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Thyroid Disorders Message Board
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Old 09-06-2004, 12:25 PM   #1
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Angry This is what we are up against

No wonder it's so hard to get doctors to listen to us. This is directly from the Canadian Thyroid Website's FAQ

QUESTION 3:
I have been feeling very fatigued for many years. I also complain of constipation, lethargy, inability to concentrate and weight gain. I have seen several doctors including an endocrinologist; they have tested my thyroid with blood tests on many occasions. The tests always come back completely normal. Yet, I have been reading that these tests are not accurate and that measurements of body temperatures are more accurate. Moreover, I understand that I should be taking thyroid medication for these symptoms despite normal thyroid function tests.


ANSWER:
Actually the routine blood tests for thyroid function are extremely accurate and precise. Moreover, the blood tests for thyroid stimulating hormone (TSH) (which is the pituitary hormone that stimulates the thyroid even more when it is failing) is extremely accurate. It is the first test to rise when thyroid function is at all low. Indeed, it will go up even before the thyroid hormone levels are detectably lower. This is a category termed "compensated" hypothyroidism. In that state, the thyroid hormone levels are still normal, the patient still feels normal but the TSH is already an indicator that the thyroid gland itself is in trouble. In your case, with a normal TSH, hypothyroidism is completely ruled out. It is important to remember that many other conditions can mimic hypothyroidism, most particularly chronic anxiety, depression and stress. Some psychiatrists use T3 (Cytomel, triiodothyronine) but usually not thyroxine, with antidepressants. How useful this combination is, remains to be proven. It is true, however, that such people who do not have thyroid disease can "benefit" from taking thyroid medication. The reason they are benefiting is that the thyroid medication is a "placebo". The drug itself has no intrinsic benefit to them, but if people think it is going to help them, then it does. It is like fooling yourself by taking a pill that looks identical but is completely inert. If we convince ourselves that there is some good in it, then we feel much better. Sometimes this placebo effect is truly remarkable and long lasting. More often, however, it lasts for only a short time and disappears. Taking thyroxine when you do not need it, is also of some danger and cannot be encouraged. Finally, skin temperatures are of no value in diagnosing hypothyroidism despite assertions to the contrary by some. It has been clearly proven they are totally misleading and really useless. While it is true that patients with hypothyroidism do have cool skin, so do people with many other conditions. These include people with poor blood supply, severe stress, anaemia and others.

This was practically verbatim what my Doctor said to me last month. Simply reading this makes me angry. Now I'm a little new to this, so please correct me if I am wrong, but if you gave thyroid meds to someone who was not hypothyroid would it not have some effect on them - wouldn't it make them hyPER? Placebo?!!

Nat
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Old 09-06-2004, 01:04 PM   #2
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Re: This is what we are up against

Reading this makes me mad too. I have a normal TSH, always have. What brought about my diagnoses was that my thyroid was enlarged. The doctor that started me on medication should of had a thyroid scan of my thyroid, to confirm his findings. If I knew what I know now about thyroid disease I would have requested one. Like I said before my TSH has always been normal on and off thyroid meds, however my free T3 & T4 are very low when I am not on any meds. And I have so many symptoms of hypothyroidism that I truly feel better when taking something and it's not a "placebo" effect. Oh and I have elevated TPO's and a nodule too.
So what this doctor is saying is that the TSH is the all mighty indicator of thyroid disease and nothing else matters!?

 
Old 09-06-2004, 01:23 PM   #3
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Re: This is what we are up against

Quote:
Originally Posted by dlkk
So what this doctor is saying is that the TSH is the all mighty indicator of thyroid disease and nothing else matters!?
Yes, I take it as exactly what they are saying here. This was exactly what two GPs told me last month; my TSH (4.3) is within normal ranges and therefore I am not hypothyroid - I am normal.

Infuriating, isn't it?
Nat
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Old 09-06-2004, 01:27 PM   #4
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Re: This is what we are up against

Quote:
Infuriating, isn't it?
Yes, very.

 
Old 09-06-2004, 02:20 PM   #5
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Re: This is what we are up against

Quote:
Infuriating, isn't it?
Infuriating isn't nearly a strong enough term.
I've said this before... forgive me if you've heard it already. A similar ignorance about the cause of stomach ulcers was stubbornly adhered to for a full ten years after a young Dr. Marshall discovered a bacterium that causes them. No one in the medical "old boys' club" would listen to him that ulcers can be cured simply and easily with antibiotics and antacids. He even infected himself with the bacterium, which caused an ulcer that he cured with his method... STILL they wouldn't listen!
These arrogant doctors time and again perpetuate myths for decades after they've been disproven - not just about ulcers, but about many conditions. So many people are doomed to misery until then. Lives ruined....

In the case of thyroid tests, though, we may be doomed for a couple more centuries. Thyroid disease was much more often successfully treated before the advent of the almighty TSH test. People were treated by their symptoms, and they got better. Period. Doctors knew more then than they do now... because the tests are much more unreliable than the the dox clinical experience ever was.
Now that there are tests, someone ought to teach these fools how to actually interpret them.

 
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