I wrote a two part article back in May of 2015 called The Two Big Problems with “Typical” Thyroid Hormone Treatment and it was posted by Dana Trentini of Hypothyroid Mom fame. Just recently, the article was reposted on Facebook and there has been a tremendous outpouring of Comments from people who just want to feel better but their “typical” thyroid hormone treatment and typical doctor’s approach is not helping. My heart goes out to you as well as my hand, in the hopes that you know I offer it to serve you as your physician to provide you with the answers you deserve. As the article attempts to make clear…it’s really not that difficult, IF you get the right type of medication and enough of it.
I wanted to address the comments in a global fashion, after reading many of them. There is a running theme with many of them, that tends to unwittingly propagate the ongoing confusion and general frustration of so many patients who have thyroid issues and are on thyroid medication. Many of the FB comments present with a lot of confusion about how to observe or judge what is going on with their thyroid gland and/or medication, and it reminds me of many of the conversations that I have had with patients over the years. A conversation that goes something like this:
Patient: My thyroid feels off, did you get my thyroid labs?
Dr R: Yes. But they aren’t really telling me what is going on with your body. The labs just reflect the amount of hormone in your blood at that moment, but not necessarily how your body tissues are responding.
Patient: Oh. Then how can you tell what’s going on?
Dr R: I can measure your metabolism through a specialized test called a Resting Metabolic Rate test using indirect calorimetry and another test that uses your reflex speed called the Thyroflex test. And along with other clinical signs and symptoms, we can paint a picture of what is doing on with you and then optimize your thyroid hormone dose.
Patient: Wow. That sounds far more detailed than what my regular doctor does.
Dr. R: Yes. I want to truly measure what is going on with your body, versus just looking at a lab value.
Dr R: :)
Dr R: ….. :)
Patient: So…let’s fix my thyroid: what about my THYROID LABS???
And of course, I always meet that statement with a smile and a lot of patience. I get it. I really do. Patients are so amazingly confused and simply used to the idea of using lab work to determine the best course of medical action in almost any medical condition. It is the age of technocratic medicine and we have all been inculcated into this system, whether we like it or not. Well…I don’t like it and neither should you.
Another theme that I saw was how natural forms of thyroid medication, such as Nature Throid or Armour, had the lab values going up and down and as a result the doctor was taking the dose up and down. The problem with this approach is that it is assumed that the doctor is making grand changes in the dose. This normally is not the case. They are small incremental ups and downs that don’t really change anything. And WHEN you get your labs drawn in relationship to when you took your thyroid hormone medication can yield a different number. The values will change literally within hours. So when you compare one lab value to the next, it is not always reflective of what was done with the dose. And of course, those values do not tell us what is going on with your body at the tissue level.
Some people stated they did better on a synthetic T4/T3 combination. This is absolutely true. In my book, The Hormone Zone (Available at my AZ Office), I clearly state that "the best form of thyroid medication is the one that works for you." Over nearly a decade treating patients with natural desiccated thyroid hormone, it has been my personal experience that it works the best…in general. But most of the time, when a given dose of natural desiccated thyroid (ie Armour or Nature Throid) does not work, we just increase the dose slightly until the metabolic rate normalizes. Other times, we may decide to switch a patient to a synthetic T4/T3 combination.
Another theme was how many of your doctors were simply not listening to you about how you were feeling, about how you STILL had the signs and symptoms of hypothyroidism, but were ignored because of a lab value. That is lazy medical practice and you deserve more than that.
Again, my heart goes out to you all and I look forward to serving you. I know many of you are not in Scottsdale, Arizona, but please know that I can consult with you remotely, in a limited capacity, but still GET YOU ANSWERS about your thyroid and all of your hormones. For those of you that can make it to Arizona, or live in Arizona, the “World is Your Oyster” and we can establish a full doctor-patient relationship and really get your life back on track.