Why are the United Kingdom's Doctors Determined to Make Things Worse for Thyroid Patients and People with Hypothyroidism?
I have to admit that it's totally perplexing. On the one hand, in the United States, we sometimes look to the United Kingdom, and it's National Health Service (NHS), as a possible model for universal health coverage in the U.S. After all, no one covered by the NHS is turned away at hospitals and doctor's offices, patients receive medications at low cost, and everyone has access to health care, and needed surgeries, even if not as fast as they'd like. There are definitely times when I've wished I had access to something like the NHS. But when it comes to having a thyroid condition, I am thankful that I am NOT subject to the NHS, and its partners in crime, the Royal College of Physicians (RCP), British Thyroid Association (BTA), and the NHS mouthpiece known as the "Onmedica" blog. These organizations seem hell-bent on moving the UK's thyroid patients back into the dark ages when it comes to thyroid diagnosis and treatment. They've been on what appears to be a concerted campaign to roll back any improvements in thyroid care for patients -- and seem to delight in kicking patients while they're down, on top of it all!
So, what's up? Here's the story... Last year, we had some so-called practitioners of the "healing profession" at the NHS's Onmedica blog, deriding thyroid patients openly. For example, Dan Brett, a GP in Bristol, and blogger for Onmedica, said to "tell the goitre girls to find a new hobby" because, according to Brett, managing thyroid disease is a breeze. "It's very simple - keep taking the tablets - if you do, you will have a normal blood test once a year - no GP consulatation [sic] required - end of story!" Brett, sadly, is a telling example of the backward, misogynistic and uninformed attitude of many of the doctors employed by the NHS.
Then, back in February of this year, we had the Royal College of Physicians (RCP), stating that "thyroxine is the only treatment that should be given" for hypothyroidism, as part of their official "guidelines" for hypothyroidism diagnosis and treatment. They want to limit hypothyroid patients to synthetic T4 (levothyroxine) only as a treatment, and eliminate natural thyroid drugs and T3 drugs entirely. And, they want diagnosis of hypothyroidism to be based only on TSH and free thyroxine (Free T4) measurement. No Free T3, no thyroid antibodies, no symptoms -- nothing else. And, get this -- on the UK, only levels above a 10.0 are considered overt hypothyroidism.
In March of 2009, the British Medical Journal published an editorial from Dr Amit Allahabadia, the secretary of the British Thyroid Association, called "Diagnosis and treatment of primary hypothyroidism." Dr. Allahabadia claims that patients are getting information from places other than NHS doctors, and that what they are learning from other doctors and web sites is causing them to be wrongly diagnosed as hypothyroid. The editorial was apparently written to support the RCP "guidelines."
Then, in late March, Onmedica "staff" (needless to say, it's likely that none of the doctors dared put their names on this -- paging Dan Brett, Oh Dan...did you work on this perchance?) issued an article (basically a rewrite of the press releases, titled Internet thyroid claims are 'misleading' .
One has to wonder...what exactly is it that Britain's doctors are so afraid of? Why are they so determined to cling to the past? Why do organizations like the British Thyroid Association pretend as if the revolution in thyroid knowledge and treatment that has occurred over the past 15 years hasn't actually taken place? Why would the NHS, the RCP, the BTA, Onmedica and their ilk want to condemn the UK's thyroid patients to sub-standard diagnosis and treatment? What's in it for them to have a generation of underdiagnosed, undertreated people suffering from hypothyroidism?
Do they have some sort of vested interest in ensuring higher rates of infertility, recurrent miscarriage, developmental problems in children, obesity, high cholesterol and heart disease by denying UK thyroid patients proper thyroid diagnosis and treatment?
I am mystified. And I'm not alone. So, I'm calling on all UK thyroid patients -- and those doctors out there willing to speak out -- to help us all understand. What is the motivation of the doctors who apparently don't want you to get properly diagnosed or live and feel well? Why are things moving backward, instead of forward? Why are these various conservative medical groups closing ranks, to not only prevent advancements in thyroid diagnosis and treatment, but to actually restrict advancement, and make things worse for thyroid patients. Do you have any theories?
Feel free to share them on our Thyroid Disease / United Kingdom Support Forum.
Photo: clipart.com
Comments
Mary, it is perplexing! My only thought is ‘follow the money’. I know it sounds cynical, but my homeopath explained to me the reluctance of many American doctors to use natural hormones instead of synthetic drugs. He felt is was because the doctors got kickbacks, perks and rewards from the makers of the synthetics. I don’t know if this is what’s going on in the UK, but it sounds very familiar.
Who knows Mary but it’s a sad state of affairs. The only thing we can think of is that thyroid folks get free prescriptions.
Prof weetman at Dr Skinners final hearing said that they wouldn’t lower the ref range cos it would cost too much money, but what false economy is that. Thankfully we have the transcripts of him saying that as proof if needed.
However as the NHS free prescriptions list is opening up to include more LTC’s will they have the same problems. Some of our members in scotland and wales have found that as soon as the scripts became free in those countries they were suddenly diagnosed ! coincidence, who knows
We along with other thyroid patient groups and advocates in the UK have written to the RCP sending in research showing how wrong they are, with the result that they are now reviewing it so everything crossed.
If they don’t change it my organisation has put procedures in place that will make it easier for our members to persue a medical negligence claim if they need to, as the only other way to change NHS guidelines is by going to court, which will of course be very expensive and lengthy so hopefully it won’t come to that
I’ll keep you posted.
Dawn
By the way does anyone know the possible implications (Thyroid-wise) for Obama electing Kathleen Sebelius as secretary of Health and Human Services?
Good or bad?
Dont get too comfortable, the Amercian Assoc of Clinical Endocronologists (AACE) will no doubt follow the British model if US thyroid patients dont jump on this dreadful Guideleine.
To insist on a TSH of 10 before any treatment and any symptoms ignored.
Also note that Forest Labs are releasing a new drug specially for Fibro - perhaps thats why they dont promote armour - when sufficient thryoid replacement fixes fibro pain.
Hi Mary
Thankyou for letting the world know about this, you have a large readership and thyroid patients the everywhere need to see what is going in in the UK hopefully to avoid the problem elsewhere. Our advocates are fighting hard for us bless them.
The OnMedica thread by Dan Brett and his cronies is absolutely ridiculous, supposedly professional people acting like school children.
I have no idea why they are treating us this way but I am sure it will come out someday and the smell will be vile, and awefully expensive for the RCP, BTA and NHS.
lotsa luv
Dawnx
The answer is very easy, we have allowed the national health service to be run by the very people who have everything to gain by us getting sick.
Read these books,
Corporate Crime in the Pharmaceutical industry by John Braithwaite
I quote
‘international bribery and corruption, fraud in the testing of drugs, criminal negligence in the unsafe manufacture of drugs - the pharmaceutical industry has a worst record of law breaking than any other industry. — based on interviews with senior executives of pharmaceutical companies in the US the UK, Austrailia, Mexico and Guatemala, his analysis shows how pharmaceutical transnational corporations defy the intent of of laws — etc ‘
also -
Trust Us We’re Experts by Sheldon Rampton and John Stauber
I quote
‘ The book that unmasks the sneaky and widespread methods industry uses to influence opinion through bogus experts, doctored data , and manufactured facts.’
Also check out Dr Mercola’s webpage for his opinion on The Swine Flu Pandemic.
We are a small part of the whole picture, we are but pawns in somebody else’s gameplan.
Dear Mary Shoman,
You asked us why UK doctors are deliberately making it worse for thyroid patients.
Well, I’ve been giving the matter an awful lot of thought over the past year or so and I think the answer is obvious. Because they are being paid to.
Lets walk through it logically. Who gains? That is the first step.
A thyroid patient successfully treated with Armour and T4 can get on with her life, remain productive, healthy and work and pay taxes. Her medication costs what? £3 -4 UK pounds a month with Armour?
An untreated thyroid patient becomes chronically ill. She gets heart disease, high cholesterol, depression, obese, infertile, loses her hair, etc. She becomes economically inactive and a burden on the state and her family.
Her medication costs how much? Statins, anti-obesity drugs, heart drugs, anti-depressants, Regain, infertility treatment. How much does all that cost?
So the key difference here is in the amount of money spent on drugs. A huge difference in fact. So who gains? Well obviously the people selling the drugs.
Am I saying the whole thing is a big Pharma conspiracy to make more money?
Yes.
Would the drug companies deliberately withhold cheap effective medication to sell more expensive ineffective ones? You bet. Like a shot. They have form.
How are they doing it?
They control the senior professors and consultants who dictate the rules. In the UK this doesn’t have much to do with the NHS. This is a very long established old boys club. The GMC, the Royal College of Physicians, The BTA, none of these are anything to do with the NHS. They are made up of senior consultants and thrusting ambitious younger ones who also work within the NHS, because any UK doctor has to, but these guys play the game with all these self appointed organisations to get influential and lucrative teaching posts, professorships, medical journal editorships and various professional enhancements.
You cannot even get information out of the Royal College of Physicians about who the people are who issued this recent dictat about thyroid treatment because the RCP aren’t a public body so they do not have to comply with the Freedom of Information Act. They are self appointed and unregulated.
The more influential the doctors the drug companies control become, the more influence the drug companies have.
There is also money. Large payments from drug companies to senior consultants have been standard practice here for years. As they are in the States.
There was a very interesting article in the New Scientist a few months ago. “Exposing the links between doctors and Big Pharma” 25 February 2009 by Jim Giles.
“Republican senator Chuck Grassley has made it his mission to shake up the cosy relationship between doctors, researchers and the pharmaceutical industry. Now he is introducing legislation to force drugs companies to disclose the payments they make to doctors.” Etc.
In some parts of the States legislation has existed for years that says doctors and drug companies must both declare payments. It’s rarely been enforced. In those places where it has you often find that those consultants paid most, by specialty, are Psychiatrists and Endocrinologists.
Psychiatrists because there isn’t much to choose between anti depressants. It’s a very subjective thing and so the biggest seller is probably going to be the one with the most effective sales force. But why Endocrinologists? For pushing a different brand of T4? Hardly. For suppressing cheap effective treatments to deliberately create a market.
Am I saying all doctors are in on it? No. Most are doing what they are told by the senior consultants. The professors and Royal College of Physician types who issue orders. When the penalty for questioning means you end up like Doctor Skinner et al, who is going to argue? Dr Skinner could only do so because he is at the end of his career. A young doctor with everything in front of him or her cannot afford principles that will destroy everything they’ve ever worked for and take away their livelihood.
Now lets look at the guilty parties. Lets look at Weetman for example. In 1997 he wrote a very sensible article in the BMJ called “Hypothyroidism: screening and sub clinical disease”. BMJ 1997;314:1175 (19th April).
In it he queries the TSH reference range then as possibly being set too high because of undiagnosed hypothyroid subjects being included in the laboratories reference population and says this raises the question as to whether thyroxine replacement is adequate in patients with TSH of above 2mU/I. No really, he does. Look it up. At this time he was a professor of medicine at Sheffield.
Within a few years he’s Dean of Sheffield University, a member of the GMC, has a finger in so many pies it’s a wonder he has enough fingers, is on every editorial board on every Endocrinology journal and a few others, and has done a total 180% turn in his clinical reviews to the extent that he publishes the famous “Whose thyroid is it anyway?” article.
You do the maths.
Doctors with opposing views to Weetman could never get anything published because Weetman blocked it. Peer reviewed journals are how medical research is disseminated. If you can’t publish, your research doesn’t exist. Conversely, control the journals you can publish what you want and that then becomes the current practice.
As you know, Weetman was also involved in the Rent a researcher Actinel scandal. Did it affect his career? No. If anything he just got more powerful.
The underhand tactics perpetrated by Weetman at the GMC at Dr Skinner’s Hearing were totally unbelievable. Can anything be done about it? Apparently not.
Associated anecdotes:
1. A man I knew in the ‘80’s told me once that in the 1970’s he’d worked on a Corporate Video for Glaxo. It was to promote a new drug. This was a cure for stomach ulcers they were very proud of. Yes, there was a cure for stomach ulcers in the 1970’s. Why did it never see the light of day? Because some bright spark from marketing pointed out that if they sold this one off cure it would cost them billions because it would make redundant their existing product which did not cure but merely reduced the symptoms and which sufferers would need for the rest of their lives. The cure was pulled instantly.
2. A person I met a couple of years ago used to work in the staff bank of a major London teaching hospital about ten years ago. All the senior consultants would put in their cheques from the drug companies there. They were collecting up to 10K UK pounds a month. Each. £120,000 a year. That was ten years ago. I expect it’s more now.
It stands to reason that the most effective hormone treatment would be that closest to nature. And those of us who have had the misfortune to experience hypothyroidism find that Armour is incomparably better than synthetic T3 and T4. You cannot patent a hormone. No one makes any money. So they will swear black is white and the real thing is no good. If you believe the advice of this new dictat from the RCP then logically everyone should have their thyroids removed and only take synthetic T4 to keep their TSH under 10. They are insisting on a “gold standard” that has no relation to that of the natural biochemistry of a healthy person.
Big business controls medicine. To some extent it always has. It’s worse now however than it has ever been because they are so very entrenched and organised. Until the link can be broken between medicine and money we are all going to be iller and poorer than we need to be.
It has been noted in the US that the drug companies also control what newspapers publish on these sorts of topics. So you get loads of pro Statins articles, none of which mention the side effects or lack of unbiased research, but little or nothing from anyone in an opposing camp that anyone would take seriously.
The Chinese Emperors only paid their doctors when they, the Emperors, were healthy. When they fell ill the payments to the doctors stopped until they were well again because the Emperors were of the opinion that to do it the other way round gave the doctors no incentive to cure them.
They were a lot cleverer than we are.
If you have time to wade through this report on the situation submitted to the UK Government by the Health Committee you will be able to start figuring out how it works.
http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhealth/42/4
2.pdf
I just want to thank Thalia for that brilliant post. I quit seeing a doctor who constantly had more pharma reps in the waiting room than patients.
Why? Money, control, bureaucratic power, and an inability to admit that socialized healthcare is a terrible model.
If it wasn’t for Mary Shomon’s work I would not of found my Doctor (Kenneth Blanchard) in Boston (MA) who I now visit twice a year. My weight gain has been halted and my tiredness is only apparent if I dont take the T3 supplement (which also contains trace elements of T2 and T1) each day. The only good thing about the UK is that Thyroxine comes in 25, 50, and 100mg sizes and do not contain colouring.
My original consultant in the UK told me this is the way it is! live with it!! With regards to weight gain his comment was “you did not get fat people coming from Belsen”
It is time the Patients in the UK demand that there is a better way.