Today Show Doctor's Thyroid Mixups

Dr. Judith Reichman May Need a Thyroid Refresher Course

A Normal TSH Rules Out Thyroid Disease?

And finally, Dr. Reichman suggests that to differentiate between thyroid and menopause, "TSH should be checked. If it's normal, than a blood test for FSH [should be performed]..."

Dr. Reichman's suggestion that thyroid diagnosis should solely rely on TSH overlooks current research, which indicates that elevation of thyroid antibody levels frequently precede elevation of TSH level, and that treatment of elevated antibodies can reduce the incidence and degree of autoimmune disease progression, and may prevent full-scale hypothyroidism and elevation of TSH levels.

The TSH test, then, is insufficient to screen out autoimmune thyroid disease in the perimenopausal and menopausal population.
Update December 10, 2002

Last week, I reported on an inaccurate television segment and accompanying NBC news web article on thyroid disease presented by NBC Weekend Today Show medical correspondent Judith Reichman, MD. ([link url=http://thyroid.about.com/library/weekly/aatodayshow.htm]See the original article[/link].) I had written to the producers of NBC Today to register my concerns, and many site readers also contacted the Weekend Today to indicate their concerns with the inaccuracies.

I received a quick email back from the producer saying only that NBC was interested in making sure that the information they presented was accurate. At that point, a check of the web page indicated that one of the most serious inaccuracies, Dr. Reichman's assertion that natural desiccated thyroid came from cows, was revised, along with typographical errors that spelled levothyroxine as "levothyroxin," and Levoxyl as "Levoxil."

All the other inaccuracies have yet to be addressed, however, and so I wrote another letter to Weekend Today producer Susan Dutcher, who has not responded as of this publication date.

December 1, 2002

Susan Dutcher, Producer
Weekend Today
NBC News
By Fax

Dear Ms. Dutcher:

As a patient advocate working in the area of thyroid and autoimmune disease education, I am thrilled that Weekend Today tackled the difficult topic of hypothyroidism in your segment with Dr. Judith Reichman, and commend you for covering a frequently overlooked subject.

Unfortunately, Dr. Reichman's report contained a number of factual errors, errors that are repeated on your web page article, located at [link url=http://msnbc.com/news/832178.asp]http://msnbc.com/news/832178.asp[/link].

Again:

Dr. Reichman says: "If the TSH is high, some doctors will want to proceed further and check all of the thyroid hormones (T3, T4 and Free Thyroxin Index), but those are fancy-schmanzy (sic) tests which just confirm what the TSH has already told us." Actually, the T3, T4, Free T4, and Free T3 tests are used to diagnose and confirm various forms of secondary and tertiary hypothyroidism, as well as thyroid disorders caused by pituitary or hypothalamic dysfunction. Since the topic was hypothyroidism and menopause, Dr. Reichman will also want to make her viewers and readers aware that the use of estrogen -- whether via the pill, or hormone replacement therapy -- can affect T4 and TSH levels. (Arafah, M.D., Baha M. "Increased Need for Thyroxine in Women with Hypothyroidism during Estrogen Therapy," New England Journal of Medicine, Volume 344:1743-1749 June 7, 2001 Number 23, [link url=http://content.nejm.org/cgi/content/short/344/23/1743]http://content.nejm.org/cgi/content/short/3 44/23/1743[/link]) Dr. Reichman also failed to mention thyroid antibody tests, which are used to diagnose Hashimoto's and Graves' disease, autoimmune conditions that are the two most common causes of all thyroid conditions.

Second, Dr. Reichman says: "The good news is that once you settle on the right dose, it generally doesn't change." In fact, the dose does often change. It can change from winter to summer, with weight gain or loss, during and after pregnancy, when starting or stopping a high-fiber diet, when starting or stopping estrogen medications, when starting or stopping anti-depressant medications, when starting or stopping a high-isoflavone/soy diet, or when in perimenopause or menopause. It can also change in response to use of supplements containing calcium or iron.