Doodlebug1

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Thyroid

Latest comment: 17 years ago3 comments2 people in discussion

You're back! I've responded to your message on Talk:Natural desiccated thyroid hormones. By the way, are you aware of any controlled trials between levothyroxine and Armour? That would be an immensely useful citation in that article. JFW | T@lk 09:49, 25 June 2006 (UTC)Reply

I don't think there are ANY controlled trials between levo and Armour. Zilch. It's a huge problem when citing. What is known about Armour right now is by patient's experiences, and they are making it clear on these websites that the medical profession knows practically squat about correct thyroid treatment, besides being narrow and closed minded about it. --Doodlebug1 20:24, 25 June 2006 (UTC)Reply

How are doctors supposed to know the "right" treatment if no studies have been performed? Being a science, medicine cannot allow itself to be guided purely by experiential knowledge. I personally think you're being a bit firm when you say "the medical profession knows practically squat about correct thyroid treatment". Do you know what is the correct treatment, given that there is no validated information? There may be 100,000s out there who are perfectly happy with their thyroid treatment.

For a doctor it can be quite exasperating to read the Thyroid Madness website, because it does not address the numerous problems it raises. For one thing, thyroid hormones have a fairly constant blood level, given that they have a long half-life. There is no need to take tablets multiple times a day, nor should there be a need to take them sublingually. T3 supplementation is not necessary because the liver converts T4 to T3 without any difficulty. TSH is a fairly reliable physiological marker of thyroid function/supplementation - it is a result of the thyrotropes sensing T3 and T4 levels, which is a more accurate representation of the body's feedback processes than any other surrogate measure. Low ferritin is common, especially in premenopausal women, and all thyroid patients may develop hypoadrenalism; a sensible endocrinologist or even general practicioner does not need to be lectured about investigating for other causes of fatigue if the symptoms do not improve on thyroid hormone supplementation.

Of course you've heard all this are and probably annoyed at my "closed-minded stupidity", but these points are not presently addressed in the natural desiccated thyroid hormones article, although I believe they should be if possible. JFW | T@lk 22:16, 25 June 2006 (UTC)Reply

Comment

You wrote: "Being a science, medicine cannot allow itself to be guided purely by experiential knowledge".

But what about acupuncture, then, for example?

If medicine could only prosper my medical studies alone, doctors still wouldn't desinfect their hands and wear gloves - because the doctor who suggested this based his recommendation on empiric observations! And he was at first ridiculed and harassed for that by his colleagues. Nowadays his critics are considered to be the dumb ones, not him!

Couldn't resist to drop these few lines...

Cheers, ibeji_at_gmx_dot_net 2006-10-03 14:45 UTC

My response (and using this to separate your entry from mine to make this all more readable. lol

Latest comment: 17 years ago1 comment1 person in discussion

I had to chuckle at your first question--because apparently some doctors knew the right treatment for thyroid conditions for DECADES without exact "studies" being done. They dosed with thyroid extract according to obvious patient symptoms, not studies. Doctors who are old enough to remember state that emphatically. And by the way, it wasn't me that said above "the medical profession knows practically squat about correct thyroid treatment". I was reporting what patients are saying on these sites. And it's impressive if you really read it, though I believe you when you say it's exasperating to read sites like the STTM site.

And if I know my subject correctly, I believe you are quite wrong that "thyroid hormones have a fairly constant blood level". That may be true for thyroxine, but direct T3 does not have a constant blood level. It peaks about 2 hours after it's introduced to the body via Armour, then starts a fall. And that fact is the very reason patients have reported that they notice better results when multi-dosing...to get that peak throughout the day, or to get their T3 throughout the day, as their own thyroids would be doing to meet daily needs. (I also believe there is a doctor out there who is on Armour, and reported the exact same thing...but I can't remember who he is.) So I hope you can be open to re-thinking your statement that "there is no need to take tablets multiple times a day", because it appears that patients are reporting all over the place that they DO need to do so, and experienced the reason they do.

As far as taking them sublingually, you are right that those patients don't "need" to take them sublingually. There certainly appear to be some who swallow their desiccated thyroid, and have success. But they are also reporting that when they switch to sublingual, they notice they get even better results. And since taking any medication sublingually has biological reasons to be more effective, they may be on to something.

When you state "T3 supplementation is not necessary because the liver converts T4 to T3 without any difficulty"--perhaps the problem is NOT that there was a "difficulty", but perhaps the problem that patients are loudly reporting on these sites is that the body was never meant to live on T4 to T3 conversion alone! And they experienced that fact. They are shouting loudly that their "experience" counts! And honestly, for you to say that T3 supplemention is not necessary only serves to cast doubt on thousands of thyroid patients who are joining all these interactive groups and stating clearly that getting direct T3, as in Armour, made a huge difference in how they feel! i.e. by these patients experiences, they DID find direct T3 "necessary" in order to finally resolve their lingering symptoms on levothyroxine only medications.

You also state: "TSH is a fairly reliable physiological marker of thyroid function/supplementation". If that's the case, why have so many of these thyroid patients reported that as long as they were kept in the TSH range, even on Armour, they never, ever fully got rid of their symptoms??? If you read the patients stories who come on the forums, there are MANY who report they had a "normal" TSH, yet they had a slew of continuing hypothyroid symptoms! In fact, the experience of patients reported on these sites mimics exactly the words of Dr. David Derry: "Why are we following a test which has no correlation with clinical presentation? The thyroidologists by consensus have decided that this test is the most useful for following treatment when in fact it is unrelated to how the patient feels. The consequences of this have been horrendous. Six years after their consensus decision Chronic fatigue and Fibromyalgia appeared. These are both hypothyroid conditions. But because their TSH was normal they have not been treated. The TSH needs to be scrapped and medical students taught again how to clinically recognize low thyroid conditions."

Finally, you stated "a sensible endocrinologist or even general practitioner does not need to be lectured about investigating for other causes of fatigue if the symptoms do not improve on thyroid hormone supplementation." Thousands of patients on these numerous sites are stating that the REASON their symptoms did NOT improve was because 1) they were left on the inadequate levothyroxine treatment 2) they were kept within the TSH range 3) they had undiagnosed low Ferritin due to a doctor who refused to test it 4) they had sluggish adrenals with a doctor who either wouldn't correctly test it, or didn't have enough knowledge about physiologic dosing of cortisol vs. pharmacologic, or 5) even on Armour, they were forced to stay within the TSH range, instead of being allowed to dose according to the elimination of symptoms, which brings their free T3 towards the upper quarter of the range, and suppresses their TSH, without a hint of hyper symptoms.

Bottom line, if you really pay attention to what these patients are trying to say on these sites, YES, they are QUITE annoyed at the "closed-minded stupidity" of their doctors. Because that failure to listen to "symptoms" and think independently and intuitively has apparently left thousands of patients chronically sick for years. They are finding that doctors forgot how to listen to patient symptoms, and as Janie aptly says on her site: They appear to be cattle in the shutes of their medical school training---paying more attention to ink marks on a piece of paper (the TSH) rather than listening the obvious continued symptoms they have from being on levothyroxine and being held hostage to the TSH range.

I think these patients on all these site have had experiences that doctors are not paying attention to, and they are forced to join these sites to get answers that they are NOT getting from their doctors. And it appears they are quite grateful for other patients like Mary Shoman, like Janie and all the other patients who are active on these sites, spreading the word about better thyroid treatment, in spite of the huge volume of doctors who aren't listening.

I was not trying to convince you of the "truth" or anything. I was just wondering if you were planning to address the discrepancies between generic medical views and those of "the patients" on the Armour page. Because I think it's necessary.

The problem with these "experiential" views is - doctors will not change their practice unless there is clinical evidence, because all statistical evidence available presently shows that levothyroxine is just fine. Has STTM not found a clinician who is willing to conduct a randomised controlled trial? And wouldn't Forrest Labs be happy to support such a trial financially?

I rather like your theory about chronic fatigue and fibromyalgia, but the vast majority of patients with either syndrome has a normal pituitary-thyroid axis. Really. Otherwise it would have been too easy. JFW | T@lk 07:23, 26 June 2006 (UTC)Reply

My reply

Ah, but what doctors are missing is in that word "normal". It has been observed over and over by these patients and by a small but growing body of doctors that just because the TSH number falls in the so-called normal range, does not mean the patient is free from hypothyroid! You can see this in many of the posts on the STTM forum---patients who cry out to Janie and the moderators that their TSH is "normal", the doctor refuses to treat them, yet they are ballooned with hypothyroid symptoms.

It's also evident in the groups like Yahoo's Natural Thyroid Hormones, Shoman's Thyroid group, and all the others. Patients are flocking to these groups because doctors fail to question what "normal" is! Is it normal to have a TSH number in range, yet the patient has all the classic hypothyroid symptoms?? Because that scenario is happening all over the place, and that is the "evidence" that makes the TSH and it's range stink! Dr. Derry was seeing it a long time ago, and now other doctors are following: Toft, Peat, Hertoghe, Dommisse, and so many others.

You stated: statistical evidence available presently shows that levothyroxine is just fine, and I have no doubt that the majority of doctors would say the same thing. But THAT IS THE PROBLEM! Since when does "statistical evidence" become more important than that patient who has a normal TSH, and still reeks of hypothyroid symptoms?? It's very sad.

I know that doctors think they need clinical evidence. But in spite of that, there are a growing body of doctors who are practicing "do no harm" and daring to listen to patients symptoms before that clinical evidence comes out. And honestly, "clinical evidence" becomes suspect when you find out "who" was financing the study! The Big Pharma is a Big Snake Oil with plenty of influence.

And by the way, since when did clinical evidence cease to be "observing symptoms"?? And when did case studies become so ignored, such as ones done by Broda Barnes and so many others?? All patients wonder why the evidence of their OBVIOUS continued hypo symptoms is routinely ignored simply because "science" hasn't proved it. They are routinely saddened by the blinders that their doctors wear, and patients are reporting a huge loss of respect for their doctors, calling them mindless robots of their training, as if their training is more important than real life patients with real life and obvious symptoms!

Yes, if you think it would be good to address more the discrepancies between generic medical views and those of "the patients" on the desiccated page, I will take a stab at it, and be quite thankful towards you for your assistance if I fail to get the references correct--though I think I am understanding better. Give me a few days.

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