The American Association of Clinical Endocrinologists (AACE), to mark Thyroid Awareness Month, has released a new issue of their online "magazine" called Power of Prevention. The magazine features information about thyroid disease, written by various physicians who belong to the group. There is some useful information in the magazine, which is available for free download as a PDF file here.Note, however, that despite the title, the magazine does not discuss prevention of thyroid disease, and focuses on presenting what is considered to be a conservative perspective on thyroid disease. The perspective is narrow, and does not acknowledge that some thyroid patients do better with T3 and natural thyroid hormone replacement drugs, versus a synthetic T4 only protocol.
In the article "Hypothyroidism in Women," author Daniel Einhorn, MD -- the president elect of AACE -- says ""Not recommended are forms of thyroid replacement that contain T3, such as desiccated thyroid (e.g. Armor [sic]) or are pure T3 (Cytomel.)"
That the AACE doesn't even know how to spell Armour thyroid, and doesn't recommend it -- or T3 drugs in general -- is no surprise. A key financial backer of the AACE is Abbott Labs, the maker of Synthroid brand levothyroxine, and Synthroid is a form of thyroid replacement that does not contain T3, and is not a natural desiccated thyroid product. AACE knows not to bite the hand that feeds it...
Dr. Einhorn would also be expected to stick to the official big pharma party line when it comes to thyroid treatment, as according to various literature he has published, he has financial relationships (i.e., received consultant honoraria, research grant support, and/or is a stockholder) with a number of big drug companies, including Amylin Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Novo Nordisk Inc., Takeda Pharmaceuticals, Halozyme Therapeutics, Allergan, Inc., Medtronic, Inc., Pfizer Inc., Sanofi-Aventis, and Merck & Co., Inc.
The magazine's fact sheet on "Radioiodine Therapy" also talks about how how this treatment causes "intentional development of an underactive thyroid state (hypothyroidism), which is easily, predictably and inexpensively corrected by lifelong daily use of oral thyroid hormone replacement therapy."
The idea that hypothyroidism is easy to treat is a classic misconception that endocrinologists frequently repeat, despite clear evidence that hypothyroidism is a complex, multi-faceted condition that requires a variety of approaches to properly diagnose and sufficiently resolve in many patients. Unfortunately, promotional information like this continues to downplay the difficulties many patients face in getting symptoms taken seriously and properly diagnosed.
Still, it's a free download, and might have some information that could be helpful, so you may want to take a look at the AACE press release and PDF magazine download.
Image: AACE
Thanks, AACE: Same stuff, different day …
Sure wish I was smart and had tons of $$$…because I would start my OWN phamaceutical company that would make good drugs that truly help people for a reasonable profit…rather than cheep sythetic inefective crap that I can sell for way more than it’s worth.
Thank you for the link to this magazine. I saw some forward strides in Dr. Einhorn’s article on hypothyroidism that thrilled me.
First, consider that I was diagnosed 11 years ago and had to insist on getting treated with a TSH of 5. I switched doctors to get treatment that would take my TSH below 2.
1.. Did you see — on the topic of hypothyroidism, the doc talked about treating the TSH down to the 1-2 range (pg 6 bottom of page). Hurrah! That reflects a tremendous advancement over docs that thought TSH of 5 was the proper treatment point. ( Yes, I do know that a few people actually are happy there; but, most are like me — and they are symptomatic at that TSH number.)
2. On the topic of T-3, on page 7, the doc did say “As with most everything
in medicine, there are exceptions, and some
women have unequivocal benefit from T3.”
3. The doc talked about measuring antibodies as well as the actual thyroid hormone levels.
Let’s acknowledge some of the other good in the magazine:
A. The majority of hypothyroidism cases can be diagnosed from the TSH number which usually shows abnormalities before the thyroid hormones do.
B. Many women do not think to request a thyroid test of any kind — many who are suffering would be diagnosed if they just knew to ask for the test. I celebrate anything that helps a woman request the test and ask questions. A woman would know to request the antibody test if she, or someone else read this article carefully enough.
C. We probably should also realize that there are some reasons for the stances these doctors take.
The human thyroid gland only produces somewhere around 5% T-3, and the porcine thyroid hormone replacement (Armour, Naturethroid, etc.) has 20%. There are risks — heart and bone being two of them. Now, I do take natural dessicated thyroid replacment (forced to compounded at the moment) — so I agree there is something in it that is better for many. I know that everyone will be reacting to my statements. So be it. I’ve simply been able to forgive the first doctor who found and treated my thyroid problem, and consequently a few others.
I’m glad for the forward movement. AACE has long deserved credit for attempting to lower the TSH diagnostic and treatment standard — and they have done it with some very real opposition if you’ve read the medical journals a few years back.
Let us recognize our friends. Sure, it is not a great thing if docs are too well connected with a drug company — However, in this one area — prompting earlier diagnosis of thyroid disease: We and the drug companies have a common interest. Our argument is in the treatment arena.
I just hope that this progress continues, and that some of the testing that should be done will be done.
The writers and staff of this magazine are either bought and paid for by the drug companies that make $ynthoid and its ilk, or have been snookered by them.
As for the BS about no direct T3, they are totally wrong.
Having been there, when changed to Armour, the results were immediate and dramatic. Desiccated thyroid is far superior to the synthetic garbage. I was still very symptomatic, but the TSH was supressed (THYCA), so the dock said there was nothing he could do, so I changed doctors. Once on Armour, in abour 6 weeks, I was almost back to normal.
Two years later, my bone density test came back excelent, and my cholosterol was down 30 points, to 170.
I had a TSH of 1.8 for years in spite of my FT4 being at the bottom of normal range and my FT3 being over a point subnormal. To shut me up about my “imagined” hypo symptoms one doc finally put me on a test dose of Synthroid, 25mcg. When my TSH remained 1.8 and my FT4 did not go up he gradually raised the dose to 100mcg. On 100mcg Synthroid my TSH remained 1.8 and my FT4 went from .8 to 1.1. My FT3 or antibodies were NEVER tested. We’re talking about regular docs and endo’s. As my goiter grew, first to golf ball size, and in the end it looked like a half a tennis ball on my neck I went to an endo decided to stop watching and sent me for a US of my neck and biopsies. It came back positive for hurthle cells and thyroiditis. This endo said I needed half my thyroid removed. So I went for a 2nd opinion. The 2nd endo also said only remove half and with a half a thyroid I probably would not need thyroid medication post surgery. He did not test TPOab or FT3 either. Both endo’s were also told I had hemorrhaged twice during childbirth and could possibly have pituitary damage that
affected my TSH output.
It was the surgeon who tested my FT3 and switched me to Armour. My FT3 was over a point subnormal. He said no one should undergo surgery when they are so hypothyroid. He also tested my pituitary and found that I had mild pit damage called Sheehan’s Syndrome. He also tested my TPO antibodies, they were 6500. With hurthle cells present, goiter and the high TPOab he said I had hashimoto’s for at least 20 years and removal of the entire thyroid was urgent. After surgery he said my thyroid was “mush” due to advanced hashimoto’s. His words, not mine.
Anyway, prior to surgery he started me on 60mcg Armour and cut the Synthroid to 50mcg. For over ten years I had been staying under 1000 calories a day trying to maintain my weight. But every “cheat” when on vacation etc. meant I gained 5 pounds that would not come off. I was up to 180 lbs, my chloresterol was 278, BP always under 100, heart rate 50-55, body temp up to 97 on a “good” day, my reading comprehension was gone, I couldn’t follow a conversation or a movie/TV show, I had
surgery for carpal on the right wrist and my left was getting worse, I had no reflexes. Yet I was constantly told “it’s NOT your thyroid” and accused of being lazy, eating too much, put on three different antidepressants (which made me worse) was being pressured to start statins for chloresterol and fosamax for bone loss. I was also sent to a psychologist about being a hypochrondriac. When the report came back that I was hypothyroid, not a hypochrondriac, I was told to find another doctor to treat my imagined symptoms.
The day after surgery the surgeon told me to stop the Synthroid and increased the Armour to 120mcg daily.
He told me not to go back to the endo as he was anti-
Armour and anti Cytomel and referred me to a DO who
does prescribe Armour. Unfortunately two weeks later my biopsy came back with hurthle cell carcinoma and I needed radio iodine ablation to destroy any remaining thyroid cells. Again, the surgeon told me not to tell the endo I was on Armour. That he would never know because all he would test is my TSH, FT4, TG and TGab.
Needless to say on the 60mcg Armour prior to surgery I felt great. On the 120mcg, with no thyroid, ALL of my
hypo symptoms were gone in a few weeks and I started to loose weight. My TSH went down to 1.3.
Well, back to the endo, who knew my surgeon prescribes Armour and told me if I did not switch back to Synthroid he would not treat me. So I went to UCSD, who also gave me an argument about the Armour but quickly backed down when I showed them pages of blood tests
that showed I was not converting T4 into FT3. And print outs that their argument that Armour had consistency and potency problems was an outright lie.
But they told me I had to stop Armour to prepare for radio iodine ablation. When I argued that I had pituitary damage and my TSH would not go up even without medication they claimed my pituitary damage was not that severe and my TSH may take longer to go up but would eventually. Within two weeks I was in the ER from constant passing out and extreme hypo symptoms…. my TSH was STILL 1.8.
I was the first patient at UCSD, Moore’s Cancer Center to have Thyrogen shots for radio iodine ablation.
Presently I am on 120mcg Armour 7Xweek and 30mcg
Armour 4Xweek. For the first time in over 20 years I feel great, have energy, and now must eat at least 1600 calories a day to keep from loosing weight. I am 71 years old and back to my weight when I graduated HS.
All those years of hypo hades, it started when I was 34 years old, and as the hashimoto’s advanced kept getting worse. And why? Because the TSH test is supposed to be the tell all? Or because the misguided claim that EVERYONE converts T4 into FT3 so they don’t bother to test FT3? Or is it because doctors are quick to blame all women’s complaints on being over emotional, lazy, depressed, it’s your age, it’s all in your head, you just don’t know how much you are eating, and in spite of very obvious hypo symptoms we get brushed aside.
For me Armour is certainly NOT a placebo. I would probably do ok on Synthroid and Cytomel but I don’t plan to find out. I go to my family doc Monday and he is writing me a script for Erfa Thyroid from Canada. Even
my endo here at home and my endo’s at MD Anderson
in Houston say my TSH of .02 with mid range FT3 and slightly under midrange FT4 is absolutely amazing. That so many on TSH suppression therapy have to be kept mildly hyper on the T4 only drugs then end up using sleeping pills, beta blockers to protect their heart, continue to have high chloresterol, and have increased bone loss, and continue to have weight loss problems.
Yet they continue to push synthetic T4 only drugs. Why?
My LDL chloresterol went down about 78 points and my once high HDL went down some but not enough to upset my chloresterol balance. I had a bone density test last June, my bone loss has actually reversed and went from osteoporosis to osteopina in my hips and it is expected that the next bone density test will show more improvement…. WITHOUT Fosamax!
So all the endo’s under the influence of Abbott Labs and other big pharma can “kiss my grits”.
Physicians take the Hippocratic Oath…..surely they know that they are to be aware of new discoveries and treatment theorems that are surely to come along…I just don’t understand. Can it really be that hard to change one’s business model?