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The pitiful challenges even a Good Doctor faces….ignorance, stupidity, resistance. Read this!

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As thyroid patients, we are continually seeking doctors who understand successful patient experience. It’s not always easy.  So when we do find a good doctor, we’re ecstatic. But little do we know the challenges a good doctor faces!  The following was sent to me by a progressive, open-minded MD, of whose name I have removed to protect him from his own medical board. Be appalled and amazed. I was.

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Janie, it is not infrequent that we are sent messages like this from Pharmacy Benefits Managers. Here is a typical letter with my reply.

Considerations for Your Review

1. Drug Safety Consideration: ARMOUR THYROID Use in Seniors  Our claims record suggests that your older patient is receiving ARMOUR THYROID. Thyroid hormones should be dosed cautiously in seniors due to a potential risk of cardiac effects. Desiccated thyroid products contain variable amounts of T3. T4 and other iodothyronine compounds. Because older patients have a high prevalence of occult
cardiac disease, the Beers criteria generally recommend transition to a safer alternative (e.g.. agents like levothyroxine with more standardized hormone content). Please consider the potential risks versus benefits of therapy for your patient.

Reference(s):
1. Thyroid Agents. In: McEvoy GK, ed. AHFS: Drug Information. Bethesda, MD: American Society of Health-System Pharmacists; 2008:Sec 68:36.04.
2. Pick DM et al. Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Archives of Internal Medicine. 2003; 163:2716-2724.
3. Semla TP et al. Geriatric Dosage Handbook. 13th ed. Hudson, OH: Lexi-Comp; 2007.

(And this brilliant doctor’s reply:)

Dear  xxxxxxx

Re: Armour Thyroid Products

I invite your attention to the P.I. (product information) in the PDR on levothyroxine (Synthroid). I quote:  PRECAUTIONS “Patients with underlying cardiovascular disease–Exercise caution when administering levothyroxine to patients with cardiovascular disorders and to the elderly in whom there is an increased risk of occult cardiac disease.”

DOSAGE AND ADMINISTRATION

“Caution should be exercised when administering SYNTHROID to patients with underlying cardiovascular disease, to the elderly, and to those with concomitant adrenal insufficiency (see PRECAUTIONS).”

I read your statement that says, “Desiccated thyroid products contain variable amounts of T3 and T4 and other idothyronine compounds.”  Forest Pharmaceuticals has stated their product is standardized as published in the PDR: “ One (1) grain or 60 mg of Armour contains by assay 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3).” I do not ever remember Armour Thyroid ever being recalled for stability or lack of standardization.

However, Synthroid and the other forms of levothyroxine have had significant problems.

SYNTHROID AND OTHER T4 PRODUCTS were subject to FDA NOTICE in the FEDERAL REGISTER: AUGUST 14, 1997 (VOL 62, NUMBER 157). These were the drugs that were not well standardized and were not stable. I quote from the report: “Some of the problems reported were the result of switching brands. However, other adverse events occurred when patients received a refill of a product on which they had been previously stable, indicating a lack of consistency in stability, potency, and bioavailability between different lots of tablets from the same manufacturer.”

Thank you for caring for the health of the patients receiving medications from your company. I request that you check your facts fully before issuing such flyers.

Respectfully,

xxxxxxxxx, M.D.

Cc: FOREST PHARMACEUTICALS

BRAVO TO THIS DOCTOR in the face of complete ignorance!!

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STTM HAS HIRED A PUBLICIST and YOUR HELP IS NEEDED!

Do you value what Stop the Thyroid Madness has given you??  Something has to be done to reach millions of individuals still lingering without a diagnosis due to the TSH, or suffering due to being on T4-only meds! You and I run into them DAILY and don’t even know it!  Or we have many family members in the TSH/T4 category. And the media does NOTHING about this scandal.  STTM has hired a publicist, and you can read about it here. But I can’t do this alone. If you value Stop the Thyroid Madness, please considering helping.

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TPA (Thyroid Patient Advocacy) STILL NEEDS YOU TO REGISTER 

Have you registered for the Counterexamples to T4-only?  So far, 1437 have, and Sheila Turner is determined to get that number to over 2000 at least. There were 900 participants on those flawed studies showing that T4/T3 combination worked no better than T4-only, and we have got to prove our point that this is wrong.  All you have to do is answer 3 very short questions.  http://www.tpa-uk.org.uk/register_of_counterexamples.php

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10 replies

Good Housekeeping replies…and let’s set the record straight!

Below this blog post, you will see my original July 25th post about the potentially harmful thyroid article that appeared in Good Housekeeping magazine’s August issue.

And sadly, though thyroid patients can appreciate even getting a reply by the Editors of Good Housekeeping (which is certainly better than the dead silence thyroid patients got from Oprah Winfrey when they emailed numerous times about this horrific thyroid treatment scandal), we certainly are saddened by the continued poor understanding and false suppositions contained in the reply:

We have read your postings and letters with great interest and are moved by the depth of feeling that underlies them. It is obvious that many of you write out of frustration with your own unresolved symptoms, and we are sympathetic to your ongoing difficulties.

Good Housekeeping‘s August 2011 article on thyroid disease describes one woman’s quest to understand her own ambiguous diagnosis. As described in the article, there is a great deal of controversy surrounding the diagnosis and treatment of low thyroid disorders – among mainstream physicians as well as those with a more complementary or integrative orientation. We recognize that much of the information on the Internet serves to support patients who haven’t been heard or understood by their own doctors – a terribly disheartening and frustrating experience for anyone. But it is often difficult to discern what’s been scientifically tested and proven versus what is still being explored. That is why this article, like all health articles in GH, drew on research and advice that is evidence-based; typically, such information comes from credentialed doctors working at leading medical and academic centers. A careful reader of our story will see that doctors we consulted acknowledged that low thyroid levels might be treated if a patient has other problems like infertility or depression or if she has Hashimoto antibodies and other factors.

It is our hope that better understanding of the disease will lead to more effective treatment for all. That’s really the goal and the motivation behind all of Good Housekeeping‘s health coverage.

We thank you for your valuable feedback and encourage you to continue to send us your thoughts. You can reach us at ghletters@goodhousekeeping.com.

And here is my reply to the Editors of Good Housekeeping:

We, as thyroid patients around the world, do appreciate that you took the time to reply. We have been the recipients of dead silence all too often in our quest to inspire and educate the media about this near 60-year thyroid treatment problem. Thank you.

But there are incorrect observations and assumptions in your reply that need clarification and intelligent re-thinking:

    1. This patient-to-patient movement is far more than ‘frustrations with our own unresolved symptoms’.  This is about  hundreds of millions of us worldwide who have been subjected to a brainwashed bias by medical professionals in the use of  T4-only medications and the TSH lab test (both which have left us with lingering hypothyroid symptoms and denied as such by our physicians).
    2. What you refer to as “a great deal of controversy surrounding the diagnosis and treatment of low thyroid disorders”  is, in our experience and observation, only within the boundaries of a dogmatically-trained medical profession comprised of those who seem to have lost the art of paying attention to CLEAR symptoms of hypothyroidism with a so-called “normal” TSH lab test or with the use of the laughable “gold standard” of thyroid treatment–T4-only.
    3. This is far more than what is “scientifically tested and proven.” Do you REALLY believe that all scientific testing is unbiased and correct??  Do you not understand that much science has been done quite badly, and the results are often in conjunction to whoever or whatever FUNDED the research? Instead, this is about real live and multiple patient experience and outcome–patient experience where lives are changed due to not going by the TSH but by symptoms; where labwork is used as the cart pulled by the horse of symptoms; where desiccated thyroid has been proven to be far more beneficial in the removal of our symptoms than thyroxine ever was or will be…and more. (And here is science that actually underscores our experience).
    4. You state that the article “drew on research and advice that is evidence-based.”  And what about the evidence of millions of thyroid patients who have endured multiple and clear hypothyroid symptoms for years before the TSH lab test rose high enough to reveal their obvious hypothyroid state? What about all of us who have suffered for years in our own kind and degree while on T4-only meds like Synthroid, levothyroxine, etc? What about the irrefutable evidence of those whose lives have turned completely around thanks to desiccated thyroid and/or T3, especially after they treated the extreme side effects of being undiagnosed or undertreated all these years thanks to a clueless medical profession?
    5. You refer to “credentialed doctors working at leading medical and academic centers” as your source of information: would it shock you to hear that MANY credentialed doctors are the very ones who have kept us completely sick for nearly sixty years??  Ask thyroid patients about all those doctors they saw over the years who were “credentialed”, and your eyes and ears will burn. And what about all the growing body of “credentialed doctors” who now have the courage to state that the TSH lab test is lousy (except for diagnosing hypopituitary), just as is T4-only treatment? They are many!
    6. And finally, if your “goal and the motivation behind all of Good Housekeeping’s health coverage” is to find more effective treatment for all, do a follow-up article in an upcoming issue about the scandal of T4-only treatment, the poor use of the TSH lab test (which is measuring a pituitary hormone, not cellular levels of thyroid hormones), the experience of patients worldwide on T4, the experience of patients who lives made a complete turn-around thanks to desiccated thyroid or T3, the experience of patients with “credentialed doctors” who have been nothing more than condescending, ignorant, biased and dogmatically close-minded to our experience and wisdom in our own bodies!

Good Housekeeping do a PATIENT EXPERIENCE article!  Let your readers use their own wisdom about the “mass experience of patients worldwide” vs the “dogmatic, pharmaceutically-brainwashed “opinion” of a several misguided and credentialed medical professionals.”

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Thyroid Tidbits: Men with low iron, Reverse T4 (yes, I said it correctly), Inflammation in thyroid patients, plus more

(No, the tatoo isn’t mine. It belongs to a gal who says STTM helped changed her life. Amazing and brave! 🙂 )

MEN CAN HAVE LOW IRON, TOO:

I’ve seen a few hypothyroid men who have found themselves with low iron. In fact, either iron anemia is growing in men, or we’re just hearing from them more thanks to the internet.

And remarkably, it has become personal for me. Turns out my own husband is very low, which explains the fatigue he had been experiencing lately. Sadly, taking iron pills gives him a headache, so he will eat high-iron foods daily, and will be exploring Floradix, a liquid herb-based iron. Men, get all the needed iron labs!

REVERSE T4 (yes, I said it correctly)

I’ve been having an email chat with a scientifically-minded guy named Brian who also has a sister with a major in bio-chemistry. And something dawned on both of them concerning “levothyroxine” which is the synthetic term for T4.  The prefix LEVO means the “left-hand” version of a molecule, and thyroxine is the biological term for the real T4.  Says Brian: “Levo-thyroxine means it has exactly the same atoms in exactly the same order, but not the same shape (handedness), so if enzymes or proteins have to chemically “fit” it to work, they may not be able to. He concludes this can be one reason being on synthetic T4-only does not work, and knew it was alluded to by Dr. Mark Starr.

But Brian continues: In just the same way that levothyroxine is the mirror-image or “left-handed” version of regular thyroxin, RT3, or Reverse T3, is the mirror-image or “left-handed” version of T3.  If we were consistent with our terminology, in other words, levothyroxine would be known as “Reverse T4”. Says Brian, just as Reverse T3 is biologically inactive , so is Levothyroxine, thus “Reverse T4”. I love it!

CHECK OUT WHAT THIS MEDICAL TRANSCRIPTIONIST SAID:

In a facebook discussion,  a female medical transcriptionist has had a realization. Namely, in almost every report she is transcribing into text or digital format,  a patient with the diagnosis of hypothyroidism also has a medical history of depression and/or anxiety. You can read about depression & anxiety here. Of course, no patient who is informed is surprised! They are HYPOTHYROID symptoms.  And she then notes the prescription ordered by the doc: Synthroid.  WAKE UP DOCTORS. You are only dooming your patients to a lifetime of depression, anxiety and far more.

WHY MANY OF YOU HAVE INFLAMMATION (and don’t even know it), WHAT IT DOES, AND HOW TO TREAT IT

One thing I see a lot when doing phone consultations, as well as on thyroid patient groups, is evidence that someone has low-grade inflammation. In fact,  research has already shown that a large body of folks with hypothyroidism have higher levels of CRP (C-Reactive Protein) which is a lab test marker of inflammation.  That inflammation, in turn, puts you at a higher risk of heart disease.

Another clue that you have an inflammation problem is having higher ferritin levels (i.e. ferritin looks great, or is too high) along with poor iron serum/% saturation lab results.  In other words, in the presence of chronic inflammation, your iron will be diverted to your ferritin iron storage, and less will be in your serum and saturation.  You can also find yourself with very low TIBC (Total iron-binding capacity). The TIBC is measuring the protein “transferrin”, made in your liver, and which transports your iron through your body. If this is the case, you can’t take high levels of iron supplementation, as explained on the above ferrritin page and more in the book.

What do you do? 1) Treat your hypothyroidism properly–a huge step in lowering that inflammation–with desiccated thyroid, NOT Synthroid. (Read the Things We Have Learned page on STTM, or even more details in Chapter 3 in the new Revised STTM book). 2) Treat proven low cortisol with HC or hydrocortisone. Don’t guess! Do a saliva test!) If saliva testing reveals you have adrenal dysfunction, cortisol supplementation will help counter inflammation.   (Read the Adrenal Info and How to Treat page on STTM, or more details in Chapter 6 in the new Revised STTM book.) 3) Use Krill Oil as a supplement. Krill Oil is an even better marine fish oil with rich amounts of Omega 3 fatty oils,  and research with even a low dose of 300 mg proves that it does a bang-up job in reducing inflammation as well as pain in joints associated with rheumatoid and osteoarthritis.  My own husband is on 1000 mg a day.

HAVE THE REVISED SECOND EDITION OF THE STTM BOOK YET? IT’S WORTH IT.

I am frankly extremely proud of the Revised Second Edition of the STTM book.  In spite of being a lot of hard work, it is good to see all the additions, details and corrections throughout the entire book.  There is much more on labs and how to read them, ferritin and iron, adrenal dysfunction and how to treat it, reverse T3 and how to treat it, plus a completely new chapter on good supplements and foods.  I added a little more hidden humor, which was fun.  There are now 36 more pages, too, and at the same price.  You can see more about the book here.  The book is ideal since you can bring that right into the doctor’s office with the information highlighted and bookmarked. As far as Kindle or other readers, yes, I’m already aware that some of you have requested it. But right now, it’s the book only.  But I’ll make announcements in the future as to what might be coming up.

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A clinical trial in progress to investigate T3 in the treatment of fibromyalgia

Oh the heels of my last blog post (see right below this if you are reading right on the site) comes something VERY interesting, and which thyroid-patients-in-the-know have already known about for a good ten years!

Namely, Dr. Ian Carroll, MD, MS, and Dr. Jarred Younger, PhD of the Stanford Systems Neuroscience and Pain Lab are currently enrolling patients for a clinical trial investigating T3 for the treatment of fibromyalgia. (Fibromyalgia is a chronic syndrome which causes widespread musculoskeletal pain and debilitating fatigue, also aching, twitching, burn sensation, joint issues).

Of course, patients who switched to desiccated thyroid the past ten years (or have used synthetic T3 in their treatment) already KNOW the truth from experience (which is usually always pooh-poohed by clinical-trial-worshipping, clinical-presentation-ignoring, medical professionals.).

Namely, fibromyalgia is usually the result of undiagnosed hypothyroidism (due to the inane TSH lab test) and undertreated hypothyroidism (due to the worst medication ever thrust on patients, aka T4-only, or Synthroid, Levoxyl, levothyroxine, Eltroxin, Oroxine, etc.) i.e. you need direct T3, the most powerful thyroid hormone, to adequately treated hypothyroidism.

i.e. we’re all kinda going duhhhhhhhh here.

But, if a clinical trial is needed to prove what we already know (and so has Dr. John C. Lowe known it for many years), it’ll be just one more underscore of the truth. Go to the following to read more and/or enroll:  http://snapl.stanford.edu/t3/

P.S. the Bobbsey Twins of the failure of the TSH labs test and treating with T4-only:  Fibromyalgia and Chronic Fatigue Syndrome.

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Does your inner ear itch?? Got an email from a gal who was on Synthroid for 7 years, and for the last 5, had torturous deep inner ear itching. And guess what?? It went away just two days after switching to desiccated thyroid. Yup, another long and pathetic symptom of a poor treatment. (If you still have it on desiccated thyroid, see what mistakes in your treatment you need to identify and change, which is also Chapter 11 in the STTM book with a little more details added.)

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Yippee!! Direct Labs is the third lab facility to partner with STTM in offering the kind of labs that patients who frequent STTM know are important in their quest to feel better and educate their doctors.  Unfortunately, they don’t offer saliva like the other two, which are Healthcheck USA and MyMedLab, but they have all the other labs you may be interested in. You can view them by going to STTM’s Recommended Labwork page.

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A continuing MEDICAL SCANDAL which is just too close to home and I grieve. WAKE UP DOCTORS!!

Tonight was a beautiful night to do my aerobic walking. It had poured this afternoon for 30 minutes, so the early evening air was slightly cool and very clean.

And on the last leg of my journey, I stopped and said to Carlin as she was walking out of her front door “Where you have been lately? I haven’t seen you out walking with your husband.”

Carlin and her husband Clint are probably in their late 70’s–both vibrant individuals and frequent walkers in the same area.

“Well”, she said wistfully as she glanced down the street I had just walked, “I have to go in Monday for a Pacemaker.”

Turns out she has fibrillations and other heart issues, and even walking from her bedroom to her living room can exhaust her.  I told her how well my mother-in-law has done with her pacemaker. She told me she’d be in the hospital for at least 3-4 days for the surgery and observation.

And as we were chatting over the low white fence, I couldn’t help but notice the scar on her neck–the same scar my own mother had from the removal of her thyroid years ago.  And the rest of Carlin’s story, and the reality of her story, made me want to punch the nearest electrical pole in disgust.

Carlin’s thyroid was removed over 40 years ago.  She remembers being on “2 grains of something”–clearly it was desiccated thyroid. And she says she felt really good. But she wasn’t on it long, as her doctor removed it and put her levothyroxine over 30 years ago. You know, that “new and modern” T4-only CRAP which doctors fell for like the blind following the blind beginning in the 1960’s until today. (The story behind the introduction of T4 onto patients in the early 1960’s is in Chapter One of the STTM book)

So I knew. Her heart troubles could be one of the many side effects of the inferior treatment of T4-only medications (which also include Synthroid, Levoxyl, Eltroxin, Oroxine…all of them). My own mother suffered the same fate while on Synthroid her entire life. And patients chat about this all the time on thyroid groups–heart issues while on T4.

I started probing. She has had issues with high blood pressure. Another typical side effect of the crap T4-only medication, and which is removed with desiccated thyroid. She has had issues with depression–another typical side effect of the crap T4-only medication, and which is removed with desiccated thyroid. She talked bitterly about the slew of medications she’s had to be on for years to counter all her problems, and which had given her bad side effects.

And the next worse thing she told me? She had acid reflux so bad a few years ago that they did surgery on her stomach. She had surgery for a condition which is VERY common with thyroid patients who are on T4 meds–low stomach acid from a lower metabolism, which causes acid reflux. i.e. a symptom of continued hypothyroidism which is CORRECTED when on desiccated thyroid.

It was hard to contain myself. Here was this vibrant, life-loving, intelligent woman who has been on T4-only for over 30 years and has endured health problems, surgeries, side effects from all sorts of money-grubbing pharmaceutical pills, and now, has to go in Monday for a pacemaker. And in all probability, most of what she has gone though could have been prevented if some doctor had been WISE enough to keep this woman on desiccated thyroid.

I am livid and sick to my stomach.

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  • Are you chewing up your Armour or Naturethroid? It will make the treatment far better, as it will release the desiccated thyroid from the excess cellulose.  If you are on compounded, you need to tell the pharmacist to stop using cellulose as a filler. On Erfa? You can do it sublingually.
  • If you are reading this right on STTM’s blog, and would like to be notified of each blog post, just sign up to the left and under the links.
  • Have you done labs and found yourself with high RT3? Get off Selenium for the time being, as it can help convert T4 to the RT3 along with the other reasons you make too much.
  • Want to spread the word about far better treatment? T-shirts and bumper stickers are here.
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