She was 32 years old, dealing with overweight and uncomfortable irregular periods. A medical history revealed a brother with Grave's Disease, a maternal grandfather with Grave's Disease, a paternal aunt with goiter; thus, she had thyroid problems on both sides of the family. Fifteen years ago, she had been treated with thyroxine by her family doctor for a few months, due to tiredness, irregular periods, and severe teenage acne, which helped her to reduce these symptoms and feel better. When a few months later her family doctor retired, her health coverage switched to an HMO, where she was told that she did not need thyroid medicine. Her prescription was no refilled.
Her weight began to increase despite exercise, but otherwise she noticed no other problem in being off the medicine. Except - of course - her periods were once again irregular, now that she was off her thyroid medicine. In the following years, she was seen occasionally by the HMO doctors for a variety of problems, for which they gave her only reassurance and symptomatic treatment. These included: being chillier than other people, more fatigued than others her age, problems with sleeping, episodic hoarseness, severe mood swings, and low sex drive.
All of this was in spite of a very good diet and working out at the gym several days a week. By the time she had come to my office, she was 43 pounds overweight and had most recently been told by her HMO that she had polycystic ovary syndrome. All the dieting she had done from an early age had been unsuccessful in keeping the weight off. She was even checked for abnormal prolactin, with normal test results.
On examination, she was as normal and healthy as the HMO had said - except for a noticeable decrease in the strength of her ankle reflex, and a mildly subnormal temperature. Based on these physical findings, coupled with her compelling family history - AND the fact that she had been tried on thyroid medicine in the past with definite success - I had the definite medical opinion that she was a hypothyroid person at present.
In addition, it was my impression that her low thyroid problem was related to her weight, and her menstrual irregularity, as well a number of other annoying symptoms. Because her blood tests were consistently in the low normal range (called NORMAL by the HMO) she elected to accept a "clinical trial" of thyroid medicine. I simply started her on the type of medicine that had been successful in the past, for her as a teen, and for her family members, who were still being treated.
Once on a simple protocol of thyroxine 50 mcg. pills, starting low and tapering up to 125 mcg. per day, she had a dramatic improvement in a matter of weeks. She was now having 29 day cycles, and was beginning to lose about a pound and a half each week - both of which were a first for her!
She was not needing to wear socks to bed at night any longer, slept better, plus had more energy for exercise during the day. She was less hoarse and less chilly. This improvement has been maintained over the last several years. She considers this now "a miracle"; in her own words "I'm a normal woman now."
From my perspective, it was no miracle at all. She is simply now receiving appropriate treatment for an inherited family imbalance. Lucy's situation was not severe enough for the large HMO for them to consider it worthy of treatment: she was not needing major medical intervention, she didn't require trips to the emergency room, nor did she need procedures, such as surgery or catheterization. Nevertheless, she represents a failure of modern medicine under the HMO protocols.
Once she was treated with a very simple inexpensive and safe medicine, her female hormone life changed for the better. I believe very strongly that this is indeed worthy of treatment. Millions of women - like Lucy - are suffering needlessly from either mild or major female hormone abnormality that can be easily remedied. It saddens and angers me that more of my colleagues do not see it this way, especially my HMO counterparts, who could benefit from preventive measures.
