British Medical Website: Thyroid Patients Are "Fat, Mad, Middle Aged, Menopausal Women" and "Goiter Girls"

with regard to this article and in defense of Joanne as I am one of the ladies she mentions. The title is from a comment I made during a converstaion with her when I stated this was how we were perceived by the medical fraternity in the UK. I have been told frequently by people within the NHS that Thyroid disease and it’s patients aren’t ’sexy’ enough to be taken seriously as the title suggests which is why we have the trouble we do in being treated and is obvious from the comments made by Dan Brett and also those in another uK drs blog last month. Joanne was truly appalled at the stories we had to tell her including with being charged for something we are allowed to have by law for free

i find this utterly ridiculous…unfortunately, i’ve read on more than one occasion where brits weren’t getting or couldn’t get proper thyroid treatment. sadder still, is that there are some docs like this here in the u.s., too. ok, so maybe they didn’t say what this loon ‘dan brett’ said, but to hear that it’s all in your head, you can’t blame all your symptoms on your thyroid (when you never had any UNTIL thyroid problems started), or people thinking you’re a hypochondriac you are left feeling like no one gives a d*mn about you. i sure hope that dan is NOT a doctor…it’s too scary to think about.

The Dan Brett chucklehead is almost certainly a young doctor with that attitude and spelling.
Doctors aren’t taught about thyroid disease in the UK, they are told a little bit of T4 will fix it and if the woman is still moaning give her some antidepressants. The BTA and it’s offshoot the BTF, referenced by the chucklehead, also promote this view. The sheer lack of logic of a so called scientific profession in believing that a complex number of different hormones produced by a natural thyroid can be perfectly replaced with a poor synthetic copy of only one of them is sadly the sort of medicine you get these days in the UK.

But then they are only interested in money. I often wonder if the whole thing isn’t encouraged by the drug companies deliberately so as to sell more anti depressants, Statins and anti-obesity drugs which make them a lot more money than hormone replacement medication.

In America, where they are starting to look at payments to senior doctors by drug companies, they are finding Endochrinologists high up the list of the big bungs.
Colour me surprised.

It seems that Dan has his own blog on OnMedica:

http://www.onmedica.com/BlogView.aspx?blogid=a9b19411-c226-42aa-bec3-6304dfa3616c

Here’s his bio:

Dan Brett
Dan Brett is a GP partner in Bristol. He qualified from St Mary’s Hospital in 1992. He has an interest in sports medicine and is currently the team doctor for the Bristol rugby club. He is also the practice based commissioning lead for his practice.

In response to the description of Dan Brett: “He has an interest in sports medicine and is currently the team doctor for the Bristol rugby club. He is also the practice based commissioning lead for his practice.”
Ah yes, a Manly Man. It’s amazing what untreated testosterone poisoning does to one’s cognition.

It’s time these idiot doctors in the UK realize they don’t know what they’re doing treating thyroid disease. Not all thyroid patients have goiters — and even with severe hypothyroidism (which causes appetite loss, for their info) not all patients become obese. Have any of these idiot doctors read studies on the “variation of bioactivity of TSH” — not everyone’s TSH is equally effective in stimulating the thyroid gland. Also, have they figured out yet that the human thyroid does not produce 100% T4? It produces T4, T3 and RT3, and all three hormones are necessary for the body’s regulation of thyroid hormone. Do these idiots understand “tissue responsiveness” as related to thyroid hormone? Not all patients have equal tissue responsiveness (thyroid hormone working effectively on the tissue and cellular level) although their blood levels may be closer to normal. These doctors are just showing their ignorance and stupidity.

I am an UNdiagnosed Hypothyroid sufferer (UK). In Feb ‘06 I started gaining weight (having always been a very slim UK size 10; at the same time I started Water Aerobics, for one hr a week, every week. One year later I had not only NOT lost weight but I had also GAINED an extra 7 pounds (but no extra muscle tone to account for it)!!!! April ‘07 I had a TSH test done (I did ask my GP to do the ALL the relevant “thyroid” blood tests – but he just refused, insisting that the “pathology lab” will only do so IF my TSH is out of range!!! – I have since found out that this is a blatant lie, and if he was that concerned about my health, he could’ve INSISTED to the “path lab” that they run the extra tests regardless of my TSH result!!!!!!!! – As it is I consider myself lucky that he agreed to do the TSH test at all: most GP’s here would’ve poo-poo’d the idea that my weight-gain was/is caused by HypoT!) About one week later, I get the result back: 2.58!!!! BUT b/c this is well under the 5.5 my hospital’s lab used at the time, my GP just patronised to me to go away, exercise more and eat less!!!!! What really annoys and frustrates me, is that not only did the NHS NOT take on board the AACE’s recommendation that the TSH range should be reduced to 3.0 (and anything above 2.50 should be monitored!!) but also earlier this year the NHS (on the advice of the BTA!!) put UP the THS level to 10.0!!!!!!!!!! Go figure – when the rest of the world are putting their TSH range down – the NHS puts theirs up!!! I am of the firm belief that they have done this purely and simply to save themselves money (here in the UK, once you have a diagnosis of HypoT, you get ALL your meds for free – not just your Thyroxine!!!!) – What the NHS seem to have overlooked is the very dangerous and life-threatening conditions a person can develop IF their HypoT is left UNdiagnosed for too long!!!

Fortunately for me, about Jan ‘08, I 1st came across Thyromine on the ‘net; I have been taking it for the last two months, and it does seem to be making some difference, my weight gain has stabilized (and provided I also include a 15 min walk per day, every day – I’m actually losing weight too!!) I’d always had greasy hair & skin (until HypoT reared its ugly head, & then they both started to dry out like you wouldn’t believe!) and I never thought I’d ever say this – but I’m really pleased to say that my greasiness is returning! I feel less fatigued, I have less muscle & joint aches, even my “Dry Eye Syndrome” has cleared up!!!! Oh, and a real plus point, as an ex-nail-biter – my nails are now stronger than ever (& given that I stopped biting my nails ten years ago, I firmly believe it must be the Thyromine)!! About the only down side, is b/c I am still officially UNdiagnosed, (and not on Thyroxine/any other “offical” meds), I have to take two Thyromine tablets per day, rather than the one a day that the manufacturer recommends! Which of course works out as more expense than the price they quote; but once my husband & I have emigrated to Australia, (hopefully) I’ll get a correct HypoT diagnosis, and FINALLY get the proper treatment from a more knowledgeable GP!!!!! (Australia’s upper TSH limit varies from 3.0 to 5.5, so it’s just a case of finding a GP who uses the most up-to-date ref range!!)
Oh, and before all you Americans yell at me “change your GP” it’s just not that simple here in the UK!! You HAVE to be REGISTERED with a LOCAL GP here in the UK, and I DID TRY to change to my husbands GP when we 1st met; but his GP would not take me on for fear of being seen as “poaching” me from my surgery!!!! In fact, when we moved just five miles up the road, we had moved out of his GP’s “area”, but my GP still kept me registered at his surgery – so ironically my husband had to register with my GP – NOT what we wanted at all!!!! This is one reason why we cannot wait to emigrate to Oz – their Medicare/GP system is much more akin to the USA’s than the UK’s – they pay a small Medicare levy as part of their tax on their wages, but they also have Private Medical Insurance as a top-up – to us it seems like a very good compromise between completely Private Medical Healthcare/Insurance (USA system) and completely free-to-all NHS (UK system)…..

I’m in the US and finding a good doctor isn’t necessaily easy here either. I’ve heard the old “just find another doctor” too and it’s not that simple. A lot depends on the insurance you have and where you live. I’ve been through five doctors since my thyroid was removed four years ago and not a one of them will listen to me when I say that I just don’t feel normal. I was not hypothyroid before my surgery and I do know the difference between normal and not. None will prescribe anything but standard meds, although on Unithroid I have less problems than I had with Synthroid. It’s very frustrating – I just want my life back!

Hey all you sufferers of not only hypothyroidism but also of psychological abuse by doctors (usually male), never give up on finding the right doctor. I have suffered from hypothyroidism for ten years and still frequently must adjust my dose. My wonderful doctor patiently calls for labwork, sometimes six times a year, as we work together to find the optimum dose for me at a given time. My previous endocrinologist told me outright that he would not recheck my throid just because “I had symptoms of hypothyroidism.” He also bluntly told me that My weight gain was “my problem” probably because of secretive eating. This kind of doctor can traumitize you unmercifully. I also suffer from m.e. and the horrors I went through getting a diagnosis for that and finding empathetic doctors parallels my search for an understanding thyroid doctor. I can not imagine a male patient going through what many of us have as females.

normal tsh range of 10.0?! are they freaking out of their minds? you’re not even allowed to travel on planes w that level. hell, you’re probably almost comatose. all my docs kept saying in normal range, but fortunately i had one doc who upped my meds. i feel my best when i’m at a 1.0-1.2. a normal person’s tsh is 1.3.

and louise…i’ve had some of the same things happen to me. i still haven’t found a doc who is really working with me 100%, but i’ve been lucky to be able to get cytomel which has helped me tremendously. but, i still feel a bit tired even in normal range. i want to try armour, but knowing kaiser, that probably won’t happen.

GMC Website: Good Medical Practice (2006. The duties of a doctor registered with the General Medical Council. Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must: Treat patients as individuals and respect their dignity. Treat patients politely and considerately. Never abuse your patients’ trust in you or the public’s trust in the profession. You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.

I have referred Dr Bretts comments and the ensuing responses to the General Medical Council for their consideration. The comments he makes are disgusting, even more so because he is a doctor.
Sheila Turner. Thyroid Patient Advocate http://www.tpa-uk.org.uk

OMG so now we know what a lot of the docs really think of us, no wonder I have gone through half my life with low self esteem, I have been getting spoken to by people like this.
I am glad he has been reported, a precendent needs to be set, we deserve respect and treatment for our ’simple’ disease which has so many co morbid conditions that the doctors don’t take into account its scary. I hope he enjoys his next game because he is ‘one of the lads’ and certainly doesn’t sound as though he respects women at all. Goitre Girls indeed, what a name from a Deplorable Doc. His patients should be spared his attitude and he should take up another profession where his stupidity would be appreciated.

It seems that the simpleton Brett could do with some ’simple monitoring’ from the GMC.

How are patients in the Bristol area with PCOS, thyroid dysfunction, adrenal tumours etc. supposed to feel about consulting with a GP who makes light of ‘girls’ and ‘wimmin’ with goiters and hirsutism while writing under his professional title?

Bristol PCT apparently has a gender equality policy
– shame they are not doing anything to put their policy into action.
http://www.bristolpct.nhs.uk/theTrust/Equality/Gender/publications/default.asp

Thanks Mary for highlighting the plight of thyroid patients in the UK. We appreciate your work.

How strange. I was diagnosed when I was 19. I was 5′7 and 130 pounds. The reason I knew something was wrong was because I went from 120 to 130 without any explanation (and I was losing hair, tired, etc). Textbook symptoms. I was no madder than a normal 19 year old not fat, middle aged, or menopausal.

I was particularly interested in this issue as a) I have an undiagnosed condition which has all the hallmarks of, I have only just read, Hashimoto’s Encephalopathy type I (thus I’m researching thyroid) and b) I live in the area covered by Bristol Primary Care Trust – the PCT is responsible for health care and, most importantly, funding GPs, there is a PCT in every area.

To write everything I have learnt in the last 4 years of struggle with my condition would need a book. But someone needs to blow the lid off the sheer incompetence, callousness, discrimination, cover-ups and lies perpetrated and/or engendered by this PCT and, I suspect most others.

I have been directly verbally abused by one or two GPs, ignored, mind-messed (read the f word here), refused treatment and tests, ganged up against by a cadre of good old bully boy medics, actual clinically evidenced results of disease tests have been dismissed/ignored, diagnosed with all sorts of erroneous conditions, and essentially just left to my own devices.

If my own devices include seeking second opinions or seeking private opinion then PCT staff automatically see this as ‘proof’ of psychosomatic behaviour. Any complaints are seen as troublemaking, being an awkward patient. Even straightforward, intelligent, informed questions are seen as a threat that could get you bumped from a doctor’s surgery.

Essentially, there is no accountability – doctors in the UK are Gods, albeit as far as we patients are concerned of the tin variety and only in their own minds! Essentially, there is definitely a sexist bias here (unfortutunately nature endowed me with two X chromosomes).

The irony of this is that before I got ill, I was on the other side of the equation (I have lost my practice, income, employees have lost jobs etc due to rank incompetence, ignorance, sexism, negligence from the NHS) . Now I don’t tell medics that I used to be a consultant: they are far more interested in that than they are in my mysterious disease – which tells me a lot: ‘are you one of us…?’

I won’t list here the number of cases in my immediate vicinity where NHS patients of this PCT have been dealt with in such a way as to bring about death or serious disability.

But please be aware that the financially and ethically bankrupt NHS functions in practice like a monolithic Stalinesque arm of state control. No doubt there are many individuals within it who mean well, but if they don’t toe the party line then they’re soon ousted. There are just as many Dan Bretts around who do toe the line and aggressively act as prop forwards (a rugby position for US and other foreign readers) whose job it is to attack patients’ claims of illness and refuse access to their goals: timely tests and treatment.

I’ve had more reasonable GPs tell me honestly that there is no chance of getting further tests because they might show up disease that needs expensive treatment. E.g. my current GP, a young woman just begining her career, is sticking her neck out and begging Bristol PCT for funding for a treatment that our American friends take for granted on a daily basis. Her application has to go before endless Soviet-style committees staffed by bureaucrats not clinicians. This young woman will only go so far though – her career could be affected if she shouts too loud.

As I said, there’s a book in this! Several books… movies to be made, campaigns to be won. The major problem is that we all collude and persist in this fantasy that the NHS is an exemplar of social medicine, a world-leading healthcare provider. It isn’t anymore. Like the British Empire, us Brits are having a hard time realising that it’s gone and that what we are now is basically a 2nd or 3rd rate power (unless you’re one of the elites) with increasingly 3rd world public services and a rising poverty index to match. The NHS will never come good again until it is completely dismantled and its increasing culture of corruption and casual negligence throughly dissipated.

Well,I posted on this blog and asked why these doctor’s were so scathing towards Hypothyroid patients and was sent an email from a ‘Medical editor’telling me my post had been removed as it was not constructive to the discussion.Says it all really…

As someone who was hyperthyroid and now hypothyroid as a result of radio active iodine my TSH remains 2 years later below 0.01 T4 settled at around 29. Clinically these results say I am still hyperthyroid and to a GP this would instantly require a reduction of thyroxine however every time they have done this I get depressed, lethargic, gain weight despite not eating, migraine headaches and eye problems.Left at these levels I am able to function quite normally. I have two wishes therefor;

1. the medical profession would realise that everyone is different and whilst we may all have feet we do not all take a size 6 and

2. the NHS would get rid of all GP’s.Starting with Dr ( too young, too sexist and too inexperienced to make comment as broad sweeping as he did)Bretts.
I have all my life wondered what on earth they are paid for, more so now, having read the blog from Dr Bretts. Unlike Vets they are not trained in every field, so cannot be expected to know everything. Indeed one sees a GP, one gets referred to a specialist and in my practise the GP’s then disagree with what the specialist suggests. Why have them? the NHS would save a fortune without them and a practice nurse is quite capable of sending a patient to see a specialist in his/her field.
Perhaps a letter of complaint to follow mine to the Bristol PCT about this GP may help re educate Dr Bretts in the field of how not to upset a huge proportion of the population!

Thank you Mary, the BNHS blog was interesting to read. I love Geoff Nicholson’s comment of 05/28. I think if I lived over there I would go see him for treatment. I started out hyperthyroid but it took many years and doctor visits to figure that out. My OB finally found it when I was pregnant w/my first son and my heart had an “extra beat.” After my second son was born I had radioactive iodine and am now hypothyroid. My blood tests fluctuate and I feel my doctors do the best they can with the wide range they have to deal with. I guess I am very lucky to have considerate physicians. If you have thyroid disease I think you really have to do some research on your own and do the best you can. I feel that I will always be fat (I watch what I eat and exercise at least 3-5 times a week) and tired, but I pray and hope I am wrong. Godspeed to you all.

Sue Thompson- re getting rid of GPs. What you suggest is pretty much what the British government is encouraging just now! They want to turn small GP sugeries into “polyclinics” which will be open all hours for all comers like hospitals.

Personally, though, I disagree with your comments. GPs actually save the Health Service a lot of cash by dealing with non acute symptoms quickly and easily and a lot of patients (especially older ones, and patients with significant co-morbidity) appreciate the more personal and holistic approach of being seen by the same doctor for many years. Obviously GPs can’t do everything right and many cases will be routinely referred to specialists but they do help most of the people most of the time.

gfabro: “a lot of patients (especially older ones, and patients with significant co-morbidity) appreciate the more personal and holistic approach of being seen by the same doctor for many years.”

But isn’t this the kind of myth promulgated by GPs in order to keep earning shed-loads of money for a cr*p service all at the taxpayer’s expense.

While a limited number of GPs might offer a decent service, more often then not the majority are more than content to push thyroid patients out the door with a prescription for antidepressants. Treating the symptoms rather than the cause has become the modus operandi of today’s doctor. So much for the ‘personal and holistic’ approach!

Perhaps when GPs become employees of private companies, they will learn what it means to provide a high quality service. Patients will be free to shop around and the GPs who don’t adapt will lose customers.

I’m with Lisa on this one. The current GP service is 95% dire. Polyclinics may not be the answer but something has to be tried.
However one of the significant problems is the fact that GP’s are fixated on their budgets and will withhold tests and treatments to save money. Technically this is illegal but what do you do? Sue them? Anyone tried? Really, I want to know because maybe it’s the way forward for a lot of us.

Lisa and Thalia, I think you’re being a bit unfair on a lot of doctors who work extremely hard, saying that their service is “cr*p” and “95% dire”.

quickly looking at the Healthcare Commission’s website shows their last survey on patient satisfaction in primary care shows that 73% of people were completely satisfied with the service and 3% not satisfied.

http://www.healthcarecommission.org.uk/_db/_documents/04019373.pdf

Not perfect numbers but, like I said, I do think GPs help most of the people most of teh time.

Dear ‘Ann On’

Please will you contact me as a matter of urgency.

Sheila

sheilaturner@tpa-uk.org.uk

I must say that this certainly applies to South Africa. However, in my case these were not public health care but private, well paid, highly recommended and extremely expensive doctors with long waiting lists.

I am 29 years old. I was diagnosed with hashimoto’s at 27 (just married then) and because of my symptoms I have been treated like a 50+ year old woman who must just accept it. The other favourite is that it must be the depression. What this translated to is ‘We don’t know how to treat you’.

It is unforgivable and unacceptable.
They are accountable to us, their patients.

Oh Dan Dan you silly young man!

Your credibility — as a general practitioner for want of a better euphemism — just went down the pan!

Keep on generating the iniquitous comments, your thought processes are amazing, bit of Darwinism at work if I’m not mistaken! And as for the tagline of ‘needing more monkeys’ don’t you mean guinea pigs or is the practise of charging guineas for private patients in decline?

Come on now lets hear more of that hypocritical oath you took, you know it makes (little) sense!

I have found this whole exchange totally excellent. Friends and family have been unable to understand why I have had to run up large credit card bills traveling to Europe to obtain simple healthcare I already pay bucketloads of taxes to supposedly get here. Now I just point then to Dr Dan Brett and Co’s finest hour for a potted explanation.

Now they are lining up to lend me money for my medical expenses.

Go Danny Boy, GO!

As a nineteen-year-old, I was diagnosed with thyroid cancer and had a complete thyroidectomy. (I was diagnosed with Hashimoto’s at thirteen.) Not even my parathyroid glands could be saved during the op as the cancer had spread quite far. I’m an American, now living in Britain, five years later, married to a British citizen and I am appalled by NHS and its treatment of thyroid patients–which I experienced first hand.

In January, I went to the GP and complained of extreme fatigue. I’m a runner and I was having the most difficult time getting up the energy to even run a few miles. I was exhausted after running (which wasn’t even daily anymore) and I noticed a weight gain, as well as forgetfulness and exhaustion at work (in a library!) I wanted to sleep all the time–the signs all pointed to thyroid, given that I’d had the problems since I was a young adolescent. When I went to the GP, he told me, and I quote, “This is probably because you’re a vegetarian.” I kept my cool, but was losing it inside. I asked him if he wanted to see my food journal, which I keep daily, or if he wanted to consult my dietitian in the US who had worked with me on building a proper diet for a vegetarian without a thyroid. He stumbled slightly and sent me to a specialist at John Radcliffe in Oxford. The specialist was amazing, a Greek man (ironically not British) who has taken me very seriously ever since… so there is hope–in the specialists! Getting there will be the battle for those who never had the cancer.

Best of luck, everyone.

Wow!!! I am glad Brent is in the sports medicine business and not an endo. I wonder what the UK docs would think of me as I don’t have a goiter, I am in my twenties (not middle aged), not menopausal, mad only when you upset me, and 10 and spiraling ever upward at time of my hypothyroidism diagnosis. Stereotyping (and insensitivity) is bad, people!

Here in France it’s even worse. There is only 1 thyroid replacement drug and if it doesn’t do the job – bad luck. After 8 years of treatment I now have fibromyalgia, carpal tunnel and have gained 35 pounds and lost over 1/3 of my hair. If the figures are good then the rest is either imagination, depression or attention seeking! HELP!

Sad but true…the reason why thyroid disease doesn’t get the respect and acknowledgment that it deserves is because most of us are women. Don’t you know it’s always in our heads, especially if it’s got something to do with hormones.~Pun Intended~