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Views & Reviews From the Frontline

Bad medicine: thyroid disease

BMJ 2012; 345 doi: (Published 09 November 2012) Cite this as: BMJ 2012;345:e7596

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Re: Bad medicine: thyroid disease

I happened to live in the UK when I first showed symtoms of low thyroid - terrible fatigue, weight gain, body aches, low mood, dry skin, high cholesterol levels despite a healthy diet, etc.

Receiving adequate medical treatment or even proper lab tests and a diagnosis proved to be almost impossible.

I had to find a private lab and order tests myself to get a full thyroid panel. Getting adequate medication was the next problem - it turned out synthetic T4 did not work well for me and did not relieve my symptoms. After much trial and error, I now happily use a natural dessicated thyroid medication made by a German compounding pharmacy and have good quality of life.

How can anyone dismiss "subclinical hypothyroidism" when most patients haven't even gotten properly tested and when the TSH is upheld as a the gold standard - even when patients present with obvious clinical symptoms? And using outdated reference rages such as a TSH of 5.0 doesn't help either. Not only aren't FT4 and FT3 routinely tested for, they don't check for antibodies either, when 80% of hypothyroidism is suspected to be due to Hashimoto's. Without treatment, Hashimoto's will get worse in most cases.

It does not only make sense to treat existing suffering, but also to prevent future disease which is brought on by untreated or under-treated hypothyroidism.

What if the reason for the increase in "subclinical hypothyroidism" (silly term really because these are people who have clinical symptoms but their doctors look at lab values instead of listening to how they feel) was that these were previously even more underdiagnosed?

If I was on too much thyroid medication, I'd find out right away - hey I don't enjoy the palpitations and anxiety this would cause.

I do think that hormone replacement should not be the only treatment though - the most successful functional medicine practitioners in the US are now going to the cause of hypothyroidism. Why doesn't anyone wonder why so many people get so sick, and more of them every day?

I have had great success and am able to reduce my thyroid medication using a diet low in allergens, specific supplements and exercise. I had high mercury levels due to dental fillings, which could have been part of the problem. Many other environmental pollutants have been shown to accumulate in the endocrine glands, plus there are dental X-Rays, halogens in drinking water which affect the thyroid and overall health.

I think the overall standard in thyroid treatment is medieval at best - ignore clinical symptoms, refuse to get proper tests, mis-interpret existing lab results, then rely on T4 treatment only if prescribing anything at all, and never ask "why?" Fortunately patients are becoming more educated, but until decent diagnosis and treatment is available, only those who can afford to pay for qualified practitioners will get a real chance.

Competing interests: No competing interests

11 December 2012
Anke Moeller
ND student
9 Tanjong Rhu Road, Singapore