JEERS: The American Thyroid Association
Where do we start with the American Thyroid Association (ATA)? This group seem determined as ever to cater to their doctor members, while making a big show out of how much they care about patients. while maintaining what appears to be an undercurrent of hostility toward patients.
If you want to know what this group actually thinks about patients, and how it views those of us who are educated, empowered, or who dare to be partners in our own care -- check out their presentations, titled "Thyroidology on the Internet: The Good, The Bad, and The Ugly," which were given at an ATA meeting in late 2003, and posted on the Internet in 2004.
You may detect a patronizing, condescending and self-congratulatory tone that suggests that for the ATA and its membership, patients and our questions are inconvenient at best. Patients who dare to discuss doctors negatively online, or who discuss alternatives to the conventional therapies, are derided by the ATA in their presentations. (Note, however, the praise given to those groups, sites and bulletin boards funded by their friends at Synthroid!) Special kudos go to Paul Ladenson, who no doubt came up with the name for the presentation, and Matthew Kim, who clearly is taking a page out of Ladenson's book when it comes to his attitude toward patients. View the presentations online now -- if you want an insider's view of the lack of respect some of these folks have for patients.
The endocrinologists who belong to the American Thyroid Association also seem determined to take whatever course lines their pockets most-- with little regard for the impact on their patients. While the issue of perchlorate has become a national concern, with many reputable scientists, including those at the US Environmental Protection Agency, concluding that perchlorate presents a danger to health -- and the thyroid in particular -- the big conclusion of the ATA? "Perchlorate levels in water within the interim EPA guidelines of 4-18 ppb do not appear to be associated with any significant impairment of thyroid gland function in adults." Meanwhile, concerns regarding perchlorate mount, and there is evidence that the government -- fearing vast cleanup costs from decades of perchlorate contamination -- is attempting to downplay or even cover up the extent of the danger. Expect another statement soon from the ATA telling us how perchlorate is safe.
CHEERS: Dr. John Lowe, Practitioner, Researcher and Patient Advocate
Since my start back in 1997 as the a patient advocate, my focus on ensuring patients receive the information they need to get the quality care they deserve has been controversial. For example, the prevailing dogma says that all you need to know is that the TSH test is the gold standard for diagnosis, and the only treatment is T4-replacement/levothyroxine. Even then, the dogma usually stipulates that you use Synthroid, the top-selling levothyroxine drug, the most expensive of all the brands, the one that has legions of drug reps in its employ, and the one that not coincidentally spreads around millions in research money, grants, honoraria, freebies, samples, and support to doctors, endocrinologists, professional groups and patient organizations each year. But all along, I have maintained that patients deserve to know that there are other brands of levothyroxine besides Synthroid, and despite a doctor's allegiance to one brand, another brand may work better for you (not to mention cost you far less). And even then, there are other medicines, such as Cytomel, time-released T3, Thyrolar, or the natural desiccated prescription thyroid drugs like Armour, that may work best for you. I've also maintained that the TSH test itself is only one part of diagnosing thyroid problems, but T4, T3, free T4, free T3 tests, antibodies tests, clinical evaluation of signs and symptoms, and consideration of medical and family history, should also be part of a thorough diagnostic process for thyroid disease. Plus, the TSH "normal" range that is used to rule thyroid disease in and out may not be relevant on an individual basis, it may be flawed, and it is subject to change, making it a rocky foundation on which to base an entire diagnosis and treatment regimen
For continuing to provide information that offers options to patients, I have been derided, and both publicly and privately attacked by heads of medical groups, by pharmaceutical companies, and in particular, by some of the most dogmatic and self-aggrandizing practitioners, who claim to be "real thyroid experts" and charge hefty fees for their for-profit "Second Opinion" services. If you asked any of these so-called "experts," most would insist that the following statements are true:
