, the National Institutes of Health (NIH) says that 5.8 million people in Western countries have fallen victim to heart failure which is one of the leading killers in the medical world, is a complication caused by a variety of heart diseases.  In a recent paper, an NYIT professor has a possible way to help heart failure patients through the use of thyroid replacement therapy.  Dr. Martin Gerdes, Chairman and Professor of Biomedical Sciences, says this complication is a major public health and economic problem and is one of the most common causes of hospitalization and death.  Dr. Gerdes however, feels his thyroid replacement therapy can help people who are experiencing heart failure. Heart failure is classified in stages by the New York Heart Association with increasing severity from stage 1-4.  Stage 1 is mild symptoms noted with heavy exercise and stage 4 is serious symptoms noted with just sitting.

 Dr. Gerdes suspects that almost all heart failure patients will have lower cardiac thyroid levels by the time they approach end stage heart failure.  He believes the presence of low cardiac tissue thyroid hormones may dramatically accelerate progression to heart failure.  Importantly, he has shown in animals that low thyroid hormone levels alone will eventually lead to diluted heart failure with impaired coronary blood flow.  Gerdes’ theory is that when a person has low cardiac tissue thyroid levels, this condition accelerates the progression of heart disease to heart failure in that given person.  If his theory is correct, giving thyroid hormones to these individuals would help return his or her thyroid levels to normal and help give that person more energy, reduce depression, help them feel better and have a better quality of life in addition to producing beneficial changes in heart muscle function and structure.  At an early enough stage, giving a person thyroid hormones will allow that person to live longer and slow the gradual process of contracting muscle cell loss.

 Based on studies done on animals, if an animal is being starved, that animal will make itself hypothyroid, meaning it’s thyroid hormone levels will lower.  The reason for this lowering in thyroid levels is because the heart’s response is to reduce metabolism to prolong dying.  “If an animal has a heart attack, the surviving part of the heart actually destroys cardiac tissue thyroid hormones and makes the animal hypothyroid,” says Gerdes.  Animals with heart disease have their disease accelerated by hypothyroid, which will cause them to have heart failure.  If this study on animals can be replicated with the same results in humans, that would show a hypothyroid state is accelerating the heart disease to heart failure process in patients.

 Based on clinical data, Dr. Gerdes suspects that over half of heart failure patients have low thyroid function or borderline low thyroid function at the cardiac tissue level.  The number could be as high as 90 percent, but we do not know for sure at this time.  Importantly, serum levels may not reflect the degree of tissue hormone deficiency.  Since the heart only receives about 3% of the blood flow to the body, blood tissue leaving the heart become diluted with blood from the rest of the body making it more difficult to pick up changes from serum.

 Gerdes feels this treatment has a promising possibility considering the strong evidence that supports it.  If the evidence concludes that hypothyroid is causing people to have an acceleration in the heart disease to heart failure process, Gerdes believes people can be helped by increasing their thyroid hormone levels to normal through the use of medication.  According to Gerdes, doctors are afraid to give this kind of medication to their patients due to a study that occurred 40 years ago.  In the early 1970s, doctors used DT-4 to treat people for their heart failure.  For those who are not in Biomedical Science, DT-4 is an inactive form of thyroxine. L-T4 is the active form of thyroxine.  Patients were given 6 mg/day DT-4, which is equal to 225 micrograms of L-T4 and corresponded to more than double the production of T4 which is approximately 90-100 micrograms/day.

 Later, doctors discovered that the medication had been contaminated with a high level of active L-T4.  “Due to this contamination, people were receiving an overdose of the drug that was supposed to help them, which did not provide proper information on the treatment for heart failure,” says Gerdes.  “Since too much of the drug was administered, doctors fear to use this medication on their patients.”  The reason for this overdose was because the Coronary Drug Project (CDP) was underfunded when they were running the treatment and they were only able to give a single dose to all of their patients.  Since the doctors didn’t want to give too little of their medication to their patients, in order to avoid the false conclusion that the medication has no effect, the doctors chose to give the highest tolerable dose to their patients, which clearly ended badly.  However, Gerdes believes giving thyroid hormones to patients, but of the proper amount, can be used to help heart failure patients if the research on those patients supports his theory.

So how do we find out if heart failure is indeed linked to thyroid function?  Gerdes believes the best way is by studying diseased hearts removed during heart transplants to see if low cardiac thyroid levels are occurring in heart failure patients.  By using these hearts, doctors could get an accurate assessment of the extent of low thyroid hormone levels in cardiac tissue, work that cannot be done in living patients except by biopsy.  Now that we know this possible problem exists, the next question is do we approach it.  Gerdes says that more work is needed in animal studies and humans with heart disease progressing to heart failure to determine the extent of the problem and potential benefits from hormone treatment.  Once researchers have gathered more information on this progression, doctors can implement a way to help patients with heart failure.

 Gerdes has strong faith in his treatment for heart failure patients and if his theory is correct, doctors will be able to help extend the lives of millions of people with heart failure and make their lives feel like they’re worth living.  So far research has given strong evidence to Gerdes’ theory and if is confirmed, medication can be made to extend and improve the lives of patients with this most fatal disease.

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