Our point is - optimal thyroid care requires freedom of choice from among the wide variety of prescription medicines available. There are four or five different brands of desiccated thyroid, of which Armour is just one. There are four or five varieties of thyroxine available to be prescribed, of which Synthroid is simply one.
T3 thyroid hormone, whether as compounded time-released or the more common Cytomel, is available to be used by itself or in conjunction with any of the previously-mentioned thyroid products. Optimal dosing sometimes requires not just the right size pill of the right medicine, but the right mix of two or more medicines. Every health consumer is unique, and deserves professional expertise in figuring out which medicines suit their particular needs ideally.
This is the kind of freedom of choice that would result in better control of thyroid-related symptoms than simply having everyone follow the AMA or AACE guidelines and get a modest dose of Synthroid.
The above discussion has been about treatment; there is even more controversy about what constitutes optimal diagnosis. Let's take one small example from this enormous field: many millions of health consumers in the state of New York are not allowed, by law, to have anything to do with saliva testing of their hormones. This is in stark contrast to the enormous medical literature regarding the benefits, easy availability of home testing, lower costs, and frequently more accurate results of this method.
Recently the World Health Organization approved saliva home testing for HIV/AIDS, thus granting elevated status to this method. NIH researchers have, for years, been using saliva testing as a quick and accurate way of determining adrenal and sex hormone levels.
What we - as practitioners - find most insulting is that endocrinologists can ignore people with obvious thyroid abnormalities, treating only the test and not the patient - and physician-caused death is estimated to be approximately 100,000 people per year, by modest standards, yet people in New York cannot spit into a test tube to help them evaluate the status of their hormones. How can these rules possibly be protecting people? Or is it a matter of laboratories and pharmacies dictating care based on their bottom line? If so, this is an affront to all we treasure in our country, freedom of care.
In our own practice, blood TSH results have shown themselves to be inferior to saliva TSH results in many cases of borderline hypothyroidism. Even a home fingerprick test for TSH is often more accurate than a laboratory-obtained specimen, because the home test analyzes a fixed dried blood spot while the laboratory sample analyzes serum that may have been sitting for hours at room temperature, allowing the thyroid stimulating hormone to degrade. Therefore, this may not be as reflective of the true patient status.
A blood spot test is considered alternative, or "irregular" according to the dictates of the funded establishment; but the long pull of history is liable to show that it is a more accurate, more economical, and therefore more appropriate technology. This is what is at stake: appropriate technology in health care, optimization of patient lives, not just corporate profits.
Robert F. Kennedy Jr. is eloquent in his new book Crimes Against Nature, saying that the society should no longer be held hostage to the profit motive of corporate polluters. And - by the way - it's often this subsidized and government-condoned corporate pollution that is creating and disseminating into our air, food and water so many of the hormone disrupters that we now need thyroid medication to counter! More about this later topic in our next article.
For now, we believe the time has come to have healthy dialogue, with endocrinologists, medical doctors and other medical practitioners, and the public to determine how the millions of people with mild endocrine disruption can be improved. In our humble view, it needs to be an open-minded discussion, not a dictate by any medical group.
After all, the endocrinologists are frequently refusing treatment to patients with clear and multiple symptomatology, and need to open their eyes to the realities of how millions of Americans feel, being doubly wounded first by years of inattention to their many uncomfortable symptoms, then by being discounted by the very specialists to whom they have paid large sums of money and entrusted their care.
