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Doctors still have a long way to go a.k.a. Those symptoms might just be the thyroid!

Just as I was finishing up the post below about a short summary on the Endocrinology Today website, I saw a link at the bottom of the page that interested me.  It took me to a blog post on the same site from December 10th titled “Why can’t it be my thyroid?”.

And a slew of thyroid patients around the world, as well as a growing body of doctors,  would completely disagree with this post.

Namely, a DO explains the problem of patients arriving in doctors offices with “innumerable possible symptoms of hypothyroidism” including “fatigue, cold intolerance, decreased energy, weight gain, depression, hair loss, low libido, menstrual irregularity and others.”

Yet, he bemoans, these patients have a “normal TSH” which is “well within the normal laboratory reference range.” He also refers to their normal free T3 and free T4, and states there is no history to suggest pituitary dysfunction or that the TSH is unreliable.”

He then proceeds to pat himself on the back because he 1) will treat some patients with a high-normal TSH and other clinical features,  2) he will treat to a low-normal TSH of less than 2.0, but like the good-boy-doctor, “still within the normal laboratory reference range” and 3) he will not induce iatrogenic hyperthyroidism, even if symptoms persist. (yikes)

“Iatrogenic hyperthyroidism”??  Since “iatrogenesis” refers to harmful medical procedures, he’s probably referring to a TSH below the range, which in his mind, equates to hyperthyroidism.

***Then comes the observation that has made many thyroid patients shiver, since so many doctors have said it: because he feels that adding T3 to T4 has more negative results than positive, he explains to his patients “that there may be causes of their symptoms besides the thyroid.”

THUD.

So here is my 6-point response to any doctor who might share these beliefs:

1) There’s hardly a thyroid patient around who hasn’t had a so-called “normal” TSH in spite of clear and obvious hypothyroidism.  The TSH lab test frequently lags behind what is reality in the body, and has been doing so since it’s creation in the early 1970’s (see Chapter 4 in the Stop the Thyroid Madness book for history).

2) Having a “normal” free T3 and free T4 means nothing. It’s “where” the result falls in that range that means something. i.e. patients all around the world are noticing that having a free T3 mid-range or lower in the presence of hypothyroid symptoms is usually a BINGO lab result pointing to hypothyroidism.

3) Exactly because doctors tend to dismiss clear hypothyroid symptoms as “something else” thanks to a lousy TSH reference range, a burgeoning number of thyroid patients are falling into adrenal fatigue with its low cortisol, which serves to mess them up even more.

4) A huge body of thyroid patients who are on desiccated thyroid hormones (aka Armour, Naturethroid, etc), and who finally have a complete removal of symptoms with a normal temperature and heartrate, also have a suppressed TSH lab result, and not one iota of “iatrogenic hyperthyroidism.”

5) When it appears that adding T3 to T4 is having negative effects, the problem is most likely adrenal fatigue that needs correction, and/or low ferritin, NOT deciding that the symptoms must be from another cause or T3 doesn’t work.

6) “Fatigue, cold intolerance, decreased energy, weight gain, depression, hair loss, low libido, menstrual irregularity and others” may be shared in other conditions, but you are most likely missing CLEAR symptoms of hypothyroidism, both in the undiagnosed patient with a so-called normal TSH, or with a patient treated with the lousy thyroxine, which leaves most everyone with continuing hypothyroid symptoms.

“I’m sorry. It IS your thyroid” is exactly what patients need to hear.

British Thyroid Association still thinks a TSH up to 10 is borderline NORMAL????

A thyroid patient from the UK, and a member of Thyroid UK, reminded me of the ongoing travesty in the UK concerning the TSH lab test. And I thought it was worth revisiting due to its extreme absurdity. Quoting from www.brf-thyroid under FAQ, then Hypothyroidism, then Treatment:

The most sensitive indicator of developing hypothyroidism is a rise in the TSH result. Generally a TSH result of <5 is regarded as biochemically ‘normal’, a result of 5-10 is borderline and a result of >10 (in a patient who is not acutely ill) is regarded as consistent with hypothyroidism. The biochemical results have to be considered along side clinical symptoms, and together they determine the point at which the physician will introduce Thyroxine therapy.

Yikes. 5-10 is only BORDERLINE hypo?? What planet to they live on?? I have come across MANY thyroid patients on internet groups who have had a TSH below 3 with RAGING hypothyroidism, and for YEARS being told they were normal. Never, ever has the TSH been a “sensitive” indicator until it finally rises enough to reveal it….but that can be YEARS in the making, and the patient is now living with adrenal fatigue to further complicate their ongoing hypothyroid condition. The TSH lab test does NOT work.

Then from http://www.british-thyroid-association.org/Guidelines/, and downloading the 2006 final version of the UK guidelines for the Use of Thyroid Function Tests , and reading 3.2.2, comes this:

The decision on treatment of patients with subclinical hypothyroidism should be guided by repeated TSH measurements. When TSH is elevated but <10 mU/L there is no consistent evidence of an association with symptoms, secondary biochemical abnormalities (hyperlipidaemia), cardiac dysfunction or cardiac events.

No consistent evidence of an association with symptoms?? Then what ARE those symptoms that thyroid patients have experienced over and over and over, even with a TSH as low as the 2’s??? And repeated TSH measurements?? There is a huge body of thyroid patients across the world who have had years of a NORMAL TSH yet raging hypothyroid symptoms.

They also add:
There is evidence of improvement in the lipid profile and symptoms when patients with modestly raised TSH (mean 11.7mU/L) were rendered euthyroid with thyroxine

Calling anyone “euthyroid” (normal thyroid-wise) on a T4 med, with an average TSH of 11, is so laughable that it stands on its humorous own.

The Dark Ages persist in the diagnosis and treatment of hypothyroidism. What a shameful, blind-sighted travesty! Are you from the UK and dealing with the backwardness? Talk to us by replying to this blog (and be patient–comments don’t always show up quickly.).

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What is going on with the Texas Medical Board?? Potentially worrisome.

This 2008 blog post was updated in 2015 here: //www.stopthethyroidmadness.com/2015/07/28/medical-boards-and-the-tsh-how-they-fail-thyroid-patients-worldwide/   Enjoy!!

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I was informed today that a very popular and well-liked doctor in Texas, who treats many hypothyroid patients, was disciplined recently.  And for what?  Under the column titled NONTHERAPEUTIC PRESCRIBING, it states:  The action was based on Dr. Launius’ prescribing Adipex, Adderal and Armour Thyroid to patients when such medications were not indicated. www.tmb.state.tx.us/news/press/2008/101608a.php

Adipex and Adderol are both central nervous system stimulants, and I can’t comment one way or the other. But the mention of Armour thyroid as “not indicated” is potentially worrisome, especially with similar disciplinary actions brought upon well-liked and wise doctors like Peatfield and Skinner of the UK, Derry of Canada, and  Springer in the US–all who dared to make obvious symptoms more important than ink spots on a piece of paper.

Take Kymm, a 45 year old woman.  She has manifested hypothyroid symptoms for 15 years since the birth of her daughter.  Yet during those entire 15 years, her TSH lab result has been completely “normal”…i.e. hypothyroidism has never been “indicated” based on the typical and widespread gold standard of diagnosis: the TSH.  But she has never, ever been normal with 15 years of easy weight gain, chronic depression, thinning hair, rising cholesterol, and other clear hypothyroid symptoms. And she has in fact started on Armour…and is soaring.

Kymm is not an oddity.  Thyroid patients on internet groups report going years with a normal TSH, no diagnosis, yet clear symptoms which are ignored by their TSH-obsessed doctors.   So their doctors may have avoided disciplinary action, but did they truly practise the art and science of healing??

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The dirty-yellow brick road to ADRENAL FATIGUE…are you headed there??

 

STTM YELLOW BRICK ROAD(This page was first written in 2008 and has been updated to the present day and time. Enjoy!)

Do you ever feel like you want to strangle your doctor with your bare hands?

Of course, we don’t mean it literally, but there is heightened frustration about the lack of knowledge displayed by our doctors! 

Today, I am once again appalled and saddened by the endless body of thyroid patients who continue to plummet into the abyss of adrenal fatigue/adrenal insufficiency, day after day after day. And it just never needs to happen if doctors would simply pay attention and be informed.

Belinda is the perfect example.

She didn’t participate in thyroid patient groups anymore, living her life happily, because she thought her post-RAI thyroid treatment was under control, being on 2 grains of Natural Desiccated Thyroid for a year and a “normal” TSH.

But suddenly, she felt the need to return to her groups and seek feedback. Because 2 grains was not an optimal dose for Belinda. She has become more irritable and moody, has a hard time falling asleep, and feels frequently anxietal. Labs are redone, and she finds herself with a slightly over-range free T3 and a very suppressed TSH. Her doctor decides to lower her thyroid meds, which in turn improves her insomnia and anxiety, but weight starts piling on. She’s confused and wonders how she can find her balance between being on too little with unwelcome weight gain and being on too much with uncomfortable anxiety and insomnia.

What Belinda didn’t get, and what her doctor didn’t get, is that Belinda had now joined the dubious camaraderie of those with adrenal fatigue/adrenal insufficiency–a needless condition of over-stressed and now under-functioning adrenals i.e. low cortisol. As a result, T3 in natural desiccated thyroid starts to pool in the blood, or raises the inactive Reverse T3, either causing anxiety, insomnia, and all sorts of low cortisol symptoms.

In Belinda’s case, the problem was that 2 grains was not an optimal dose for Brenda, even if her TSH looked oh-so-normal! Because it’s never about the TSH. It’s about where our free T3 falls and more.

Thyroid patients just like Belinda have to first discover what is going on, then face the complicated balancing act of treating adrenal fatigue AND hypothyroidism. And it’s a path that never needed to happen.

WHAT IS POTENTIALLY TAKING YOU DOWN THE DIRTY-YELLOW BRICK ROAD TO ADRENAL FATIGUE??

  1. Being undiagnosed, or being dosed by, the faulty TSH lab test and its dubious “normal” range, which will leave you with lingering hypothyroid symptoms. 
  2. Being treated by T4-only medications like Synthroid, Levoxyl, Eltroxin, et al, which end up teasing your adrenals to work harder to take up the slack of an inadequate treatment, then to fall into the abyss of low cortisol.
  3. Lowering your expectations of what “normal” is. No, it’s not normal to have less stamina than others, to be on an anti-depressant to bandaid your hypo depression, to feel colder than others, to require frequent naps, to feel the need to avoid people, to be bothered by lights or noises, to be told by those you love that you are too defensive or over-reactive…and so on.

I hope anyone reading this comes to an understanding that you canNOT enter your doctor’s office as if you are entering the throne of a god. Your doctor, no matter how educated, dedicated or wonderful, may not have a strong understanding of the role of adrenal function in relationship to bad treatment via T4-only meds or the TSH lab range. You may have to bring this knowledge to your doctor, or find another one who is either learned, or open-minded. Because your chances of having adrenal fatigue/insufficiency are higher if you are on T4, if the TSH is worshipped by your doctor whether on T4 or desiccated thyroid, or if you keep walking into the doctor’s office and hang your own knowledge on the hook outside his or her door.

JanieSignature SEIZE THE WISDOM

 

 WANT TO UNDERSTAND MORE ABOUT HOW WE FALL INTO HAVING LOW CORTISOL?  

Order the STTM II book and read Chapter 15. It’s brilliantly written by an MD who gives a most excellent explanation of how we get there!

 

 

 

STTM graphic How cortisol can cause problems when raising NDT

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Puff. Puff. Puff. If you are a cigarette smoker & hypothyroid, you might want to read this!

Screen Shot 2015-05-15 at 11.01.08 AM(Though this post was originally written in 2008, it has been updated to the present day and time! Enjoy!)

Who, as a smoker, hasn’t heard how deleterious tobacco smoking is for your health. Not only will you acquire health problems directly related to smoking, but your life is shortened by 10-15 years average according to statistics. My own father died at age 63 directly related to his smoking i.e he got emphysema, then lung cancer. (Update: Discovered from doing my own genetics that I have inherited a mutation which can cause me not to break down Nicotine well. This may explain why my Dad died so young from smoking!)

But in spite of strong reasons to quit, most smokers will tell you it’s NOT easy. Why? Because the nicotine in tobacco is the addictive bogeyman. Nicotine stimulates those pleasure centers in your brain, besides being a substance which “gets you going” by releasing both blood sugar and adrenaline. The American Heart Association states that “Nicotine addiction has historically been one of the hardest addictions to break.”

But for hypothyroid patients, tobacco smoking presents another whammy.

Namely, smoking may be stressing your adrenals over and over. And with adrenal problems being a common side effect of treating hypothyroidism with T4 meds like Synthroid, Levoxyl, Eltroxin, et al, as well as being dosed by the lousy TSH, you’ve got a third reason to fall into adrenal issues if you are a smoker.

Additionally, another factor in the difficulty of quitting is that cortisol decreases when you try to quit.

A 2006 research report found that the lowered cortisol after quitting is associated with smoking relapse and with reports of increased withdrawal severity and distress. So, when you already have adrenal stress, and you quit smoking–a double whammy against being successful.

Does being a smoker affect the TSH lab test?

Yes, in such a way that smoking will lower your TSH, which can hide the fact that you can be undiagnosed hypothyroid, or undertreated. See an interesting research study on smoking and your TSH here.

What’s the solution?

If you don’t have adrenal fatigue and want to quit, it may be wise to have a good adrenal support on hand, such as adrenal cortex or any quality OTC adrenal product at your health food store. If you DO have adrenal fatigue, staying away from cigs may require adding additional cortisol to your daily amount. Chapters 5 and 6 in the STTM book have good information to help you with cortisol support. Also be prepared that by quitting, your hypothyroid state may be revealed, or may get worse.

Are you a smoker with hypo? Don’t hesitate to respond to this post with your experience. We learn from each other!

READ DEBORAH’S STORY ABOUT HER ATTEMPT to STOP SMOKING.

JanieSignature SEIZE THE WISDOM

 

 

 

 

 

 

**Have you Liked the STTM Facebook page? It gives you daily inspiration and information. 

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