Thyroid disorders are multifaceted, and there are many aspects of the conditions that are not yet understood. This section presents a range of articles and other information geared specifically to the medical practitioner.
IMPORTANT READING Can medical practice, with existing counterexamples and without scientific basis, dictate the abuse of patients?
Customary practice and prudent patient consent criteria are substantially different in the diagnosis and treatment of the mimics of hypothyroidism (maladies with the same symptoms but having different causes). Consequently, patients within this niche of healthcare are dissatisfied with customary practice because it ignores these mimics.
IMPORTANT READING The Greater Thyroid System - Information for Your Doctor
Many patients are being denied adequate relief from the symptoms of hypothyroidism because less than half of the greater thyroid system is being considered by physicians. And even that half is not fully tested if the thyroid-stimulating hormone is normal. This chart illustrates the flow through this system starting at the top of the chart with signals from your brain to the bottom of
the chart where the symptoms are sensed.
IMPORTANT
READING Dear Doctor….A Serious Appeal to the RCP et al
". . . My youngest sister hanged herself. At her funeral, her husband
said that she had always improved when they could persuade her GP to increase
her pathetically modest levels of Thyroxine. . . Read more about this
family's history.
IMPORTANT READING
Individual letters and messages sent to the RCP regarding their thyroxine-only
statement
Please read these many letters sent to the RCP from patients and their
families explaining the seriousness of the RCP's decision on their health.
International
Hormone Society President Dr Thierry Hertoghe officially responds to the
RCP
International Hormone Society President Dr Thierry Hertoghe responds to
the RCP thyroxine-only statement: to include in the guideline the practical
application of the increasingly growing body of research suggested in
this letter, along with its accompanying references.
Stability,
effectiveness, and safety of desiccated thyroid vs thyroxine: A rebuttal
to the British Thyroid Association by Dr John C Lowe, Director of Research,
Fibromyalgia Research Association
Both BTA publications contain factual errors and unbalanced presentations
of data, excluding or limiting data favorable to T4/T3 therapies. Specific
examples from the publications are included in this rebuttal.
An Examination of
“The Diagnosis and Management of Primary Hypothyroidism” and
other Hypothyroidism Practice Guidelines
This essay attempts to resolve the dispute between medicine and patients
in the diagnosis and management of the symptoms of hypothyroidism. This
rather convoluted language is used to open minds to the potential for
mimics of hypothyroidism, which become more and more possible and eventually
a certitude through the reading of this essay. Studies demonstrate the
existence of a problem. A Quality Assessment of Life Years (QALY) demonstrates
there is a problem, potentially costly problem.
Patients respond to
RCP and their thyroxine-only statement
Many patients have already written to the RCP to voice their serious concerns
about the RCP's thyroxine-only statement. Their letters and messages are
featured here.
Fluorosis internship available through the Fluorosis Research & Rural
Development Foundation
A five-day fluorosis internship sponsored by the Fluorosis Research &
Rural Development Foundation is available for teaching faculty of medical and dental
schools of developed countries. Further details and an application form
are included in this document.
TPA-UK rebuttal to the
RCP thyroxine-only statement
Although we appreciate the recommendation for investigating non-thyroid
causes for the symptoms of hypothyroidism, the conclusions in the guideline
destroy the diagnosis and management of the non-thyroid causes for the
symptoms of hypothyroidism, which exist in those patients suffering deficiencies
in peripheral metabolism and deficient peripheral cellular hormone reception
(post thyroid deficiencies). The effect of this conclusion is simple –
it will return many people to abject misery and will keep many more sufferers
from ever realising their full potential.
RCP statement
poses SERIOUS healthcare problems for those patients
The statement “The Diagnosis and Management of Primary Hypothyroidism”
by the Royal College of Physicians presents very serious healthcare problems
for those patients with the post thyroid deficiencies of deficient peripheral
metabolism or deficient hormone reception by the peripheral cells.
Royal College of Physicians: "Thyroxine
ONLY treatment for primary hypothyroidism"
New guidelines on the diagnosis and management of primary hypothyroidism
state that thyroxine is the only treatment that should be given for this
condition, which is caused by underactivity of the thyroid gland. The
guidelines also state that the only validated method of testing thyroid
function is on blood, which must include serum TSH (thyroid stimulating
hormone) and a measure of free thyroxine (T4).
Hypothyroidism Mimics
Require Consideration by Eric Pritchard, M.Sc. with TPA-UK letter to BTA
She wakes tired. Struggles to get up. Dresses slowly. Now exhausted, she
falls back into bed. Once again she will have an after-nap breakfast.
She wakes for her doctor’s appointment. Once again, he claims her
tests were normal. Once again she claims she is sick. Once again, he writes
the same old prescription, saying that she is really suffering from functional
somatoform disorders. Once again, she is reduced to tears. “Why
again? Must I suffer more? Why can’t you help me?” Is the
diagnosis and treatment of hypothyroidism trivial? Or, is it more complex,
even mysterious?
Evidence-based Medicine
Leads to Mediation of Symptoms of Mimics of Hypothyroidism by Eric K.
Pritchard, M.Sc.
Evidence Based Medicine is a modern, scientific alternative to the eminence
based medicine. Currently, eminence based medicine is ignoring the mimics
of hypothyroidism. Consequently, those patients are seemingly doomed to
a life of chronic suffering with the symptoms of hypothyroidism, constant
exhaustion, hypo-metabolism, hyper-cholesterolemia, deformity by myxedema,
droopy eye lids, weight gain, etc. Furthermore, these patients are doomed
to a life shorted by their greater susceptibility to life’s great
killers, diabetes and heart disease.
TPA-UK Hypothyroid Patient
results published
In this survey of 1500 hypothyroid patients, which was undertaken in 2005-6,
the dissatisfaction of many patients is highlighted. Of all respondents,
93.8% (n=1407) had not been told of medicines other than L-thyroxine by
their medical practitioner. 38.8% (n=768) felt they had “not been
dealt with very well” or “not very well at all” by their
doctor whilst seeking a diagnosis of their symptoms; 233 (15.5%) had given
up paid employment; 300 (20%) had taken time off work as a result of thyroid
illness; 500 (33.3%) felt their close relationships had been affected
by thyroid illness and 632 (42.1%) had stopped or altered their exercise
routines as a result of their symptoms. When asked of those patients undergoing
L-thyroxine therapy, “Do you feel that you have fully regained your
optimal state of health?”, 1176 (78.4%) Answered “No”.
The Linguistic Etiologies
of Thyroxine-Resistant Hypothyroidism
by Eric K. Pritchard
The thyroxine resistant victims of hypothyroidism are not suffering because
there is no treatment available—the Food and Drug Administration
approved and indicated them long ago. These victims are suffering because
the proper treatments are not considered—linguistic etiologies keep
the science of “exo-endocrine” (outside of the endocrine system)
hypothyroidism beyond the reach of the practicing physician with the confusion
of “overinclusion” (identical treatment of two classes that
burdens one excessively). The linguistic etiologies must be eliminated.
TPA-UK Quarterly
Newsletter
In this inaugural newsletter, TPA-UK reports on its numerous initiatives,
including the publication of its hypothyroid patient survey results and its Bristol meetings
with Dr Colin Dayan, Bristol University Head of Medical Research and Dr Vijay Panicker.
The Thyroid Patient Advocacy-UK
(TPA-UK) response to: “A Statement from the British Thyroid Association
Executive Committee on Armour® Thyroid”
TPA-UK disagrees with many of the statements made by the Executive
Committee of the British Thyroid Association (BTA) on natural desiccated
porcine thyroid extract (Armour® Thyroid, USP). TPA-UK are very concerned
that the BTA continue to advise that L-thyroxine (T4)-replacement remains
the treatment of choice despite the amount of evidence contrary to their
opinion, showing it to be ineffective in relieving many patients' symptoms.
This research paper extensively refutes the incorrect and inaccurate BTA
statements on Armour Thyroid.
The Thyroid Patient Advocacy–UK
(TPA-UK) response to the British Thyroid Association’s (BTA) Statement
on the Use of Combination Thyroxine/Triiodothyronine (Liothyronine) Therapy
TPA-UK believes that the experience of patients is not being considered
in the diagnosis and treatment of hypothyroidism, and NHS doctors fail
to offer alternative therapy if L-thyroxine is ineffective in resolving
symptoms or is poorly tolerated by patients. Although ‘evidence
based medicine’ is to be applauded, much of the evidence base for
the treatment of hypothyroidism is based on research that does not consider
the patient’s experience and may be flawed. This research paper
refutes the BTA's incorrect and inaccurate statements regarding combination
T4/T3 therapy.
Vitamin
D Deficiency and Thyroid Disease
Not many endocrinologists realize this, but several articles published
over 20 years ago showed that patients with hypothyroidism have low levels
of vitamin D. This may lead to some of the bone problems related to hypothyroidism.
It was thought that one of two mechanisms may explain the low levels of
itamin D in patients with hypothyroidism. This paper discusses those mechanisms.
The Vitamin D
Newsletter by John Cannell, MD
Dr Cannell discusses the Vitamin D connection with serious health issues
and yet another major concern as to why patients who are hypothyroid are
not getting well.
Thyroid Hormone References
This document contains
a selection of references compiled by Dr Thierry Hertoghe. It features
multiple scientific studies on thyroid hormones, deficiencies and therapies.
The reference list
contains the major references of the pro and con studies on thyroid hormone
therapy use, as it is important that physicians should be aware of these
when debating with colleagues or other representatives of medical institutions.
IHL Consensus # 1 on Hormone Therapies of
Hypothyroidism
After having reviewed the scientific literature and exchanged experiences
between physicians from all over the world who are competent in hormone
therapies, we, members of the Consensus Group of Experts of the International
Hormone Society, think the time is ripe to reconsider current concepts
on thyroid treatment of hypothyroidism.
Response from Medicine and Healthcare Regulatory
Agency sent to UK endocrinologists regarding Armour Thyroid and porcine
thyroid extract for thyroid replacement therapy
MHRA Pharmaceutical advisor Graham Matthews clarifies the importation
of Armour Thyroid and porcine thyroid extract for thyroid replacement
therapy.
Fluoridation and the Thyroid Gland
Fluorides are dangerous in general and in particular highly damaging to
the thyroid gland. Experts are concerned that in concentrations as low
as one part per million (1ppm), fluorides damage the thyroid system on
four major levels.
The Effects of Fluoride on the Thyroid Gland
There is a daunting amount of research studies showing that the widely
acclaimed benefits on fluoride dental health are more imagined than real.
Fluorides are cumulative and build up steadily with ingestion of fluoride
from all sources, which include not just water, but the air we breathe
and the food we eat. With 141 million Europeans now at risk from fluoridation
poisoning, Dr Barry Durrant-Peatfield discusses the dangers of fluorides
in general and particular, explains in great detail their highly damaging
effects on the thyroid gland.
Dr Barry Peatfield's response to Professor
AP Weetman's Medscape and Clinical Endocrinology article
In his article mysteriously entitled “Whose thyroid replacement
is it anyway?” Professor Weetman starts the discussion by taking
the view that “there seems nothing more straightforward than the
treatment of hypothyroidism”. One certainly wishes that this simplistic
view were true. Sadly, this is very far indeed from the case, according
to Dr Barry Durrant-Peatfield.
Serum TSH: Is the TSH serum
measurement alone sufficient for diagnosis and follow up of thyroid deficiency?
This document, prepared by Dr Thierry Hertoghe, examines the current claim
that the TSH serum measurement alone is sufficient to diagnose all forms
of eu-, hypo- and hyperthyroidism with no other testing necessary. Because
this claim is inaccurate, it then states the facts and provides an extensive
collection of references to support those facts.
FOR DEBATE: Are biochemical tests
of thyroid function of any value in monitoring patients receiving thyroxine
replacement?
Originally published in the British Medical Journal, authors
Fraser, Biggart, et al report their findings emphasise the need for laboratories
to make their users aware that the reference ranges for serum thyroxine,
free thyroxine, and thyroid stimulating hormone concentrations in patients
receiving thyroxine replacement are considerably different from the conventional
ranges; they should also point out the limitations of these ranges. This
is especially important for general practitioners and non-specialists,
who generally rely on the biochemical findings more than specialist endocrinologists
do in managing these patients.
Thyroid and Adrenal dysfunction:
The diagnosis of an endemic syndrome
Both thyroid and adrenal dysfunction are so commonly met with as indeed
to be endemic and disgraceful diagnostic failure is the rule. Thyroid
dysfunction, and its partner in crime, adrenal dysfunction are all around
us, every day, in our clients/patients and even our colleagues. Adapted
from Your Thyroid and How to Keep It Healthy, thyroid specialist
Dr Barry Durrant-Peatfield explains why practitioners should check for
thyroid and adrenal problems when presented with a familiar range of symptoms
that often mask prolonged dysfunction in these two organs.
"Why I changed my mind about water fluoridation" by Dr John Colquhoun, from the Journal of the International Society of Fluoride Research
Cushing disease is not necessarily a progressive and fatal disease
TPA-UK founder Sheila Turner comments on conventional thyroxine (T4) treatment
"Treating thyroid despite normal labs" by Jacob Teitelbaum MD and Kent Holtorf MD
"Health Musings: The Thyroid" by Clifford S. Garner, PhD
Biological effects of 3,5-diiodothyronine (T2) by F. Goglia (excerpt)
"Thyroid hormones explained" by Dr Barry Durrant-Peatfield
Suggestions for an approach to the management of thyroid deficiency