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Endocrinologists and the looney tune TSH lab test

“It is far better to grasp the Universe as it really is than to persist in delusion, however satisfying and reassuring.” –Dr. Carl Sagan

You may have seen the segment on NBC’s Today Show this morning, January 29th, 2010, or you may have heard about it on the internet. But in case you didn’t, the Today Show had a rare short piece about hypothyroidism and diagnosis which presented a Nurse Practitioner, Eola Force, with clear symptoms of hypo, including extreme tiredness, feeling like she’s dying, huge weight gain, depression, and brain fog, to name a few.

Yet, she had a so-called “normal  “TSH” lab test. The explanation for her symptoms?? She’s FAT, HORMONAL and FEMALE, of course!

And because she is under the care of a wise and knowledgeable doctor named Dr. Kent Holtorf and his clinic, which uses additional tests besides the TSH, he diagnosed her clearly, put her on thyroid hormones, and changed her life.

And the response by Dr. Singer, an Endocrinologist? There is “no real scientific basis” for what Holtorf does in his practice, and it was equivalent to the “laying on of hands”.

Well my dear Dr. Singer sir, if hundreds of millions of patients all over the world waited on “science” to prove what they know by decades of miserable experience because of the TSH, we’d all still be sick as dogs. The mutually accepted delusion by the Endocrinology field about the TSH lab test has left millions of thyroid patients undiagnosed and undertreated for nearly 40 years of its existence.

Other than to potentially diagnose a pituitary problem, no, the TSH lab test is NOT the gold standard for thyroid screening anymore than reading tea leaves tells me what kind of day I’m going to have.

Read more about the TSH lab test here, or find even more detail in Chapter 3 in the book called TSH: THYROID STIMULATING HOOEY.

See much better labwork than simply the TSH here.  Find what your results mean here. And here‘s how to find a much better doctor.

P.S. Thyroid patient Lynn Dunning emailed me about talking about the craziness of current thyroid treatment at her work, and one of her colleagues put this up on the work website:
http://www.spunout.ie/health/Healthy-body/Thyroid-madness Good for Lynn and the SpunOut website!

Doctor questions if adrenal fatigue is real….so is it??

Screen Shot 2015-08-13 at 1.26.06 PM(This page was updated. Enjoy!)

In 2009, Louis Neipris, M.D., a staff writer who has written many fine articles for myOptumHealth.com, wrote one article titled Adrenal Fatigue: Is it for real?

It appeared on Upper Michigan News, TV 6 website on July 16th and made the rounds on other sites.

His answer to his own question?  “Not really”. He adds  “It’s not an accepted medical diagnosis.”

Oops. Thyroid patients and a growing body of informed medical practitioners beg to differ.

About the term “Adrenal Fatigue”

Patients in the earliest discussion groups were using the term “adrenal fatigue” right after the turn of the 21st century, probably because they saw it used so often on the internet, as well as referred to in certain books. And we did think that the adrenals became “tired” as a way to explain the low cortisol we outright saw in each other’s saliva results, as well as symptoms. The term “adrenal insufficiency” also fit.

Later, it became more popular with patients to identify the biological cause of our low cortisol as being rooted in a sluggish HPA axis, i.e. the messaging between the Hypothalamus to the Pituitary to the Adrenals. That messaging wasn’t as vibrant as it should be.

Fast forward to the 2014 book Stop the Thyroid Madness II, where the last chapter by Dr. Lena D. Edwards et al does a bang-up job explaining what might really be going on, and which they term “hypocortisolism”. They propose five brilliant and biologically valid reasons why we see low cortisol:

  • a developmental response to high stress
  • a corticotrophin-releasing factor (CRF) receptor down-regulation
  • inadequate glucocorticoid signaling
  • intrinsic adrenal gland dysfunction
  • an adaptive response towards infection or inflammation.

See Chapter 13, pages 291-292 for more details on each of the five. It’s a brilliant chapter on the subject within the STTM II book.

In other words, there are explainable and logical reasons why certain thyroid patients have low cortisol, and it’s very real, whether you call it adrenal fatigue, adrenal insufficiency or hypocortisolism.

The cortisol saliva test

One excellent method, we as informed patients, prove our low cortisol state is by the use of saliva testing. The important aspect of saliva testing has been two-fold: 1) it reveals our cellular level of cortisol, which we’ve noticed has always fit our symptoms (if the facility we use knows that they are doing, as do the ones listed on the Recommended Labwork page which do not need a doctor’s prescription), and 2) it tests us at four key times during a 24 hour period (which is important to see the fuller picture of what our adrenals are doing.)

We’re learned repeatedly, in comparison, that blood cortisol is not the way to go, since with blood, you are measuring both bound and unbound cortisol. And as informed patients, we have noticed that blood cortisol can look high, yet both saliva testing and our symptoms reveal we are actually low, cellularly. We’ve even seen blood cortisol measure low, yet saliva and our symptoms reveal high…even though it’s less common that the other way around. It’s uncanny! Also, with blood cortisol testing, a misinformed doctor will only do one test instead of the needed four.

What has been the impetus behind the low cortisol state of a large body of thyroid patients?

Two very clear reasons:  first, being held hostage to the TSH lab test, giving one a “normal” reading for years in spite of obvious clinical presentation of hypothyroid symptoms, and pushing one’s adrenals into overdrive with high cortisol and adrenaline to keep the patient going, and ultimately leading to the downwards spiral of adrenal fatigue/adrenal insufficiency/hypocortisolism.  On page 65 of the revised Stop the Thyroid Madness book, you’ll read about a 44 year old woman who went 15 years with a “normal” TSH result, in spite of obvious clinical presentation of hypothyroidism, and which led to her own low cortisol. This is not uncommon.

Second, the risk of adrenal fatigue is high due to the inadequate treatment of T4 medications like Synthroid, Levoxyl, levothyroxine, Eltroxin, Tirosent and other T4-only meds. Because of being forced to live for conversion alone, and missing out on the compliment of all five thyroid hormones, T4-only meds leave a high percentage of patients with their own brand and intensity of lingering symptoms of a poor treatment…sooner or later…forcing the adrenals to kick in for too long, for many.

Even William Mck. Jeffries MD., who wrote the medical classic Safe Uses of Cortisol around 1984, understood the preponderance of adrenal fatigue and low cortisol, even without the diagnosis of Addison’s disease, and the need for physiologic doses of cortisol treatment, or the amount needed by each individual’s body to function correctly.  And he would certainly be amazed by the explosion of adrenal fatigue that has occurred since then in thyroid patients thanks to the lousy TSH and synthetic T4-only ‘affaire de coeur’ with doctors.

Adrenal fatigue may not be an “accepted diagnosis” by some medical professionals.  But today, there are a growing body of open-minded practitioners who recognize its reality as an acceptable diagnosis, and for which we are grateful.  Now our job as patients is to make sure our more open-minded doctors understand what we have on how to treat it! 

JanieSignature SEIZE THE WISDOM

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** Chapters 5 and 6 in the revised STTM book contain the best details about adrenals and treatment in any book. 

** Here’s a page on STTM listing a variety of symptoms related to a cortisol problem: //www.stopthethyroidmadness.com/adrenal-info/symptoms-low-cortisol/

Thyroid Patients sending a big KISS to this British Doctor!

kiss2

I recently discovered a very humorous and appropo medical blog on the net, written by a United Kingdom General Practitioner who wisely stays incognito. His blog is called The Jobbing Doctor.

And his most recent and humorously brilliant post is titled Hairy legs are better than blood tests! He describes his occasional confusion when blood tests don’t agree with the patients symptoms.

Says the UK doc: “The textbooks teach that the level of circulating thyroid hormones (which are called T3 and T4) are inversely related to the Thyroid Stimulating Hormone (TSH). If your T3 and T4 are low, your TSH will be high: this suggests an underactive thyroid gland. If the T3 and T4 are high and the TSH is low, then you have an overactive thyroid gland. That’s easy, huh!”

But his confusion sprang forth when a patient’s labs showed “a highish TSH, T4, and a normal T3.” Yet apparently her symptoms didn’t imply there was any problem, so he chose to do nothing as far as changing her treatment.

A month later at her next appointment, this patient expressed her approval that he didn’t change anything…because her leg hair and eyebrows were coming back.

And his conclusion?  “Pah! Who needs blood tests!”

Jobbing Doctor, you are discovering what thyroid patients have been learning over and over for years: it’s SYMPTOMS (or lack up) which need to pull the cart, NOT labwork. Sure, we love our labwork. They can give clues to areas where our bodies are screaming for help.  But they definitely do NOT tell the whole story.

Look at the ignoramus TSH lab test. Countless patients have walked into their doctors offices with clear and obvious hypothyroid symptoms–and desperate for a diagnosis–yet the ink spot on the office piece of paper called the TSH lab result proclaims they are “normal”. And that dubious “normal” diagnosis can go on for years before it rises high enough to reveal what was already there by SYMPTOMS.

Or, while on thyroid medication, patients will have a lamebrain “normal” TSH lab result, yet will continue to have their own brand and degree of continuing hypothyroid symptoms which the clueless doctor dismisses as an hysteric female interpretation, motherhood, stress, a need for psychological help….or just “something else”. Uh huh.

In fact, Jobber Doctor, patients have learned that when they are optimal (on desiccated thyroid), along with optimal ferritin and cortisol), they will generally have a free T3 in the upper part of the range, and a SUPPRESSED TSH, with no symptoms of hyperthyroidism.  That is general, and there can be some exceptions, but overall, it has spoken volumes to patients on how inadequate thyroid lab tests can be.  i.e. being in the “normal” range—anywhere in the normal range–can be mean squat.

Thanks for a great post,  UK Jobber Doc. And P.S.  Desiccated thyroid is an even better treatment than thyroxine. 🙂

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The “Three Stooges of Belief” of the British Thyroid Association (let’s hope this stupidity doesn’t rub off in the US!)

The British Medical Journal (BMJ) recently came out with yet another thyroid article, benignly titled Diagnosis and treatment of primary hypothyroidism and authored by the British Thyroid Association (BTA),  that at first blush, looks so caring.

Namely, they express deep concern that that since hypothyroid symptoms can mimic other conditions, patients may be getting an incorrect diagnosis which could expose some patients to the harmful effects of excess thyroid hormones, while other serious conditions may go undiagnosed.

And they add: In other patients, adequate replacement with levothyroxine does not resolve symptoms, which are attributed to hypothyroidism rather than other conditions that may coexist, such as depression.

The article continues with:  Normalisation of thyroid stimulating hormone means a return to normal health in most patients with primary hypothyroidism.

In other words, what you have above are the Three Stooges of the stated beliefs of the British Thyroid Association.

Stooge stated-belief #1: “Incorrect diagnosis allow other conditions go undiagnosed” What is inferred is that there are a host of diagnoses of hypothyroidism that are incorrect. Why? Because a wise physician dared to listen to clear symptoms of hypothyroidism or use the free T3, in spite of a so-called “normal” TSH–a lab test which measures a pituitary hormone, not the cells ability to receive enough thyroid hormones.

Stooge stated-belief #2: “If adequate doses of levothyroxine do not resolve symptoms, those symptoms are due to something else.” That is akin to saying if eating 100 calories a day results in malnutrition and starvation, your malnutrition and starvation is due to something else. And one particular symptom they are referring to is depression–a classic symptom of undiagnosed and undertreated hypothyroidism in MILLIONS of individuals around the world.  And isn’t it just odd how that depression resolves itself when the patient is put on Armour and allowed to dose by the elimination of symptoms.

Stooge stated-belief #3: “A normal TSH lab result equals normal health in those treated for hypothyroidism”. Gee, funny how millions of thyroid patients around the world have had a so-called “normal” TSH lab result along with a diverse blend of continuing and CLEAR hypothyroid symptoms.  Additionally, we have a large and growing body of patients who, when they switched to Armour desiccated thyroid or other fine desiccated thyroid prescription meds,  had those symptoms resolved when they were dosed according to the free T3, improved blood pressure, strong heart beat, lowered cholesterol, and complete elimination of symptoms. Patients have learned what works!

When you understand the British Thyroid Association’s hell-bent and rigid stands against Armour desiccated thyroid, their promotion of one of the worst labs ever created to diagnose and dose by, their love affair with the most inadequate thyroid medication ever thrust onto the market by money-grubbing pharmaceuticals (levothyroxine), and their complete failure to listen to patients and recognize continuing symptoms of hypothyroidism while on synthetic T4, you come to realize how meaningful any article on hypothyroidism will be by the British Thyroid Association.

P.S.  Do ya wonder if the British Broadcasting Corporation (BBC) has the smarts to report the other side of the story??

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Is grandpa sleepy? The innocent victims of the TSH lab.

lynn-doralynn-donna1 Most of us are in our prime when our health is slaughtered thanks to the lousy TSH lab result–a result which can be normal for years before it rises high enough to reveal our hypothyroidism, or a range which keeps us with lingering hypo symptoms.

But the elderly are also wide open targets of the scandal of  the use of the TSH test to diagnose hypothyroidism.

My father-in-law was stout, tall and healthy as an ox his entire life.  For the first eighty-eight years of his life, life was active and grand. Oh did I love him.

Yet as he was nearing ninety, fate became fickle. He became like a Rip Van Winkle,  sleeping more than being awake the final three years of his life.  He slept in the mornings, he slept after lunch, he slept before dinner, and he went to bed early.  And he seemed depressed.

Family concern (mine) prompted his doctor to test his TSH,  widely used by clueless doctors to ascertain thyroid function. The family doc proclaimed “Normal”

Sad. Because I had to watch him waste away in his fatigue until he died.

Hypothyroidism increases with age,  and many of our elderly fall victim to it. Using most any search engine on the net, you’ll find numerous articles on thyroid and the aged. But I suspect it’s an even greater problem that most any article can relay, since most of them are talking about the TSH and thyroxine. So the elderly, just like us,  suffer due to the infinitely lousy TSH lab, just like my dear father-in-law.

Read my latest article on OpEdNews titled “TSH: Thyroid Stimulating Hooey and the Loss of Wisdom” (Yup, the first part is the same title of Chapter 4 in the STTM book) : http://www.opednews.com/articles/TSH-Thyroid-Stimulating-H-by-Janie-Bowthorpe-090205-60.html

Have you noticed suspicious hypothyroid symptoms in your grandma or grandpa, or your own elderly patients? Tell your story by commenting on this blog post.