There are innovative, enlightened doctors, including a small subsection of endocrinologists, who do in fact understand the process of diagnosing and treating thyroid patients. They recognize:
- Different patients feel better at different TSH levels
- Free T4, Free T3 and thyroid antibodies testing and evaluation may reveal information that can help make a thyroid diagnosis and fine-tune treatment
- Some patients may do better on a brand of levothyroxine besides the market leader Synthroid
- Some patients may require the addition of T3 (via Cytomel, compounded T3, or using the T4/T3 drug Thyrolar)
- Some patients may feel their best on natural desiccated thyroid, such as Armour or Nature-Throid
I champion those doctors who want their thyroid patients to feel and live well -- not just test "normal." I also dare to suggest that there are thyroid treatment options, options patients should ask their doctors to discuss. No surprise then, that the conventional doctors, dogmatic endocrinologists, and old-fashioned "thyroidologists" want to go on the attack. I'm making their job difficult, since they don't have anything to offer but a prescription for their favorite levothyroxine drug!
3. Some doctors have financial incentives to prescribe and support Synthroid, versus other thyroid hormone replacement options.
Synthroid is one of the top five selling drugs in the U.S., and is a consistently profitable drug for its manufacturer. The drug has always been heavily marketed by an army of pharmaceutical sales representatives, and its manufacturer, currently Abbott Labs, provides patient literature, and sponsors endocrinology meetings, med school lectures, and funds various thyroid-related medical organizations and patient organizations. The American Thyroid Association and American Academy of Clinical Endocrinologists, and many individual physicians all have a history of receiving substantial funding from Synthroid's manufacturer. If you want to get ahead in endocrinology, get grant money, advance in one of the professional or patient thyroid groups, or get your golf outing partially paid for, you had better have a good "relationship" with Synthroid, its maker, and its representatives.
Then there's me. Since 1997, I have been actively covering the various scandals and issues involving Synthroid -- including the suppression of research about Synthroid, ultimately published in 1997, the resulting class action suit, the overcharging for the drug, the failure of Synthroid to meet the FDA's deadline for approval of the new drug application for levothyroxine, and other concerns. I've educated patients that there are other brands of levothyroxine, that are equal to, and at certain times better, than Synthroid. I've let patients know that some patients may not feel well on just levothyroxine, and instead require the addition of T3 (via Cytomel, compounded T3, or using the T4/T3 drug Thyrolar -- drugs NOT made by Synthroid's manufacturer). And I've helped educate patients regarding the fact that some may feel their best on natural desiccated thyroid, such as Armour and Nature-Throid. I don't have it out for Synthroid -- it works fine for some thyroid patients. But I do want thyroid patients to know the facts, and to know they have other options. And let's face it, I don't have any vested interest in cozying up to Synthroid. Many doctors and thyroid-related organizations can't say the same.
By making sure that the public knows the full story about this profitable drug and its pervasive influence, I'm posing a threat to an almighty sacred cash cow for many doctors who treat thyroid patients. No wonder some doctors want me to keep quiet!
4. Some doctors look down on self-educated patients.
At one point in my treatment, my regular practitioner suggested I visit another doctor to get a second opinion. So my husband called his internist and asked, "who is the best person you know to deal with thyroid disease." "Me, of course," said the internist. (Some doctors are so modest!)
"But up front, I want you to know that my wife is very informed about things, she reads a great deal about thyroid disease," my husband said.
"Aha," he said. "She's a petit papier woman," said the doctor.
My husband inquired as to what the doctor meant by this. The doctor explained that women who come in with papers, notes, etc. to show to the doctor are often referred in a derogatory way as "petit papier" (little papers, in French) women. He said most doctors did not like "petit papier women," as we're too "high maintenance."
In the end, the doctor turned out to be fairly condescending and ignorant -- he declared after a few minutes that my hair loss problem was "stress" and that it couldn't have anything to do with the Synthroid I was taking at the time. (I did some further research, and discovered transient hair loss was a Synthroid side-effect, and my regular doctor switched me off the Synthroid -- and my problem was solved.)
But the real message is that this doctor was not alone in being intimidated and/or irritated by "petit papier" patients -- patients who read, research, ask questions, and want to discuss options. In Time magazine, Dr. Scott Haig referred to these sorts of empowered, self-educated patients with a more technology-oriented epithet; he derisively calls us as "Googlers".
