In a message dated 4/14/2002 1:00:28 PM Eastern Daylight Time,
[log in to unmask] writes:

> Andrea Briand <[log in to unmask]>


>  He said thyroid tests are 100% accurate in
>  every single case, it is a very simple test checking for something called
>  TSH.

Dr. Derry is being attacked for believing differently.  The Thyroid
Foundation of Canada says the same thing on their web site, even if you have
all the symptoms and a normal TSH you do not have a thyroid problem.  It
seems the official view in Canada.  And one a lot of U.S. doctors believe.

>.There was a man in the bed ahead of me
>  that was brought in because he had lapsed into a coma. .  But this same
doctor said  to this man's
>  family that his blood tests were perfectly normal, so there was no reason
>  why he was in that coma and there was nothing they could do.
Lots of people have died with perfectly normal labs.  Maybe even what would
be considered good labs. My mother went into a coma and that's when they
started giving her Synthroid after many years of suffering.  Too little, too
late.  But the doctor treating her coma in the hospital knew what it was that
caused the coma.  He called it "some autoimmune disease" and put her on
Synthroid for the rest of her life.  The coma and the years with too little
oxygen made treatment too late.  At least traditional treatment, if she had
an adequate amount of Armour she might have gotten better.

  a blood test a couple of months later said that my thyroid was normal, so
>  this doctor concluded I was on the right supplement and my symptoms were
>  not thyroid related (even though they were the same as before).
That's what my doctor said when I was asking to increase my Armour due to
fatigue, then I developed sleep apnea, and ultimately cured it be increasing
from 2 to 3 grains, but "It couldn't be a thyroid problem."


>  There is a doctor in the U.S. (I am in Canada) who does telephone consults

No thyroid lab test is definitive.  The truth is found in getting better on
medication.  As long as you go slowly, if you can find a mail order source
for Armour, you would probably do just as well treating yourself.  Doctors
probably shouldn't be treating people they don't see.  As for TSH it depends
on the pituitary gland.  What if something is wrong there, is the "more
sensitive" TSH test going to compensate for that?  What if you are simply
having problems converting T4 to T3, they don't really have a good test for
that yet.  Thyroid and adrenal problems typically create the same symptoms,
is she going to be able to say for sure your problem is not your adrenals?
One way to tell that is with the blood pressure test, which you can do
yourself if you get yourself a blood pressure cuff.  If you take your blood
pressure sitting, then take it standing it should increase.  If not then it's
likely there's an adrenal problem, maybe in addition to the thyroid problem.


>   How does the doctor know whether to
>  treat Wilson's (with T3) or to treat for regular hypothyroidism  that is
not yet showing in blood tests?
>  Do the symptoms differ at all between the two?  I hope it is not treated
>  just by trial and error!

They are both forms of hypothyroidism with the same symptoms.  The end result
is the same, your cells are not utilizing or getting enough T3.  One way to
tell is if someone requires large doses of Armour while maintaining normal
pulse and blood pressure.  My wife's blood pressure was high before thryoid
treatment and her pulse over 100.  On 18 grains her blood pressure was normal
and her pulse in the 70s.  Dr. Richard Alford commented in a paper that he
had one person all the way up to 12 grains to compensate for the person's
production or reverse T3.

Wilson's should be the first treatment for someone like Doc Don.  ( I hear
from some people he's a one treatment doctor because he pushes a lot of
people in this direction, but that's far from the truth.)  Someone who goes
to Doc Don has probably already been to a lot of other doctors.  If the
problem was solved by Synthroid, it's likely they would already have been
fixed.  Not getting better on Synthroid is a hint that the problem can only
be solved with T3 which leaves a drug like Armour or Cytomel (time released
for Wilson's. but some get Cytomel without Wilson's treatment.)  Unless
someone has been to several doctors they are not likely to want to follow the
"complicated " treatment.  (Lots of people use the term complicated, that
really just means you have to follow a routine, take your temperature, and
take the medicine every 12 hours and the timing is very important.)  But, one
can get well with Wilson's treatment and not need thyroid meds at all
anymore, a nice advantage Armour doesn't offer.

On the other hand, one can have Wilson's Syndrome plus "regular"
hypothyroidism.  So, the Wilson's treament lets them get by with less
medicine so when they switch back to Armour (if they do) they can get by on
less.  I don't have the classic case of Wilson's my wife has, but I'm taking
the T3 and honestly, I don't know why anyone needs T4.  It's not active and
I'm not sure it changed my labs significantly.  My free T3 much to my
surprise was still in the normal range, and my free T4 is still low.  I
switched back to Armour for a few weeks, just to see if I would feel better
on T4 and the answer was no.

As for hoping the Wilson's treatment isn't trial and error, doctors don't
like that so they use labs instead.  It's OK if a patient goes into a coma as
long as it's not the doctor's fault.  If a patient complained of thryoid
symptoms the doctor probably doesn't have any liability for the outcome if he
took a TSH test.  It's the doctor's standard of practice and if it went to
court the doctor would have a strong defense.

But as for helping people get better who have thyroid problems, it is trial
and error.  The alternative is to rely solely on labs, like the person in the
coma who shouldn't be that way.

Skipper Beers

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