Many of those millions of undiagnosed patients are complaining to their physicians and practitioners about symptoms that could point to thyroid disease, and yet these people are NOT being tested for thyroid disease. Some patients are being misdiagnosed and treated for depression, menopause, or other conditions with symptoms similar to thyroid disease. Other people are victims of a managed care environment that discourages their doctors from ordering blood tests. Still others find that their physicians dismiss the symptoms as stress, aging, or other lifestyle issues.
In their 2005 awareness campaign press release, the AACE says "More than half of the people with thyroid disorders are unaware that they have this medical problem." I find this phrasing interesting, as it seems to put the burden of diagnosis on the patient. The reality is that more than half of the people with thyroid disorders have not been diagnosed . True, some are "unaware" they have a medical problem. But many people are uncomfortably aware, suffering from debilitating symptoms, and complaining to their doctors, only to be misdiagnosed as depressed or menopausal, given a prescription for an antidepressant, or sent off with a handout on proper diet and exercise.
Many Thyroid Patients Don't Feel Well Even After Treatment
Many -- and some say the majority -- of thyroid patients still do not feel well, despite receiving what most endocrinologists consider to be "adequate" treatment. The Thyroid Foundation of America found that two-thirds of Graves' patients on thyroid replacement had a variety of continuing symptoms. In my own 2003 survey of almost 1,000 thyroid patients, nearly 95% still had symptoms despite treatment. The poor level of health of many thyroid patients raises the controversial issue of whether or not Synthroid (the most often prescribed levothyroxine, and third most prescribed drug in America) or levothyroxine in general -- the drug treatments provided most often to the vast majority of patients -- is in fact a sufficient treatment for hypothyroidism.
Almost Half of all Treated Patients Fall Outside the TSH "Normal" Range
Among patients diagnosed with thyroid disease and being treated with thyroid hormone replacement by physicians, an estimated 40% of patients have TSH levels that fall OUTSIDE the normal range of TSH (and this is based on the OLD normal range of .5 to 5.0). * [* Canaris; Gay et. al. "The Colorado Thyroid Disease Prevalence Study," Arch Intern Med. 2000;160:526-534.] This huge number of improperly managed patients suggests that:
- physicians may not be knowledgeable about how to treat hypothyroidism
- monitoring and adjustment of dosages needs to take place more than once a year in order to maintain normal levels
- levothyroxine -- which is the preferred treatment of conventional endocrinologists -- may not be an adequate treatment for a substantial percentage of patients.
Synthroid, made by Abbott, drug enjoys dominance in market share, and was in fact the third most prescribed drug in the U.S. in 2003, with sales of [link url=http://www.rxlist.com/top200_sales_2003.htm">$900 million[/link] in 2003 alone. The nearest competitor was 20th most prescribed Levoxyl, with $200 million in sales in 2003.
As of Jan 13, 2005, a 30-day supply of Synthroid 88 mcg is $13.99, $5.00 per month more than brand name Levothroid, which is only $8.99 for a 30-day supply. and $3.00 more per month than brand name Levoxyl, at $10.99 (Source: Drugstore.com.).
Why does Synthroid continue to charge so much more when there is no double-blind, peer-reviewed, journal-published evidence demonstrating that the drug is any better than competitive brands, much less generic levothyroxine drugs?
Unfortunately, this gouging of America's thyroid patients is an issue that you definitely WON'T see taken up by any of the professional groups or thyroid patient organizations. Because they are all receiving financing from the manufacturers of Synthroid, and to a lesser extent, other thyroid drugs.
The Key Professional and Patient Groups Accept Drug Company Funding, Which Calls Into Question Their Ability to be Unbiased
The professional groups working on thyroid disease -- the American Thyroid Association, the Endocrine Society and the American Association of Clinical Endocrinologists -- all accept substantial funding from various drug manufacturers, and in particular, Synthroid. You can also count in the patient groups -- the Thyroid Foundation of America, the National Graves' Disease Foundation, the Light of Life Foundation, and the Thyroid Cancer Survivor's Association.
