Rapid Responses to:

LETTERS:
Gordon R B Skinner, R Thomas, M Taylor, M Sellarajah, S Bolt, S Krett, and A Wright
Thyroxine should be tried in clinically hypothyroid but biochemically euthyroid patients
BMJ 1997; 314: 1764 [Full text]
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Rapid Responses published:

[Read Rapid Response] Sick and tired of feeling Sick and tired
P Davis   (7 October 1999)
[Read Rapid Response] Response
David Derry   (18 October 1999)
[Read Rapid Response] successful for me
M Beattie   (12 February 2000)
[Read Rapid Response] Hope for us all.
Gina Wright   (13 February 2000)
[Read Rapid Response] Overwide ranges don't help..
Philip Stowell   (16 February 2000)

Sick and tired of feeling Sick and tired 7 October 1999
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P Davis,
Co ordinator for TED

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Re: Sick and tired of feeling Sick and tired

Would someone please address the problems of all those Thyroid patients who despite optimum doses of Thyroxine still feel very far from well but are told

" Your blood tests are ok so you must feel ok "

Response 18 October 1999
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David Derry,
General Practitioner
Victoria, BC Canada

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Re: Response

I wonder why Skinner and associates hesitate to use thyroid therapeutically when for eighty years clinicians of outstanding ability regularly treated thyroid patients with enough thyroid to clinically normalize the patient regardless of the dose.

It is well documented that symptoms corresponding to Fibromyalgia and Chronic Fatigue in the 1930s were cured by the simple early treatment with thyroid hormone. Professor R. Hoffenberg in 1974 in this British Medical Journal in his first article on Hyperthyroidism gave an example of the doses that the current repudable physicians were potentially using to help their patients. The maxim of the day before the TSH arrived was you gave enough thyroid until the patient was better. Because of 80 years of experience with thyroid hormones it was found that normal people need approximately 200 to 400 micrograms of eltroxin or 180 to 250 mgs of desiccated thyroid. Long term studies over 40 years showed no difference from controls. The doses today are 1/3 that dose and the consequences are that the medical students are taught to treat a lab test and not the patient. This has gone a long way to alienate the patient from the doctor and seek alternative practices for relief.

Thyroid is probably the safest long term drug of the century. Deaths from suicide attempts do not occur, whereas deaths from aspirin (also from the last century) overdoses number in the thousands per year. There has not been a documented case of osteoporosis caused by thyroid medication in this century. This may mean that thyroid prevents osteoporosis by energizing the patient to walk and be active. But because of the TSH test the whole medical profession has turned a blind eye to all the symptoms of low thyroid.

Consequently we have millions of people disabled by Chronic fatigue and Fibromyalgia. Most other chronic diseases have a fatigue component and if thyroid is used therapeutically, ignoring the tests, the precedent set by Osler and all the great clincians after him up to the TSH arrrival in 1973, can be followed and then the quality of life of these people too can be very much improved. In the light of all the medications available now for treating any type of disease it is a sad commentary that thyroid, the safest drug that has survived for a century, cannot be used therapeutically for anything. Every single other substance known to man is used or tried for different diseases but after 1973 thyroid, one of the great therapeutic agents of this century, was effectively banned for "replacement doses". Current replacement doses of 1/3 the historically and clinically effective doses is not treatment-- it is blind obedience to a lab test which has no clinical correlation with the signs and symptoms of the disease.

successful for me 12 February 2000
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M Beattie

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Re: successful for me

I am one who suffered many symptoms (mental confusion, fatigue, profuse hair loss, sensation of cold in a warm room) yet laboratory tests said I was normal (T4=.9, TSH=2.3) My physician decided a trial of levothyroxine would be harmless and would settle the question once and for all. Only .025 mg and all symptoms retreated. I wish more physicians would take this step with their patients, it is inexpensive and risk is almost non-existent.

Hope for us all. 13 February 2000
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Gina Wright,
Reflexologist

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Re: Hope for us all.

At last a voice of reason. For all those who suffer with Hypothyroidism (I mean suffer) who are contantly told blood levels fine, the reason you cannot lose weight is "you must be eating too much, the wrong things, or you drink too much alcohol.

Why don't our doctors move with the times, keep up-to-date and above all listen to their patients. My own GP is great but refuses to believe how tired I feel, how frustrated that I cannot lose the weight that crept on before I was diagnosed and how fed up I get.

So doctors if it worked better in the past before TSH tests came in, for heavens sake go back to what worked and help us sufferers to lead a normal life again.

Overwide ranges don't help.. 16 February 2000
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Philip Stowell,
GP
Brisbane

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Re: Overwide ranges don't help..

I am always interested by the so called "Normal Ranges" quoted by labs or other authorities as representing what is normal or healthy and implying that the two terms are interchangable. They clearly are not ... How can a normal ferritin possibly have a normal healthy range of 10 - 290 or thereabouts this is a 29 fold difference TSH is quoted as ).4 - 4.0 or thereabouts. This is better but it is still a 10 fold difference. Normal ranges are usually determined by asking people if they are well and then doing a test. No more and no less. There surely should be a little more protocol about this system of providing reference ranges.

With reference to Thyroid problems and for anyone who is interested.....

if you go to the site below

http://thyroid.about.com/health/thyroid/msub4.htm#search gp to the SEARCH link and then look for and type

dommisse

you will be taken to a list of articles about and by this Dr . You can then read the interview you will find a very cogently argued article that makes a lot of sense to me at least.

Philip