TREAT YOUR THYROID BETTER Robert G Carlson, MD, FACS

Most endocrinologists. Internists and Family Practice physicians subscribe to the practice guidelines of the American Association of Clinical Endocrinologists. Guidelines that totally disregard a patient’s symptoms and place more importance on worthless reference range lab values. Why do they totally disregard a patient’s plea of classic symptoms of low thyroid function, with weight gain, exhaustion, hair falling out, dry skin and worsening memory, even depression when confronted with a “normal” TSH level??? I have no idea why. I believe how the patient actually feels is the absolute most important decision making factor in choosing therapy as well as in increasing or decreasing doses. The TSH level is absolutely, unadulteratedly worthless test! Studies have repeatedly shown the ineffectiveness and potential harm of only T4-replacement. The studies show that T4-replacement leaves many patients suffering chronically from hypothyroid symptoms and gaining weight they can't lose through dieting and exercise. I believe Synthroid may be a reasonable medication, but ONLY for someone who has no stress. T4 is inactive, and does not interact well with thyroid receptors. It has to be activated to T3, which is the only form of thyroid hormone that interacts with thyroid receptors. Stress blocks this conversion. Therefore giving a patient synthroid to a patient with any type of physical, emotional or situational stress is a worthless effort. It will not work! Patients have to use the combination of T3, and T4. The T3 will provide immediate energy. I prefer the Armour thyroid from Forrest labs, and avoid the use of generic thyroid supplements.
Now here is one more twist. When a person has Hashimoto’s (Autoimmune Thyroiditis), they have antibodies that have attacked their own thyroid. Because these antibodies “gum” everything up and block any hormone from interacting with thyroid receptors, thyroid levels are absolutely worthless. You can have high “normal “ values and still demonstrate severe low thyroid symptoms. The lab tests are worthless, and the ONLY way to manage Hashimoto’s Thyroiditis is by adjusting the medications to a patient’s signs and symptoms. I repeat …Lab results are worthless, and patient’s symptoms are the most important and only way to adjust medications. The only way! So, spending time speaking with patients, as well as ongoing adjustment of thyroid replacement therapies is critical to achieve optimization of thyroid management.

Dr. Rob