I can never decide whether to love the New York Times or hate it. One week the Magazine is exceptionally strong; the next week Tom Friedman and Maureen Dowd stink up the Op/Ed page. One week they get all the facts wrong about Israel; the next week they’re proving themselves culturally relevant with an important article about subclinical hypothyroidism. They even included in it a photo of Mary Shomon, the virtual thyroid guru whose book Living Well With Hypothyroidism was the crucial step in my diagnosis of the same (my case was not subclinical).
The article isn’t even that bad, going perhaps too far out of the way to report a controversy when the simple fact is that the standard TSH (thyroid stimulating hormone) test is good at indicating hypothyroidism, but not great, or even very good. What’s unfortunate is that reporter Kate Murphy didn’t dig deep enough to learn that TSH is an awful test at managing hypothyroidism, which is how it’s used obsessively by the vast majority of doctors. Case in point: my TSH is so low right now that if an average doctor saw it, he might call an ambulance to send me to an emergency room in anticipation of my impending heart attack. And I feel better and healthier than I’ve felt since my 21st birthday. On the other hand, Murphy gets a passing grade for raising the issue that Abbott Laboratories, which distributes Synthroid (synthetic T4, levothyroxine), funds endocrine research, an obvious conflict of interest that has led to Synthroid’s immense popularity.
What TSH and Synthroid have to do with each other is that Abbott promotes both of them in a way that enables doctors to prescribe both without thinking: order a simple blood test for a patient; prescribe drug if test result is above test’s upper limit; don’t treat at all if test result falls anywhere in the test’s “normal” range. This amounts to medical malpractice, and there are thousands – possibly hundreds of thousands – who’ve either been told they don’t have hypothyroidism when they do, or been told that their cases of hypothyroidism have been treated when they haven’t. Actually, this isn’t any sort of medical practice at all – it’s reading from a glossy handbook or brochure. The way hypothyroidism ought to be treated is with a combination of T4 and T3 (such as with Armour Thyroid, which I use) or with T3 alone, and a combination of clinical analysis (ie, doctors using the diagnostic skills they were supposed to learn in medical school) and blood tests that actually measure thyroid function, like T4 and Free T3 (TSH is produced by the pituitary gland, so it’s at best an indirect indicator of what’s up with the thyroid). Of course, Forest Pharmaceuticals, to the best of my knowledge, doesn’t have an advertising budget for Armour, so this is about as likely to transpire as the discovery of a cure. What I hope will develop sooner is the public’s budding realization that most doctors are clueless, or incompetent, or downright liars, or all of the above.
It is unfortunate that more people do not behave as their own best advocate in health care as you obviously have been doing. Mazel tov! G-d forbid you should have a heart attack. I do not recommend them at all.
Sorry for the long response, but I have to tell my story because it is typical of so many others
like me.
I have experienced this very thing with doctors. I have Hashimoto’s thyroiditis, which is
autoimmune thyroid disease where the body’s immune system attacks and eventually destroys the
thyroid gland. I was diagnosed with hypothyroidism in February 2004 with a TSH of 10. My (now
former) doctor told me that he didn’t start treating patients for hypothyroidism until their TSH
reached over 10, but made “an exception” with me by giving me a Synthroid prescription because
I originally came to him for help with problems I had losing weight. I was dieting and
exercising properly and was taking Aikido. I should have been losing weight but was gaining
instead. So I took Synthroid for a year and my health rapidly declined. My hair started to fall
out. My skin turn yellow and white like leopard spots. My triglycerides soared to 550, and my
cholesterol reached 220 when it was always below 100. My blood pressure which was normally
90/80 was now 170/100. I felt like I had the flu all the time and I was so exhausted and
mean to everyone because I felt like I was dying, and in all reality I was but slowly. I asked
him to switch me to Armour and he said no because my TSH was too low at 0.4, however a week prior
it was 13. My TSH fluctuated wildly on Synthroid and it made me feel awful. I really don’t
believe that he was ignoring me. I feel more that he just didn’t know enough about the
disease so I went to see an endocrinologist who diagnosed me with Hashimoto’s disease after
seeing my high antibodies. He refused to switch me to Armour too saying that my TSH, now at a 5
was fine and that my symptoms were not thyroid-related. I went to yet another endocrinologist
who wouldn’t switch me to Armour because she said it was evil and very bad for you. Finally I
went to the Forest Pharmaceuticals website and found a doctor who prescribed me Armour. By the
time I saw that doctor, my TSH went back up to an 8 (keep in mind my dose on Synthroid did not
change.) A month later on Armour, my cholesterol dropped to 180 and my triglycerides dropped to
453. My TSH went to 0.2 and it never changes. My blood pressure is now a healthy 130/88. My
new doctor found out that I have low adrenal function and that my undertreated thyroid disease
was masking it. He put me on adrenal hormones and I feel great! I also take B12 shots because
I had been sick for so long that I lost the ability to absorb it from food or even if I take it
in powder form. I also found out that I am prediabetic so I started the South Beach diet because
it is low glycemic and lost 14 pounds after being on it for two months. My skin is no longer
yellow, I have energy and my mood has improved. All those other doctors I saw would never have
found any of the additional problems I had, and even if by some small margin they did, they
would have never prescribed natural hormones or B12 shots as treatments! I am thankful to Mary
Shomon and all the hard work she has done to educate us and make us realize that sometimes we
have to be our own doctors. I picked up Living Well with Hypothyroidism from the library days
after I was originally diagnosed and visited the thyroid.about.com forum. If I was not armed
with all the information Mary gave in her book and with all the great information from the good
people from the forum, I would be jobless, divorced and thinking I was crazy because of bad and
misinformed doctors. I owe them all my heartfelt thanks for teaching me to take control of my
health and not leave it solely to the doctors like I had my whole life!
Quite powerfully written and accurate. I’m a 36-year-old male with Hashimoto’s. Very little keeps me down – I was a college football player and I’m a black belt in Brazilian Jiu Jitsu. However, my diagnosis and subsequent year of Synthroid (with a course of 6 different doses) never made me feel a whole lot better. TSH eventually came down, but I still felt terrible and tired for no reason. Switched to Armour, and started feeling better within a few short weeks. My respiration improved, and I was able to train like I’d never suffered from this condition. BTW, I used to work for Abbott Labs in North Chicago. Good company, but they do control the thyroid market and have medical professionals convinced of Synthroid’s ability to stymie any problem. From first-hand experience, that’s not always the case.
CrashMichele could you please contact me and give me the name of your
efficient Dr./Endo? I am in a similar position as you and have been
suffering with incompetent Dr.s. I live in New York as well, it would mean a lot to me
You can contact me at SSammikat@aol.com, Thank you! Sam
“health care” my @ss
I’m seriously considering doing this. Michael Moore has a letter up at his website, appealing to others to Send Me Your Health Care Horror Stories. Not only have I already been through the wringer for