NBC's "Today Show" To Discuss Thyroid Disease on Mon. April 10: Will Dr. Judith Reichman Get It Right This Time?

NBC Today show correspondent Dr. Judith Reichman doesn't have a stellar track record when it comes to discussing thyroid disease. (See Today Show Doctor's Thyroid Mixups and Mixups: Part 2.)

So, when I heard that she was going to appear this Monday April 10, 2006 on Today, in their "Today's Woman" segment, to talk about thyroid disease, I thought it would be helpful to contact the producers, and encourage them to ensure that Dr. Reichman has correct information for her segment.

if you want to write them either before, or after the segment, drop your note to: today@msnbc.com. And in the meantime, you can read my letter recapping some of the my thoughts regarding key issues for the thyroid patient community, and thought I'd share an excerpt from that letter here...

I did want to just mention a few key issues for Dr. Reichman, however. In past appearances, she's made some errors in discussing thyroid disease, including a series of misstatements presented on an NBC Weekend Today show that were discussed with the show's producer at the time, Susan Dutcher, and resulted in an on-air correction.

I would urge you to review ahead of time with Dr. Reichman some of the key facts, so that she is able to make this discussion as valuable as it can be.

The TSH Test is Not the Only Valuable Test

Reichman regularly reports that only a TSH test is needed to diagnose thyroid disease. However, additional tests such as T3, T4, Free T3, Free T4, and thyroid antibodies tests may be needed to confirm Hashimoto's and Graves' disease, the autoimmune conditions that are the two most common causes of all thyroid conditions. Additional tests are also critical for women who are pregnant and on estrogen replacement therapies.

TSH Normal Levels Aren't Even Agreed Upon

It is critical that if Dr. Reichman mentions the TSH tests, or "testing normal on the thyroid test," that she also mention that there is a major controversial debate among endocrinologists who do not agree as to what the "normal range" is for the TSH test. One one camp are the endocrinologists and practitioners who use the old "normal" range of .5 to 5.0. Under .5 is hyperthyroid, over 5.0 is hypothyroid.

On the other side are the endocrinologists and doctors who follow the recommendations of the American Association of Clinical Endocrinologists (AACE), which states that the new normal range to use for diagnosis and patient management is .3 to 3.0.

This means that a patient who has a TSH result of 4.0 could be told by one doctor that they are "normal" and another doctor that they are hypothyroid, and receive treatment.

Millions More Are Hypothyroid Than Previously Thought

The fact that the endocrinologist authorities now believe that the normal TSH range is from .3 to 3.0 means that millions. Currently, various groups claim estimates of thyroid disease as low as 8 million Americans, to 13 million Americans, to as high as 27 million Americans. BUT...a 2005 study found that lowering the normal range consistently from 5.0 to 3.0, approximately 20% of the population are hypothyroid. That means 59 million people in the U.S. have a thyroid problem (most hypothyroid) and the vast majority of them undiagnosed. I hope that Dr. Reichman will use these more accurate numbers, rather than the outdated and disproven 8 or 13 million figures that the media often uses.

The Right Thyroid Dose Can Change Over Time

Dr. Reichman has in the past reported that "once you settle on the right dose, it generally doesn't change." In fact, this is not true, and many factors can cause a dosage change. According to the medical literature, dosage requirements can change from winter to summer, throughout and after pregnancy, with weight gain or weight loss, when starting or stopping a high-fiber diet, when starting or stopping estrogen medications, when starting or stopping anti-depressant medications, when starting or stopping a high-isoflavone/soy diet, or when in perimenopause or menopause. It can also change in response to use of supplements containing calcium or iron, among other interactions.

Natural Thyroid is Not Made from Cows

In the past, Dr. Reichman has reported that natural thyroid is made from cows. This is incorrect. The key brands of natural thyroid, which include the popular drug Armour Thyroid, are all derived from porcine (pig) thyroid.

Natural Thyroid's Purity and Activity Doesn't Vary

Dr. Reichman has in the past recommended against use of natural thyroid because, she has said, "some clinicians are concerned that the purity and activity can vary." This may be a concern, but it is medically unfounded, with no research to back it up.

Dr. Reichman may be unaware that to ensure that these products are consistently potent from tablet to tablet and lot to lot, analytical tests are performed on the thyroid powder raw material and on the actual tablets to measure actual thyroid hormone levels. Various lots of thyroid powder are then mixed together and analyzed to achieve the desired ratio of T4 to T3 in each lot of tablets. This method ensures consistency according to the United States Pharmacopoeia (USP) official standards and specifications for desiccated thyroid consistency.

Dr. Reichman may also not be aware of the purity and consistency problems that besieged the levothyroxine products for decades until the recent drug approval process mandated by the FDA.

I am grateful for the coverage of thyroid disease, as it’s much needed, so thank you. And I appreciate in advance any consideration you can give to getting this information to Dr. Reichman ahead of her segment, so that the community of millions of thyroid patients receive the type of information that will truly help us to live well...