I give up. Like Danny Glover’s iconic character in Lethal Weapon:
You win, alt med – everyone is hypothyroid. Lab testing in the evaluation of hypothyroidism is worthless, unless it shows low T3 or high reverse T3 levels, in which case it’s highly reliable. If a thermometer waved somewhere in the neighborhood of one’s tongue, ear, forehead, or axilla shows a value < 98.6 degrees F (37.0 C), that’s good enough for me to say the thyroid just ain’t right. Depressed? Hypothyroid. Weight gain? Hypothyroid. Fatigue? Hypothyroid. Alive? Definitely hypothyroid.
I’ve so often lamented the misguided attribution of nonspecific “symptoms of life” to the thyroid, that I thought I’d stop writing about it someday. Apparently, that day is not today. For as long as there are charlatans preying on vulnerable patients, I suppose I will continue to burn copious amounts of ATP counteracting the cacophony of crazy.
When Medical Doctors Go Rogue
What has me all lathered up this time, you ask? I received the following email from an actual Doctor of Medicine in the United States (below). Before I get to it, let me point out a few things.
First, this is just one example of similar messages I’ve received over the years from other alt-leaning physicians. These messages are always rambling, barely coherent, and make me absolutely frightened for the patients being counseled by these folks.
Second, the author of this email is not an Endocrinologist. She’s not even an internist or family practitioner.
Third, after some light googling, I was able to discern that (a) she believes that diabetes, hypothyroidism, and other diseases are all caused by mineral imbalances; (b) she runs a supplement company that will sell you minerals to rebalance you; and (c) she offers phone consultations at a “reasonable” price, during which she will tell you how to figure out what you’re deficient in so that you can…see (b).
Without further delay, here is the barely-edited email. The only changes I made were inserting paragraphing for readability and redacting all identifying details. Any attempt to identify this practitioner in the Comments will be deleted.
Please understand I am also an expert on Hypothyroidism. Please read chapter 5 of [redacted] and watch the book lecture online [redacted] click on watch lecture or U-tube my name and watch it to learn more.
Also, I have a lecture on Hypothyroidism recorded available through [redacted] Conference 2019.
You have left out a tremendous amount of literature on this subject, but first you must understand that the TSH used as the standard of care and for all conclusions you made, is NOT reliable. I have at least 13 studies and counting. Therefore, all assumptions of adequate care are unreliable and lack of basic physiologic interactions, biochemistry and physiology, as you state, are unreliable. Also, I have significant research information that shows the T3 is not 24 hours, but it has a much lower half-life of around 8-12 hours.
Only basal body temperatures taken reliably sublingual with a reliable thermometer, taken on wake up only after 5 or more hours of sleep, is reliable for the diagnosis of Hypothyroidism. This temperature must be 97.8 or greater to be normal thyroid. Yes, nearly everyone is Hypothyroid, nearly 90-95% [HD: bolding is mine]. This conclusion is after over 11 years of clinical research using BBT’s and appropriate testing.
Clearly, you do not understand the diagnosis or management of this illness, but very few do.
I appreciate your reading and research into this area, but the pitfalls are too numerous and the current standard of poor care is too ridiculous to get proper research done.
Dr. Barnes have the right approach. He concluded less than 5% reliability of TSH. I would allow possibly 10% reliability, mostly only if elevated or suppressed not on any therapy. Outside of these groups, the current levels of TSH norms are completely unreliable for the diagnosis or management of hypothyroidism.
You miss completely the significance and reasons for rT3 elevation and the whys. But you should know, it is the ratio that matters, not the absolute levels. This ratio changes more significantly with physiologic issues, but it still reveals Hypothyroidism when correlated with BBT’s with 95% reliability.
Once one understands the symptoms of Hypothyroidism more clearly and bases the treatment on the BBT’s correction, and doing the appropriate TT3 and rT3 use, FT3 in pregnancy only, then one can begin to make sense of the confusing and contradicting nonsense you espouse from the general Hypothyroid literature.
I hope you continue to grow in your understanding of Integrative Medicine. It is NOT alternative as you espouse. It is good care, trying to get it right all the time with less toxicity, reversing and preventing illness, not just treating the symptoms. It is not drug dealing as is the typical doctor care. It is caring, compassionate, and compelling once one gains more understanding of the pitfalls and ignorance continually being espoused by AEA and ATA, e.g., 2012 “Position Paper on Hypothyroidism” where it specifically states, “signs and symptoms do not matter since only 25% of these patients will have an abnormal TSH.” That is an appalling statement of ignorance and represents a separation from the reality of medicine. Who gave those doctors the right to suspend symptoms in the practice of medicine due to their ignorance. Appalling to be sure!
And…breathe. Did you actually make it through the entire thing? If not, don’t feel bad. It’s a painful read and I had to skim it the first time through to avoid banging my head against my laptop. Normally, I don’t give these diatribes such a prominent platform on my blog, as there are already enough of them in the Comments sections of my other posts. One, I view addressing them head-on as punching down, which does not further the mission of Hormones Demystified. Two, it’s impossible to argue with someone like this. It’s like locking a rabid pro-choice person and an equally rabid anti-abortion person in a small room and instructing each of them to convince the other her position is correct. They’ll scream at each other for eternity, never getting any closer to common ground.
Quackery is not Exclusive to Naturopathy
I decided to shine a light on this particular email, however, to illustrate a critical point that does further the mission of this blog. Many of my non-physician readers land here because they are desperate for answers. In many cases, they have been unwell for a long time. They often feel dismissed or condescended to by their doctors; they no longer care who will fix them or how – they just want to be fixed.
Patients turn to alternative medicine physicians – like the author of the above email – believing that her medical degree confers credibility upon her unconventional approach. After all, this is not some naturopath espousing all kinds of quackery that sounds plausible to the layperson – this is coming from a real doctor. More than that, though, people’s desire to believe is strong and leads smart people to become incredibly stupid when it comes to their health.
Based on comments on my posts and emails I receive, I know that many – if not most – of my readers are highly intelligent. I’d like to think that they perused the above email and were horrified that an actual physician who is responsible for people’s lives couldn’t craft a message with a semblance of coherence. Not to mention that there are factual inaccuracies and outright misrepresentations of mainstream medicine throughout.
But I’m not so sure that everyone will read it that way. The author of that email is a self-professed expert, references her book and lectures, and uses a lot of technical jargon. To people who don’t know much about thyroidology, they might simply assume that this physician is, indeed, an expert. People might believe the author when she claims that “nearly everyone is [h]ypothyroid, 90-95%.”
It’s also possible that this doctor talks a better game than she writes. What if she’s charming, a good listener, and validates patients’ concerns? Is it possible that even intelligent folks could be duped into believing whatever nonsense she’s slinging? Absolutely.
On the spectrum of “danger to public health,” I still believe that slick alt med sites like the one I wrote about in Alternative Medicine is Kicking Our Ass occupy the high end. But it is equally important for the individual consumer of healthcare to be vigilant when seeing a practitioner who expresses ideas unlike anything she has previously heard. Further, if said practitioner offers copious testing followed by recommendations to purchase hundreds of dollars worth of supplements, something may be rotten in the state of Denmark.
Everyone is not Hypothyroid
Let me be clear: I am not minimizing the suffering of people with un-, under-, or over-treated hypothyroidism. Rather, I am taking issue with alt med’s rampant over-diagnosing of the condition. I have written these words dozens of times, but I guess I need to keep saying it: if you’ve been spinning your wheels for more than a year, tried multiple thyroid hormone cocktails, have had a TSH in every part of the range, and you still don’t feel well, it’s time to consider the possibility It’s Not Your Thyroid.
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