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Mary Shomon

Good Housekeeping Thyroid Article Causes Controversy Among Patients and Practitioners: Nation's Top Integrative Physicians and Experts Respond

By July 23, 2011

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Good Housekeeping magazine has caused a controversy among the community of thyroid patients and practitioners working with women's hormonal health, with their August 2011 publication of the article titled "Understanding Thyroid Problems." The piece, written by Susan Carlton, starts off with 40-something Carlton listing her symptoms, which include loss of energy, fuzzy thinking, and a rapid 10 pound weight gain. Her doctor, suspecting a thyroid problem, tested Carlton and found that she is borderline hypothyroid with a slightly underactive thyroid. In addition, Carlton mentions that she has a family history of Hashimoto's; Hashimoto's disease is the autoimmune condition that is the most common cause of an underactive thyroid in the U.S.

Carlton then goes on in the article to call thyroid disease the "disease du jour," and claimed that thyroid information and websites are a "virtual cottage industry." She also interviewed several traditional, conventionally-oriented endocrinologists, and presented their opinions as the official medical position on thyroid issues.

In her article, Carlton touched upon the major debate over the "normal range" for the TSH test. Up until late 2002, the standard reference range was 0.5 to 5.0. But since that time, the American Association of Clinical Endocrinologists (AACE) has recommended that the range be 0.3 to 3.0. Carlton, however, quotes Gilbert Daniels, MD, one of the directors of the Thyroid Clinic at Massachusetts General Hospital, who continues to use 5.0 as the cutoff, and says: "There's no compelling evidence that medication helps patients whose TSH is in the 5.0 to 10.0 range." (This controversy over the normal reference range for the TSH thyroid levels has been a point of disagreement among endocrinologists for almost a decade.)

Carlton then quotes Boston endocrinologist Jeffrey Garber, MD, who said that women are eager to start thyroid medication because they want to lose weight. (You can read my past interview with Dr. Garber, The TSH Normal Range: Why is There Still Controversy? for more on his ideas.)

Interestingly, Carlton features a comment from Phoenix endocrinologist Daniel Duick, MD, president of the American College of Endocrinology, who says that for hypothyroidism treatment: "The goal is to take the lowest dose possible to get the TSH in the 1 to 2 range." But Carlton does not explore how or why the treatment objective is a TSH of 1 to 2, but when TSH levels are above 5, or even under 10, they are also considered "normal" for diagnostic purposes by the other doctors she interviewed.

In the end, after talking to the doctors, getting retested, and still having borderline hypothyroid blood test results, Carlton concludes her article, saying: "Given my family history, my doctor recommends I check again next year. With all I'd learned about hypothyroidism, I had already decided that even if my levels had nudged up a bit, I would opt out of treatment. In the meantime, I'm drinking more java (for energy) and honing my crossword skills (for focus). As for the unwanted pounds, there's a spinning class on Saturday with my name on it."

Thyroid patients and the nation's top integrative practitioners and hormone specialists, none of whom were interviewed for Carlton's article, have expressed frustration at what they perceive to be Carlton's rather superficial and flippant treatment of thyroid disease, as well as some controversial or one-sided medical information presented in the Good Housekeeping article. Patients and doctors are sharing their concerns and criticisms in comments at the Good Housekeeping thyroid article, around the Internet, on Facebook's Thyroid Support page and in dozens of recent emails to me personally as well.

In light of the controversy, some of the nation's top integrative practitioners are speaking out. These doctors and thyroid experts -- who are considered to be on the cutting-edge in diagnosis and treatment of hypothyroidism and autoimmune Hashimoto's disease -- have agreed to share their concerns and cautions regarding Susan Carlton's discussion of Hashimoto's and hypothyroidism diagnosis and treatment in Good Housekeeping.

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Erika Schwartz, MD is a Manhattan-based physican with expertise in hormonal medicine, serves as Chief Medical Officer of AgeMD, the Age Management Institute, and is a Founding Director of the Bioidentical Hormone Initiative.

What a sad state of affairs for the health of America's women. Thyroid disease -- undiagnosed and mismanaged -- is rampant. It isn't the 'diagnosis du jour,' although maybe if doctors looked and listened to the patient, it would have to become so. In my practice I see hundreds of women and men with undiagnosed and mismanaged thyroid problems. I treat the patient, not the blood test. All you have to do is ask my patients how they feel and function, decades into their treatments. They don't take thyroid to lose weight. They take T3 and T4 and they don't need caffeine or crosswords to stay mentally and physically sharp. To recommend these remedies is an insult to common sense and a disservice to all of us.

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Jacob Teitelbaum, MD is an internationally-known practitioner, educator, and best-selling author of From Fatigued to Fantastic and a number of other books.

It's sad that a magazine as dedicated to its readers would run an article that is so harmful and misleading. Although the writer notes the increase in heart attack deaths associated with a TSH of 5 to 10, she ignores the major HUNT study(1), which included over 17,000 women. This study showed that women with intermediate (1.14-2.52) or "high" levels (2.5-3.5) of TSH had a 41% and 69% increased risk of heart attack death compared with women who had TSH levels in the lower range of normal (0.50-1.4 mIU/L). Women whose thyroid levels were actually abnormally low had an even greater risk of heart attack.

This is a major point to gloss over, as heart attacks are the number one cause of death in the US. As cholesterol medications called statins used for primary prevention (their most common use) decreased heart attack deaths by under 2%, this suggests that an optimized thyroid function in women with TSH of 2.5 to 3.5 would be over 30 times more likely to prevent heart attack deaths than the medications. This suggests that in addition to leaving women feeling miserable, Susan Carlton's misguided advice could result in tens of thousands of unnecessary deaths in women reading her article - a devastating effect. At least she briefly notes the importance of checking not only a TSH but also an anti-TPO antibody (the test for Hashimoto's) in women who might get pregnant. Not treating with thyroid hormone - even if TSH is normal by any standard - is associated with a 400% increased risk of miscarriage - which is totally preventable by simply giving a low-dose thyroid hormone. That's another 50,000+ preventable miscarriages per year - that are simply missed by most physicians.

Fortunately, more and more physicians are becoming aware that it is critical to treat the patient and not only the blood tests. Her argument would suggest that in the presence of overt symptoms of hypothyroidism, a woman should not be offered a treatment trial with thyroid hormone unless she's in the lowest two and half percent of the population. She may as well say that no woman should be offered any shoe larger than a size 4, as that would technically be in the normal range and no study has shown that wearing a shoe size larger than this is of any benefit. Quite sad.

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David Borenstein, MD is an integrative and holistic physician with expertise in hormone balance, in private practice in Manhattan:

In my practice, I have seen hundreds of patients who have been to many other medical specialties, and were told their thyroid function was "normal." Meanwhile, they were drinking coffee, exercising constantly, and getting enough sleep, but instead of feeling more energetic and losing weight, they ended up more exhausted, fuzzy-brained, and continued to gain weight. Only by properly diagnosing and treating their thyroid dysfunction -- and addressing the underlying adrenal issues -- was I able to get them feeling well. The TSH is just one of a number of parameters -- including Free T4, Free T3, Reverse T3 and antibodies -- that must be evaluated before properly treating a thyroid patient.
>> Read More Comments from Thyroid Doctors and Experts

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Kent Holtorf , MD is founder of the nationwide Holtorf Medical Clinic network, a Founding Director of the Bioidentical Hormone Initiative, and founder of the National Association of Hypothyroidism.

I hope that thyroid patients do not follow her advice. If they do, they may suffer for years with fatigue, depression, weight gain, heart disease and early mortality. Numerous studies show that most doctors practice 10 to 20 years behind what is in the medical literature, and continue to adamantly defend what they were taught in medical school, even in the face of overwhelming evidence. Hundreds of studies show that the TSH is a very unreliable determinant of tissue levels of thyroid hormones. (See the National Association of Hypothyroidism website). Relying on a simple test and discounting all other signs, symptoms and tests because one test states "normal" may be easy, but doctors need to be doctors, and not lab technicians. None are so blind as those who do not wish to see.

With regard to Dr. Daniels statement that "there's no compelling evidence that medication helps patients whose TSH is in the 5.0 to 10.0 range," the Whickham study (2) followed over 2,700 people with TSH levels in the 6 to 15 range, compared to normals, for over 20 years. It was shown that those with the "mildly elevated" TSH had a 76% higher heart disease. If treated, the risk was equal to "normals." The Hunt study (1) showed that even minimal elevation of TSH within the reference range was associated with a 70% higher risk of coronary heart disease. Another study published in the journal Clinical Cardiology (3) found that low free T3, regardless of TSH, was associated with 2.5 times the risk of cardiac mortality. A large study published in the Annals of Internal Medicine demonstrated that those with low normal thyroid levels were shown to have significantly increased risk for atherosclerosis (1.7 to1.9 times normal) and heart attack (2.3 to 3.1 times normal). The study demonstrated that low normal thyroid levels (mildly elevated TSH) contribute to 60 percent of heart attacks and are more of a risk factor for heart disease than smoking, high cholesterol, hypertension or even diabetes."

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Richard L. Shames, MD, is a graduate of Harvard University, trained at the University of Pennsylvania Medical School, served as adjunct clinical faculty at UCSF Medical Center, and has three decades of thyroid practice in San Rafael, California. He is author of the books Thyroid Power, Feeling Fat Fuzzy or Frazzled, and Thyroid Mind Power.

First of all, this article muddles the science of thyroid diagnosis. The millions of people suffering with a sluggish metabolism need better diagnosis, not worse. Arguing about ranges of normal for a thyroid screening test is virtually meaningless without knowing the clinical circumstances of the patients involved. A borderline high TSH result in a patient with few symptoms means something totally different than the same result in a patient suffering terribly with suspicious thyroid-like symptoms of fatigue, chilliness, constipation, and distressing dryness of skin, hair, nails or eyes. Sadly, this article's author does not make that crucial distinction. Instead, she confusingly quotes highly credentialed medical professionals about TSH test scores, without the accompanying clinical context these doctors obviously intended. In thyroid health education, this is a big no-no.

Second, and more important, this article deceptively overstates the usefulness of thyroid blood testing in general. Far too many thyroid-challenged individuals suffer needlessly, sometimes for years, all because of the "tyranny of the TSH test." Good thyroid doctors know that blood test for thyroid issues are only part of a proper diagnosis. Often, just as important are the patient's symptoms, basal temperature, family history, associated illnesses, and physical exam. For instance, researcher-clinician Ernest Mazzaferri, MD, said it well in the Journal of Postgraduate Medicine: "Thyroid tests do not replace good clinical judgment, and should not be used alone to confirm or refute a diagnosis, or to dictate therapy." Indeed, supporting this view are numerous scientific articles by respected researchers (such as those by W. Fraser in the highly-regarded British Medical Journal), which for years have severely questioned the debated value of thyroid lab tests.

My medical colleagues' current over-reliance on blood tests alone is largely what is driving the interest in thyroid advice websites. Health care consumers are literally sick and tired of having their very real thyroid conditions being under-diagnosed and inadequately treated. They know the truth when they see it. And this time they did not find it in Good Housekeeping magazine.

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Datis Kharrazian, DHSc, DC, MNeuroSci is an educator, nutritionally-oriented chiropractor, and author of the book Why Do I Still Have Thyroid Symptoms /When My Lab Tests Are Normal?.

In a sense these doctors have a point -- medication often doesn't help hypothyroidism when it's within a certain range. That's because for most people in this country hypothyroidism is caused by an autoimmune disease called Hashimoto's, in which the immune system slowly attacks and destroys the thyroid gland. In these cases it's important is to address the immune imbalance. Luckily the scientific literature gives us ample evidence on how to do that clinically. Only then can we truly address the cause of hypothyroidism, regardless of whether thyroid hormone medication is necessary.

It's unfortunate this author is using coffee to sustain her energy and relying on crossword puzzles to maintain her cognition when she knows she has an autoimmune thyroid condition. The research shows that by ignoring an autoimmune thyroid condition one raises the risk of developing future autoimmune issues. Also, the brain is highly dependent on sufficient thyroid hormones to function normally and she is accelerating her own brain degeneration, memory loss, and autonomic dysfunction by ignoring her declining thyroid health. It is best to address an autoimmune thyroid condition sooner rather than later to avoid increasing health problems.

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Mark Starr, MD is an integrative physician in Arizona, with expertise in hormone balance and thyroid treatment. He is also author of the book Hypothyroidism Type 2: The Epidemic.

The thyroid gland controls our metabolism. For decades, the Basal Metabolic Rate (BMR) was used to help physicians diagnose hypothyroidism. Despite normal BMR test results, astute physicians would often give patients suspected of being hypothyroid a trial of thyroid hormones. Doctors knew the BMR test was not infallible. The research in my book 'Hypothyroidism Type 2: The Epidemic' shows there is no correlation whatsoever between the TSH and patients' BMR. The fact that the TSH levels required to diagnose hypothyroidism varies from 10.0 in the UK to 2.5 in Sweden proves there is no science to justify using the TSH to diagnose hypothyroidism. It is the medical dogma of our time and an abomination that results in the suffering of tens of millions.
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Kenneth Woliner, MD is an integrative and functional medicine practitioner who works extensively with thyroid and hormone imbalance patients. His private practice, Holistic Family Medicine, is located in Boca Raton, Florida.

Dr. Daniels, as someone who mainly specializes in treating cancers of the thyroid, parathyroid, and adrenal glands, seems oblivious to the overwhelming medical literature regarding hypothyroidism and the need for early diagnosis and treatment. Untreated hypothyroidism not only leads to troublesome symptoms of fatigue, constipation, depression, and obesity, but also causes kidney disease, elevated lipid levels and fatal coronary heart disease.(5, 6, 7, 8).

Dr. Garber flippantly dismisses his patients who have attempted to get treatment for their troubling symptoms. It is true that thyroid hormone is not indicated for the treatment of obesity and giving thyroid hormones to a person without a thyroid condition, in an attempt to speed up the metabolism, will not lead to weight loss. Hypothyroidism, however, is associated with a low basal metabolic rate (BMR), and when untreated, makes it extremely difficult for a patient to maintain a normal weight, despite eating a very low calorie diet.(9,10). Instead of listening to his patients, it appears that Dr. Garber is more interested in giving placating remarks.

Hypothyroidism is increasingly common, with many patients still yet undiagnosed (11, 12). Patients are unsatisfied with condescending physicians such as Dr. Garber and the care they provide (13, 14)Rather than being verbally abusive toward his patients, perhaps Dr. Garber should listen to his patients and give them the medicine they desperately need (15, 16).

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Writer, researcher, former professor, and longtime practitioner in the field of cardiology, Richard N. Fogoros, MD is also About.com's guide to heart disease.

Whether to treat subclinical hypothyroidism when the TSH level is less than 10 mU/L is, as Ms. Carlton points out, controversial. Many endocrinologists (such as those the author consulted for this article) generally recommend no therapy for these patients. However, other expert endocrinologists are inclined to treat subclinical hypothyroidism in patients who have symptoms suggestive of hypothyroidism, or who have goiters, or who have significant risk factors for heart disease (since subclinical hypothyroidism has been associated with an increased risk of coronary artery disease, heart failure, and cardiac mortality).
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David Brownstein, MD is Michigan-based practitioner, author of a number of popular books on thyroid disease and hormone health, and Founding Director of the Bioidentical Hormone Initiative.

Each patient is a unique biochemical individual and needs to be treated as such. My experience has clearly shown that a drifting TSH, even in the normal range, is a precursor to bigger problems down the road. Most patients are optimized with a TSH around 1.0 mIu/ml. A study showed that higher rates of thyroid cancer found in subjects with a higher mean TSH (1-5 mIU/L) as compared to those with benign disease with a mean TSH 1.01miu/ml.
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Richard Podell, MD, MPH, is in practice in New Jersey, and is also Clinical Professor in the Department of Family Medicine at the UMDNJ-Robert Wood Johnson Medical School.

Double-blind studies have shown that thyroid is an effective treatment for depression--even when thyroid hormone blood test levels are normal. Psychiatry textbooks now include thyroid hormone as a standard treatment option for persons with difficult to treat depression. For example, a recent study found that thyroid was more effective than placebo for improving depression among persons who had not responded well to initial treatment with Zoloft. (4)
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In his book, Bioidentical Hormones 101, integrative physician and hormone expert Jeffrey Dach, MD says:

Mainstream endocrinology relies on the TSH test, which is not a direct measure of thyroid function, and can, in fact, be unreliable....In spite of the obvious need for a better approach to the low thyroid condition, there has been very little movement to rehabilitate mainstream endocrinology, which dogmatically clings to the TSH test.
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TAKE ACTION!!

Do you think Good Housekeeping has done a disservice to thyroid patients? Share your comments here on my blog, or at the Thyroid Support community on Facebook.

And to reach out to Good Housekeeping, start by telling your thyroid story.

I also encourage you to write to Good Housekeeping's Editor, Rosemary Ellis, at ghletters@goodhousekeeping.com, and by regular mail at:

Rosemary Ellis
Good Housekeeping
300 West 57th St., 28th Fl.
New York, NY 10019

About Mary Shomon | Thyroid Forum | Twitter | Facebook

Photos: courtesy individual physicians

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References:

(1) Bjorn O. Asvold; Trine Bjoro; Tom Ivar L. Nilsen; David Gunnell; Lars J. Vatten Thyrotropin Levels and Risk of Fatal Coronary Heart Disease: The HUNT Study Arch Intern Med. 2008;168(8):855-860. Online

(2) Vanderpump MP, et. al. "The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey." Clin Endocrinol (Oxf). 1995 Jul;43(1):55-68. Online

(3) Auer J, Berent R, Weber T, Lassnig E, Eber B. "Thyroid function is associated with presence and severity of coronary atherosclerosis. Clin Cardiol. 2003 Dec;26(12):569-73. Online

(4) Cooper-Kazaz, R. et. Al. Combined Treatment with Sertraline and Liothyronine in Major Depression, A Randomized , Double-blind, Placebo-Controlled Trial, Archives of General Psychiatry 2007; 64-679-88 Online

(5) Exley A, O'Malley BP. Depression in primary hypothyroidism masquerading as inadequate or excessive L-thyroxine consumption. Q J Med. 1989 Sep;72(269):867-70. Online

(6) Asvold BO, Bjøro T, Vatten LJ. Association of thyroid function with estimated glomerular filtration rate in a population-based study: the HUNT study. Eur J Endocrinol. 2011 Jan;164(1):101-5. Online

(7) Asvold BO, Vatten LJ, Nilsen TI, Bjøro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol. 2007 Feb;156(2):181-6. Online

(8) Asvold BO, Bjøro T, Nilsen TI, Gunnell D, Vatten LJ. Thyrotropin levels and risk of fatal coronary heart disease: the HUNT study. Arch Intern Med. 2008 Apr 28;168(8):855-60. Online

(9) Svare A, Nilsen TI, Bjøro T, Asvold BO, Langhammer A. Serum TSH related to measures of body mass: longitudinal data from the HUNT Study, Norway. Clin Endocrinol (Oxf). 2011 Jun;74(6):769-75. Online

(10) Bastemir M, Akin F, Alkis E, Kaptanoglu B. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Med Wkly. 2007 Jul 28;137(29-30):431-4. Online

(11) McMillan C, Bradley C, Razvi S, Weaver J. Psychometric evaluation of a new questionnaire measuring treatment satisfaction in hypothyroidism: the ThyTSQ. Value Health. 2006 Mar-Apr;9(2):132-9. Online

(12) Gibbons V, Lillis S, Conaglen J, Lawrenson R. The reality of subclinical hypothyroidism in general practice. J Prim Health Care. 2009 Sep;1(3):215-21. Online

(13) Bjoro T, Holmen J, Krüger O, Midthjell K, Hunstad K, Schreiner T, Sandnes L, Brochmann H. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol. 2000 Nov;143(5):639-47. Online

(14) Walsh JP. Dissatisfaction with thyroxine therapy - could the patients be right? Curr Opin Pharmacol. 2002 Dec;2(6):717-22. Review. Abstract

(15) What to do if you are in an abusive relationship. Am Fam Physician. 2011 May 15;83(10):1173.

(16) Cayley W. I just want my pills... WMJ. 2004;103(2):11. Pubmed listing

Comments
July 23, 2011 at 7:51 pm
(1) Linda says:

THANK YOU Mary, and all the Dr’s who “get” thyroid disease for participating in this rebuttal to the Good Housekeeping article!!

July 23, 2011 at 8:20 pm
(2) Lolly says:

Thank you Mary for writing this article and getting Dr’s to speak out about that article by Susan Carlton in Good housekeeping which can only do more harm that good.

July 23, 2011 at 8:46 pm
(3) Paula says:

Wow! That article will set back thyroid treatment another 50 years!

July 23, 2011 at 9:02 pm
(4) Lori says:

Thank you Mary and all the docs who responded to Ms. Carlton’s very poorly researched article in Good Housekeeping on July 19, which included dangerous information for thyroid patients. I do hope she heeds the advice many have given her and takes care of her own health before it’s too late and she experiences anything like what I and so many others have. I don’t wish the devastating complications that this autoimmune disease can cause on any one, when left untreated!

July 23, 2011 at 11:18 pm
(5) CindiS says:

Thank you for this great response to the Good Housekeeping article. What a huge disservice they have done to women by publishing information that surely will physically harm someone.
I am hopeful the outrage sparked by this article will prompt GH to request that you address the issue from the thyroid patient advocacy perspective. Publishing accurate and up-to-date thyroid dysfunction information in GH could truly change and save lives.
I have written the GH editor and commented at the on-line article…and am thankful for everyone who has taken the time to do so.

July 24, 2011 at 10:55 am
(6) shelley says:

Disease du jour? It is irresponsible for any publication to classify thyroid disease as such. If Carlton chooses not to seek treatment, that’s her right, but to suggest to her readers that caffeine and crosswords are adequate treatment is nothing less than reckless.

I’ve been diagnosed with Hashimoto’s myself, which runs on my mother’s side of the family.

July 24, 2011 at 10:58 am
(7) AirdaleLady says:

This article is terrible: it never ceases to amaze me how many willing collaborators Big Phama has in their barn. If it were not for a good doctor who had thyroid problems himself and knew how to treat thyroid, I would be a very fat unhappy woman. I hope Good Housekeeping listens to all of us and figures out that the kind of information they published helps no one but the pharmaceutical companies and the people who want to keep women down.

July 24, 2011 at 11:09 am
(8) Shirley Braden says:

Thank you so much for bringing this unbelievable disservice to light and adding the dissenting, enlightening opinions of many qualified medical personnel. I’m going to share this with many who have gotten the same advice from their own doctors. As someone who suffers from hypothyroidism and as a gluten intolerance/celiac support group leader (thyroid issues can be relate to gluten intolerance/celiac), as well as someone who has friends who’ve been “dismissed” by doctors when they had obvious thyroid symptoms, I feel this is critical info to share. One of my doctors told me that when you feel like you “cant’ get off the couch, no matter how much you want to” that usually points to thyroid issues.

Thanks again!
Shirley Braden

July 24, 2011 at 1:01 pm
(9) Anna says:

Thank you for digging deeper into this issue and presenting an alternative, well-researched perspective. I’m seeing the same sort of “pooh-poohing” articles on Celiac/gluten intolerance, which I now have (diagnosed after years of docs telling me my digestive issues and rashes were “stress-related”), and I wonder if there exists a super-reactionary branch of medical professionals and publicists who feel compelled to debunk anything that doesn’t fit within their rigid decades-old knowledge system. Closed minds do not help patients and in fact can harm them — doesn’t that go against the Hippocratic Oath?

July 24, 2011 at 8:31 pm
(10) Robyn Bray says:

It’s good to see some honest, caring docs speak out on this matter. Of course, the only ones who see this are the ones informed enough to know to visit your pages, Mary.

What a horror it is that this battle has to be fought by people who are too tired and fuzzy headed to keep abreast of their own daily affairs or even remember to take their meds. If we all keep doing what we can, maybe it will add up to something. My 21 year old son is already barely making it, and I fear for his future. He would be in worse shape than he is, maybe even dead, if I had not had your work to inform me and fight with every ounce of strength I could must when my own levels were hovering around 13. I often avoid reading about it, because I only get more frustrated. To paraphrase Dickens’ Tiny Tim, “God help us, every one!” Hey! I bet Tiny Tim had thyroid disease. That would explain him being so weak, but recovering when he got proper food and medical care!

July 25, 2011 at 11:40 pm
(11) Paola says:

I use to read Good Housekeeping but in my eyes after reading the article about hypothyroidism, the magazine has lost so much credibility.

July 26, 2011 at 12:47 am
(12) Jan Masleid says:

Wonderful follow up article by Mary Shomon and the caring physicians who clearly demonstrate that they comprehend the issues surrounding hypothyroidism.
It truly does appear that the consequences of hypothyroidism contribute, sometimes quite discretely, to many states of illness and co-morbidity in this country as well as in other developed nations. I believe it is an unfortunate trend that may not (ever) be able to reverse its direction.

Hmmm… nor is the direction really changing for the user friendly catch-all diagnostic term, ‘depression.’
Well how convenient is that, I ask you?

Truthfully, it is beyond me why it is so difficult for some physicians to accept that ‘boring old hypothyroidism’ is simply NOT a cinch to treat with one-trick-pony methods. Good Heavens – what physical conditions are?
Hahahaha-
‘One sure-fire test’ and ‘One sure-fire pill’?
Now, if THAT ain’t snake oil doctoring, nothing is!!

Perhaps the burden of management of hypothyroidism could be shared with clinical nurse practitioners (in collaboration with licensed medical providers as needed/indicated).
~Think about it, Docs.. its a far better plan than continuing to be unpleasantly overwhelmed with exponentially increasing numbers of VERY frustrated, depressed, angry – and most of all – ill – patients.
Also, just so you know, ‘the internet effect’ isn’t really making them become ill, –or even angry. And patients actually don’t enjoy screaming at you docs any more than you enjoy being the eternal recipient of it.
So.. maybe we need change.

Oh, and Docs– regardless of what our trusty endo aces say, its just not all that tough to learn about FreeT3 and FreeT4 lab values. In fact, check it out–you might be quite the hero some day. :-)

Janet Masleid R.N.
Chicago, IL

July 26, 2011 at 8:49 am
(13) Ellen says:

Mary, thank you for this article and for your tireless work on behalf of thyroid sufferers.

It is incredibly hard to get most medical professionals to listen. I think I saw every endocrinologist in Southern California.

I finally found a Los Angeles thyroid specialist who would listen at the Beverly Hills Rejuvenation Center.

July 26, 2011 at 11:28 am
(14) Margaret says:

Thanks to Mary and the doctors who took the time to comment on this reckless and unprofessional article by Susan Carlton in GH. I have written to the editor of GH voicing my incredulous disbelief in such a thoughtless and un-research piece of journalism. As someone suffering from Hashimoto’s I can only hope that Ms. Carlton seeks a second opinion and additional medical help. Had I been diagnosed correctly, I would not have suffered through a painful surgery to remove half of my thyroid gland due to a 10mm tumor! My experience shows what main stream medicine is good for – ONLY treating the disease when it finally causes a pathological problem NOT preventing illness from happening or from getting worse.

Keep up the good work Mary!

July 26, 2011 at 11:46 am
(15) Shannon says:

Funny, I’m at 250 mcg of Levoxyl. I weigh 175lbs. At 5’2, I am obviously not taking meds to lose weight. That article is insulting.

July 26, 2011 at 12:07 pm
(16) Becky McDonald says:

Thanks Mary and the Docs how have been kind enough to care and give their rebuttals to this literally outrageous and under-thought article that Good Housekeeping has published. My papillary carcinoma has changed my life forever. That said, I had a “borderline” thyroid panel for over 20 years. Thank God my doctor cared enough to check me out more thoroughly. When I gave my symptoms of severely dry hair and skin, change in the way my body was reacting to heat, hair loss, fatigue, and general malaise, he immediately felt my thyroid and found it to be enlarged. He did a thyroid panel and though it was “borderline”, he sent me for an untrasound. When that came back with two enlarged nodules, I was sent for a thyroid uptake. After that it was a hop, skip and jump to not one, but two surgeries to remove my thyroid, 3 parathyroids and multiple lymph nodes. It has almost been a year now and I am still not quite right as I am still suffering fatigue and dry skin, sleeplessness and now the lovely added mood swings, oh and my weight, well, that isn’t too terribly high, but I cannot seem to lose any. The thing that this whole article has brought to my attention and the responses to it as well, is that I was diagnosed with Hashimotto’s after the surgeries. I am at a loss as no one seems to be talking about it as far as my doctors go and after having looked online, I see that I still have the disease.

July 26, 2011 at 12:07 pm
(17) Becky McDonald says:

Thanks Mary and the Docs how have been kind enough to care and give their rebuttals to this literally outrageous and under-thought article that Good Housekeeping has published. My papillary carcinoma has changed my life forever. That said, I had a “borderline” thyroid panel for over 20 years. Thank God my doctor cared enough to check me out more thoroughly. When I gave my symptoms of severely dry hair and skin, change in the way my body was reacting to heat, hair loss, fatigue, and general malaise, he immediately felt my thyroid and found it to be enlarged. He did a thyroid panel and though it was “borderline”, he sent me for an untrasound. When that came back with two enlarged nodules, I was sent for a thyroid uptake. After that it was a hop, skip and jump to not one, but two surgeries to remove my thyroid, 3 parathyroids and multiple lymph nodes. It has almost been a year now and I am still not quite right as I am still suffering fatigue and dry skin, sleeplessness and now the lovely added mood swings, oh and my weight, well, that isn’t too terribly high, but I cannot seem to lose any. The thing that this whole article has brought to my attention and the responses to it as well, is that I was diagnosed with Hashimotto’s after the surgeries. I am at a loss as no one seems to be talking about it as far as my doctors go and after having looked online, I see that I still have the disease.

July 26, 2011 at 12:08 pm
(18) Becky McDonald says:

What is the treatment and how the heck do we get doctors to talk to us about these things without being dismissive. I appreciate GH article, if for nothing else, it has gotten people talking and hopefully, it will get the information out there to not only the general public , that we all need to know, but maybe doctors in general. I believe personally that if more men suffered from these things doctors would pay more attention. I cannot tell you how many times since I was just a child I have had some callus doctor dismiss something I had told them simply because I am female and therefore prone to”hysteria”. All I can say to doctors like that is,’ Dr. A. you were wrong, it is called endometriosis, Dr. B. you were wrong too, it is called an aneuyrsism, Dr C. you were wrong… it’s called cancer.”

July 26, 2011 at 12:08 pm
(19) Becky McDonald says:

When are these people going to start listening to their patients and lending credence to those patients words. Stop over-booking your waiting rooms and making us sit for hours, then rushing us through when we finally do get to see you, and ignoring our questions, or doing the bare minimum to get rid of us. You are supposed to care about your patients well fare, physically, mentally and emotionally. We are “whole” people. Read a book, an article, take some continuing education and for goodness sake, treat us as you would want to be treated or want your family to be treated. Consider this your invitation for all of you to join the twenty-first century and step out of the dark ages.

July 26, 2011 at 12:09 pm
(20) Becky McDonald says:

.” When are these people going to start listening to their patients and lending credence to those patients words. Stop over-booking your waiting rooms and making us sit for hours, then rushing us through when we finally do get to see you, and ignoring our questions, or doing the bare minimum to get rid of us. You are supposed to care about your patients well fare, physically, mentally and emotionally. We are “whole” people. Read a book, an article, take some continuing education and for goodness sake, treat us as you would want to be treated or want your family to be treated. Consider this your invitation for all of you to join the twenty-first century and step out of the dark ages.

July 26, 2011 at 1:28 pm
(21) Becky Stockum says:

Thank you, Good Housekeeping/Susan Carlton/Oprah. What a disgrace you all are!

July 26, 2011 at 1:47 pm
(22) Karen says:

Now honestly, who actually reads Good Housekeeping for health advice?

July 26, 2011 at 7:45 pm
(23) Antoinette says:

Karen, my sentiments exactly. Who actually reads Good Housekeeping, period? I won’t even pick it up to browse thru while I’m in the doctors office.

July 26, 2011 at 6:29 pm
(24) Suzanne says:

Mary,

Thanks for bringing yet another disservice to the thyroid community’s attention. Here is the letter I wrote Rosemary.

Rosemary,

Your thyroid article and undermining of your own autoimmune condition is an absolute disgrace. You should be ashamed of yourself. Maybe one day when you fully acknowledge and embrace your condition and when you are one of the many millions of thyroid patients completely minimized by your endocrinologist, you will learn some empathy and compassion. I would think someone like you with family who have Hashimoto’s and yourself who is clearly developing it, you would have more understanding. While you are allowed to take whatever course of action with regard to whether or not you seek medical care for your thyroid condition, please DO NOT undo what advocates like Mary Shomon and wonderful practitioners have spent years to establish as a very real and troubling diagnosis. You have done an incredible disservice to the magazine for which you work and for women and men across the world that suffer. SHAME ON YOU!!!

Sincerely,

Suzanne Smith (Hashimoto’s and atrophic gastritis sufferer)

August 2, 2011 at 4:30 pm
(25) Jan Walker says:

I was interested in Suzanne Smith’s comments and her diagnosis of Hashimoto’s and gastritis.

Last week I had a colonoscopy and was diagnosed with gastritis and esophagitis, and I have long suffered with Hashimoto’s. I wonder if Hashimoto’s often goes along with the itis’s, the inflammation in our stomach, colon, esophagus etc? Jan

July 26, 2011 at 8:31 pm
(26) Jen says:

Mary, as you make $100/30 minutes coaching people to do the opposite of the article I find your outrage interesting. I am alos interested that no academic physican is listed above as an expert who supports your views. Most of your doctors have books to sell and private practices to support and so by nature are biased as well.

It woul dbe nice if you could find a well published researcher to support your opinions that the article is garbage.

July 27, 2011 at 6:56 am
(27) CindiS says:

oh, so you’re an ob-gyn? perhaps like those I consulted for a multitude of “female” problems when I was undiagnosed hypo – the ones that recommended various biopsies and surgeries ($$$) but never ever once mentioned “thyroid” to me? Lucky for me I refused those invasive procedures and surgeries wanting to take my lady parts – because once I was on natural thyroid all those problems disappeared. who knew? well, an ob-gyn should have known…

July 26, 2011 at 10:46 pm
(28) Mary Shomon says:

(Disclosure – Jen is an ob-gyn at an HMO. Jen, there’s much more credibility in putting your full name on blog comments.)

First of all, Jen, if you are going to join Good Housekeeping’s effort to demean thyroid patients, please start by doing more due diligence than their misguided article did.

That would mean reading up on the background of the physicians quoted in the article, as well as the many journal articles referenced. Several have the academic credentials you revere, and have impressive credentials from highly prestigious American medical schools, and have been in private practice successfully handling thyroid and hormone patients since before you were in medical school.

You find my outrage “interesting” and you say that I earn money coaching people to “do the opposite” of what was written in the article. Rather than taking a passive-aggressive approach, why not say what you mean?

Are you suggesting that because a small part of my living is from patient advocacy coaching, that I then have no right to advocate for patients when an injustice has been doing in a national magazine?

And let’s take a look at I objected to in the article.

Good Housekeeping basically said if your TSH is less than 10, there is no reason to treat you, and if you do need treatment, you’re just following some sort of “disease du jour” fad, you’re trying to lose weight, or you’re some sort of dupe who’s been reading too much on the Internet. TSH over 5, Hashimoto’s antibodies, weight gain, brain fog, and exhaustion? The answer is coffee, crosswords and spinning class.

So yes, you are right that I coach people on the opposite. I have been doing it here in my articles at About.com — thousands of articles written since 1996…all free btw. I have been doing it in my books, and in my one-on-one coaching.

The opposite?

  • I want women to know that physicians don’t all agree that a TSH of 5.0 to 10.0 is normal and not worth treating.
  • I want women to know that the research shows that treating euthyroid Hashimoto’s may help prevent progression to overt hypothyroidism.
  • I want women to know that they have an increased risk of thyroid cancer if they fail to treat Hashimoto’s with subclinically hypothyroid TSH levels.
  • I want women to understand that the weight will not — as some of your colleagues suggest — just “fall off them” with thyroid medication. In fact, they will have to work harder and longer than others to lose weight — but at least treating their underactive thyroid will make it possible, and they might stop gaining weight on a rigorous diet and exercise program. An interesting story: I coached a marathon runner whose doctor told her that gaining weight on her 1500 calorie/day diet, and 10 mile a day runs was impossible, and that she MUST be eating secretly. You have “Fork in Mouth disease” the doctor — an endocrinologist — told that runner.
  • I want women to understand that caffeine and stimulants are not a substitute for proper thyroid treatment.
  • I want women to understand that even the most rigorous exercise program may not result in even an ounce of weight loss if the thyroid is undiagnosed and untreated.
  • I have a question: by your logic, since you work for an HMO, and HMOS are notorious for rushing patients through the “7 minute” visits, and limiting access to tests and treatments, should I assume that you are biased? Biased in favor of spending no time listening to patients, and instead blaming symptoms on lifestyle issues that require no medical tests or treatments? After all, the appointment is faster, and the HMO doesn’t have to pay for the blood tests or the medications, if all you have to do for Hashimoto’s patients is to tell them to drink coffee or take up spinning classes and send them on their way. YOU personally get paid either way, right?

    I find it interesting that you attack the physicians who presented their approaches to thyroid disease, suggesting that some of them are not qualified to comment because some are not academics, or they have private practices, or have written books.

    Doctors in private practice rely on reputation, skill, and a demand marketplace…their patients WANT to come to see them, and request them specifically. These doctors have to produce results for their patients, and get them well, or the patients don’t come back. What recourse do HMO patients have if you don’t help them get well?

    Based on the 500 emails I’ve been getting from thyroid patients for more than 10 years, there are many HMO doctors out there who tell a woman who has a family history of thyroid disease, a visible goiter, and a laundry list of thyroid symptoms that her problem is stress, depression, PMS, etc., and send her on her way with advice to “get off the couch,” stop eating so much, or with a prescription for a cheap generic antidepressant, rather than the thyroid tests — and not just the almightly TSH — that could properly diagnose a thyroid condition. Thyroid tests and drugs cost the HMO money — platitudes and derision cost the HMO nothing. Thyroid patients may be brain fogged, but we can do the math, Jen.

    I don’t know you, or how you practice, or whether you regularly evaluate thyroid function in your patients, or whether your patients love you or not. I hope that you are a happy, smart, wonderful doctor, with a long list of satisfied, healthy and well patients. But please, keep an open mind to the idea that not everything there is to be known about health and wellness — and thyroid disease — is published in a peer-reviewed, double-blind crossover study in a major medical journal. And among your integrative MD colleagues are talented, caring knowledgeable and compassionate practitioners who deserve your respect, not derision.

July 27, 2011 at 2:17 pm
(29) Andrea Fowler says:

Well said Mary!

November 29, 2011 at 7:02 am
(30) sophia says:

My mother and i are hypothyroid Mother is on synthroid and i am on cytomel since my thyroid dropped 15 pts from caring for my mother during a breaking of her bones during alzheimers.i wasnt synthesing t4 anymore.the trauma really affected.me, we have been hypothyroid many years.I am also vegan and i work out continuously.I was also evaluated in Switzerland and nyc. the horrifically irresponsible article from good housekeeping is insulting dangerous and raises serious red flags Mary your work is essential for women Hypothyroidism is complex the adrenals and pituitary come into misalignment and it is not an overnight cure. a holistic picture and a good dr a plan to rebalance for a lifetime. I honour your dedication to helping women.I dont recomend veganis for hypothyroid.I take alotof herbs supplements and practice alot of tai chi work out and yoga and i am an opera singer.i know i would do better with eating fish but i cant wrao my head around it.
bless you for your work

July 30, 2011 at 3:40 pm
(31) Linda says:

Excellent, Mary. Thank you!

Come on back when you’re hypo and need help Jen!

August 3, 2011 at 3:52 pm
(32) Susan says:

Mary, please keep up the good work and patient advocacy! Without your website and blog I would be one of those many women without proper treatment. However, once I was diagnosed, I did research and found your website. With this information, I was more involved with my physician and was able to stand up for myself when told my “numbers were fine”, even though I was once again experiencing the fatigue and weight gain, coupled with high cholesterol and high blood pressure. I was also able to locate an endocrinologist who understood that my “numbers” needed to be under 2.0 and listened to what I was saying/experiencing. I am very thankful that you have done so much work and have helped so many of us.

August 6, 2011 at 5:01 pm
(33) Jane Frank says:

Wonderfully written as always, Mary. It’s obvious Susan Carlton was going to ‘dis you no matter what was discussed when you spoke with her. I sincerely doubt her “method” of solving her thyroid problem will work. Drinking more coffee, more crossword puzzles AND a spinning class? Puhleez. None of that will hurt her of course – but it won’t “fix” her thyroid issues. Thank you Susan but I’ll stay with Mary who gives great advice and LISTENS.

August 8, 2011 at 6:57 pm
(34) Irene Hogan says:

Great to see all the comments,this article is a diservice to women who are suffering.Too often I consult with women who are not listened to or put on antidepressants or told to live with it or it’s stress related when they have a clinically underactive throid or other hormonal imbalance.Yes lifestyle interventions are always helpful,howver in my exeperience any TSH over 3.0 indicates a sluggish thyroid in a patient and atrial of natural thyoid or T4/T3 mix is indicated.Many times the symptoms go away.Even in patients on medication they still have issues and are not optimally treated.It is a shame that most times this occurs in women and around menopause so it is all blamed on hormones and nothing is done about it or the wrong things.Thanks for the rebuttals by the excellent doctors who really care about their patients and get results.
From a pharmacist that deals with menopausal women.

August 9, 2011 at 4:03 pm
(35) Suzanne Austin says:

Susan Carlton has had a typical first thyroid review by the medical community. She was convinced that she should only listen to her physician and she would be “fine”. Susan should blog so we can follow her journey because she will have one. It is very difficult to get good thyroid treatment and we should not be surprised she did not get good treatment out of the gate. The surprising fact is that her doctor decided to even consider her thyroid before she was in dire straits. She has conflicting advice in different sections – Treatment is not needed between the TSH of 5-10, the treatment described in the “if you are pregnant” section is a must, or where the doctor says to target a TSH between 1 and 2. Susan quotes a doctor that says that desiccated thyroid doses vary is clearly wrong. There are quality standards that prevent this such as the Good Manufacturing Practices checked by the FDA. The doctor is probably quoting a sales person rather than a journal or a scientific study. Susan then goes on to disparage online help. It exists because it is needed. Susan talks about using a thermometer for diagnosis as online advice that is harmful. Temperature was the only test to assist diagnosis before the modern lab work was developed. Dr. Broda Barnes and Dr. Bruce Rind, http://www.drrind.com, would disagree with this characterization of the use of temperature. So with all of the disagreements among doctors quoted in the article, it shows there is little consensus about thyroid treatment. Susan’s own conclusion to pursue more coffee, crossword puzzles, and exercise will land her in worse shape and she may be calling Mary Shulman for advice. I for one will be my own advocate and pursue my own research (in thyroid and related subjects like supplementation and adrenal fatigue) to pursue optimal health for myself. Practitioners like Dr. Datis Kharrazian add to the knowledge base. The bottom line is clear – thyroid treatment is difficult at best.

August 17, 2011 at 10:46 pm
(36) Bridgette says:

I am SO happy to have all this discussion at a time when I am searching for answers. I have read SO many books and articles, and there is SO much information out there. When I go to my endo and all they do is change dosages of the usual meds, and nothing else, I know there is so much more. But the hours and hours it takes to try and understand all of this is inordinate! NOW would be a great time for everyone who is going through this to band together and create a resource list of good doctors (a newer list than the 2006 list on about.com). Mary, is can a newer list be generated with input from all the people that read your blogs? I would love to find doctors in my area who could help, and just don’t know where to look.

August 18, 2011 at 12:52 am
(37) Tracy says:

My story will not be well received here,but I feel I must tell it.Five years ago, after having a TSH level of around 3ish,I began taking Armour.After several months at 15 grams,I felt I should have had relief from fatigue and weight gain.I did “research” and found a site that encouraged patients to go against conventional medical teaching and up the Armour gradually.I took matters into my own hands and began every few weeks adding 1/2 grain.My energy started lifting and I think I may have lost 5 lbs. At this point I was up to 90 mg, which was still lower than what I was reading was a good level for most people to find relief from hypo symptoms.The bothersome side effect I had was a racing heart.Again, my “research” said not to worry about symptoms such as this.Six months after being on the Armour, in the spring of 2006, I collapsed and went into cardiac arrest.I was clinically dead for 18 minutes.Fortunately my husband was nearby and did CPR for that time until EMTs arrived.When I came to enough (I was still intubated)I motioned for something to write with.I begged the doctors to test my thyroid levels.The results came back-I was very hyperthyroid.There are many details to add to this but to save space I won’t go into everything except to say my heart finally failed last year and I received a heart transplant.I must add, prior to my incident I lost my mother at a young age due to heart problems and a brother at 42 one year prior to my cardiac arrest (his death certificate stated VFib) So in all honesty,I probably did have a pre-existing heart condition.I have wondered at least a hundred times if I may have “pulled the trigger” a little earlier by aggravating my thyroid.I guess I feel compelled to tell my story because there may be that other person out there who has an underlying heart problem.

November 29, 2011 at 11:34 am
(38) Linda says:

As Judge Judy says: “if the story doesn’t make sense – it isn’t true!” And your story doesn’t make sense. You need a doctor’s prescription for Armour. There are very few doctor’s that even prescribe it. And if you are lucky enough to find one that does – they would not keep upping your dosage every few weeks. Get a life – maybe you should start by telling the truth!

August 18, 2011 at 5:46 am
(39) marion says:

small note re Suzanne’s advice –
as someone who was diagnosed with Hashimoto’s 21 years ago I find I have to be very careful with drinking coffee – [even though I like it]…
it can send me shaky and feeling really weird – out of balance physically [I am better with tea]
..and I have underactive, not overactive thyroid [I know hyperthyroid people, like my husband, and possibly my teenage daughter, have to be careful with coffee].

November 29, 2011 at 7:16 am
(40) Kathryn says:

Thanks Marion for this. It solved a problem I have been having since being treated for low thyroid. I also find that when taking painkillers with caffeine in them, I get the shakes.

By the way, this Web site of Mary’s with its comprehensive “Wiki” type knowledge is very useful in understanding the disease.

August 18, 2011 at 5:47 am
(41) marion says:

sorry – re. my previous comment [cannot edit]
I meant Susan [Carlton], not ‘Suzanne’

August 24, 2011 at 6:08 pm
(42) Johanna says:

Mary, thank you for exposing this completely infuriating article. It is hard enough getting it through to mainstream doctors that they need to listen to their patients at least as much as they listen to the drug company reps who bring them their daily lunch for free (true! They do this!)

Most doctors don’t want to hear about thyroid short of prescribing the latest profitable (patented) compound some big pharma company has dreamed up. And most wouldn’t be caught dead prescribing the actual hormone — probably because it’s too cheap to make money from!

My question is, how can we apply pressure to get things to change? We have the truth on our side, but sometimes it seems like that’s not enough when they have the money.

I’m sorry if I’m sounding cynical, but I’m pretty disgusted!

Mary, thanks for everything you do to get these issues the hearing they deserve.

September 6, 2011 at 2:32 pm
(43) cathleen haggerty says:

I have been on thyroid pills for about 6 years now. The doctors always tell me the same story the my tsh leveals are normal allowance. this article only proves the meds I have been on are not working and I now have info to show them at my next app.

September 7, 2011 at 1:17 am
(44) Alice says:

I agree with the “disease du jour.” After my diagnoses of hyper thyroid and then hypothyroid, I went for acupuncture, exercised more, used diet and vitamin suggestions that I found on the internet, meditated every morning, made fresh vegetable juice before work, and brewed herbal chinese medicinal teas. I am fine now and have completely cured the fluctuations.
The drs would have done surgery and/or had me on pills the rest of my life. It was a lot of research and a lot of commitment, and I think a lot of people would rather take the “experts” advice and a pill to solve the problem. Problem is, it doesn’t solve anything.

November 29, 2011 at 11:41 am
(45) Linda says:

Alice – I would agree with you if life were that simple. I am into alternative health care, exercising, eating well and don’t like popping pills to resolve my physical ailments. Unfortunatley, a little over a year ago – I was diagnosed with Hashimoto’s and I am doing everything in the hope that I can cure this autoimmune condition but in meantime if I don’t take my thyroid hormone it is the difference between night and day between feeling like I am 90 years old and 25 years old. You need to be careful what you say and who you say it too – you have no clue what people are going through.

November 29, 2011 at 2:51 pm
(46) Kim B. says:

If only it was as easy as drinking coffer and doing crossword puzzles. No one knows what it’s like to have thyroid disease unless you have it yourself.

November 29, 2011 at 9:57 pm
(47) TMoody says:

I can only say that if Susan Carlton ever experiences all the very real symptoms that go along with thyroid disease, she will rethink her treatment. Caffeine cannot revive someone with truly debilitating fatigue. This is not a situation were you pull up your bootstraps and pull yourself together. It is a situation where you are too exhausted to even walk to the back of the store for milk. Exercise is always encouraged and may help with weight if the person has a low metabolism. Having been treated for Hashimoto’s I went from barely moving around to feeling like a human being again. There is always a low level of fatigue, but I can function. I haven’t lost an ounce of weight but I feel like a human being and that is worth a whole lot.

December 29, 2011 at 8:30 pm
(48) Michelle says:

Alice, the idea of “disease du jour” in this case is a load of bull. I was diagnosed with hypothyroidism more than 15 years ago. Not exactly yesterday. I continue to struggle with the issues that Mary addresses so eloquently and thoroughly. Valid information (education) goes a long way in alleviating some of those struggles.

January 10, 2012 at 3:36 pm
(49) Katie says:

For the physician who initally comment that there was no evidence that meds help a TSH level of 5-10: Mine was 6.8 initally and I could not function. Should we as medical professionals say that a potassium of 6.8 is not worth treating? I am 26 years old. I want to have more children. Why should I be at risk for infertility and/or miscarriage because I’m being “neglected”. For God’s sake it isn’t like thyroid patients are asking for narcotics. When I began my synthroid my dose was 50mcg. After being on it for a mere 3 weeks I was still having symptoms including no BM for a good 6 days. I started to have other symptoms like abdominal pain, nausea, bad breath. I was worried about a bowel obstruction. I also landed in ER for chest pain and palpitations and once I saw an endocrinologist who increased my dose the above mentioned symptoms subsided. Please remember that all patients are human beings and your ID badge says “M.D.” not “G.O.D”

January 10, 2012 at 4:27 pm
(50) Tina says:

The one item that Katie is forgetting to mention is that she was the biggest skeptic when it comes to extreme fatigue and what the thyroid function plays into. I am her older sister and have been diagnosed with Hashimotos since the age of 3. I am now 35. She has always had the energy to exercise so when she was complaining about her exhaustion and other symptoms mentioned I though they sounded quite familiar. The difference between the 2 of us is she is fit and I have had the weight problem my entire life. I have had the extreme exhaustion, cold extremities, infertility, constipation, hair loss, brain fog etc, etc. I always hear if you don’t like what you look like get up and do something about it (exercise). I have been so tired in the past its been all I can do to get up for work and take care of my family. Exercise when you are at the point where I’ve been does not give you energy. The brain fog I’ve had is upsetting to say the least. So doctors telling me that my thyroid function is normal when I fit the mold for underactive thyroid burns me up. I’ve been hypo and hyper and know what they feel like. I am now to the point where I will probably not be able to have children because of some standardized test that says I’m in the normal range… when I know I don’t feel right. If we are not proactive for ourselves then no one else will. Doctors LISTEN TO YOUR PATIENTS. You may have gone to school but, we know our bodies!

April 17, 2012 at 5:51 pm
(51) Susan Jennings says:

I am so tired of hearing this self-righteous mantra “Sure, you have thyroid problems, ha ha ha, well, if you only exercised enough . .. ” This infuriates me because I jogged 3 miles per day, lifted weights, engaged in aerobics, step aerobics, spinning, treadmill etc for YEARS and I did not lose an ounce of excess weight. I restricted calories to the point of starvation and I was still fat.

The ONLY thing that has caused me to lose any weight is when I stopped eating all wheat and gluten products, Period. Nothing else worked.

April 17, 2012 at 7:10 pm
(52) Joan4U says:

Sttill improving my thryoid treatment, 14 years after diagnosis, and 18 years of problems before that. Incidentally, I was seeing an endo before I was diagnosed, who never noticed.
That doc moved, and I went to an internist who diagnosed me, and got me on Armour after I asked to try it. T3 helped, esp. for leg pain.
After moving, I got a doc that kept up the T4/T3, but I went to an endo for more info. He said Armour was synthetic and only had T4! He was “board certified” and knew better than I.
My current doc (moved again) listens to me, and I am doing fine.
Since starting T4/T3 14 years ago, not only has it helped the brain fog, fatigue and pains, etc., but every time I’ve gone for a eye checkup, my eyes have improved. Nice something is getting better as I age! I’ve also have allergies and finally found the right combo of meds that let me breathe, so I’m finally losing weight, without really doing anything different! Definitely helps getting oxygen!
It may take a while, and life stresses can change it, but just keep at it!

April 20, 2013 at 4:03 am
(53) home renovations oakville says:

I leave a response whenever I especially enjoy a article on a site or I have something to contribute
to the conversation. It’s a result of the fire displayed in the post I browsed. And after this article Good Housekeeping Thyroid Article Causes Controversy Among Patients and Practitioners: Nation’s Top Integrative Physicians and Experts Respond.
I was actually moved enough to drop a leave a responsea response :) I actually do have
a few questions for you if you do not mind. Could it be simply me or does it give
the impression like some of these responses appear like written by brain
dead visitors? :-P And, if you are posting on other online
social sites, I’d like to follow you. Could you list the complete urls of your public sites like your twitter feed, Facebook page or linkedin profile?

April 23, 2013 at 3:17 am
(54) Kristen says:

She won’t be singing the same tune when she has dementia because she didn’t treat her thyroid. If you have antibodies to your thyroid, regardless of your TSH level, your thyroid IS BEING DESTROYED! Studies have shown that thyroid hormones given to patients before they reached the threshold so many doctors mistakenly use as a norm, actually decreased the damage over time to their thyroids, reducing the symptoms. Those not on the meds experienced more damage to their thyroids. The risks of not treating the disease far outweigh the risks of putting someone on the smallest dose of synthroid and changing the dose as needed from that point on. Silly doctors. I agree with the statement that your license is as an M.D., not G.O.D. Doctors fail in not keeping up with the scientific research that is available for them to read!

May 11, 2013 at 8:47 pm
(55) jd says:

What is Susan Carlton’s credentials to write such an artical? Who is she, what kind of background does she have?

May 21, 2013 at 7:51 am
(56) Gloria B says:

Thank you Mary for this very thorough article. And I have to say that my adrenals hurt at the thought of caffeine and spinning class as a remedy for low thyroid. Ouch!!

May 21, 2013 at 8:08 am
(57) Sal Paradise says:

I still believe the real test of this is the end result: which treatments actually work and allow the patient to live a fairly normal life. I know I was ready for the nuthouse when I first had this. It took several months for my GP to even test for it, but once we did and began treatment things were much better. It also took awhile to find out T4 wasn’t working and I needed T3, which then worked very well and which I’ve been on over 2 years. Point is, as you noted, this is a very personal disease and requires unique, not cookie-cutter treatment. The GH article presents one way to deal with it and backed it with doctors who share and reinforce the writers thinking. However, we all know that her approach doesn’t work for everyone, a point she failed to even mention. And, if you ask me, is the key to changing how the disease is taken care of. Her ‘disease of the day’ comment is rather racially charged, designed to downplay people who don’t agree with her and something she needs to be taken to task for.

May 21, 2013 at 9:55 am
(58) Andramida says:

Yes, absolutely I thank you for responding to the so called “good housekeeping” article! I almost dare to say that it doesn’t deserve a response but my fear is that even one person reads that and makes the mistake of ignoring a thyroid disorder or decides not to take their prescribed medication. How sad!

May 21, 2013 at 11:36 am
(59) Ed Arnold says:

no “compelling reason” to treat when TSH is between 5.0 and 10.0? When my TSH was 8, I felt like death warmed over. That seems like a “compelling reason”! HELLO, Susan Carlton, ARE YOU LISTENING??

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