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Jason - 28 Apr 2007 21:07 GMT

I just finished reading this book:

"Hypothyroidism--The Unsuspected Illness" by Broda O. Barnes, M.D.

Doctor Barnes practiced medicine from about 1950 to 1988. He specialized
in treating patients that had hypothyroidism. He prescribed thyroid
hormones to all of his patients that had a lower than normal body
temperature. He kept records related to all of his patients.
The information in the book was mostly based upon those records and the
research projects that he conducted related to hypothyroidism.

Hypothyroidism is associated with about a dozen different diseases such as
Skin Diseases; psychological problems such as depression and anxiety;
menstrual disorders; heart disease; arthritis; diabetes; lung diseases;
obesity and aging related diseases. His records indicated that none of his
patients that took thyroid hormones on a daily basis ever developed any of
those diseases. Many of the patients that already had any of those
diseases were helped in a major way by taking thyroid hormones.

The medical establishment had determined that the TSH (thyroid related
blood test) should be 0.27 to 4.2. I downloaded a report which indicated
that really healthy people have a TSH score of 0.5 to 1.5 MMOL/L. It's MY
opinion that the reference range for TSH should be 0.5 to 1.5 instead of
0.27 to 4.2. If that happened--millions of people would be prescribed
thyroid hormones. Most of those people would NEVER develop any of the
diseases or disorders mentioned above. The drug companies would lose
billions of dollars. Specialists that treat the disorders mentioned above
would lose billions of dollars. Needless to say, the TSH reference range
will NEVER be changed to 0.5 to 1.5 because the medical establishment is
more concerned with making money than helping people. Of course, I know
that some doctors really do care about their patients but they have to
follow the rules established by the medical establishment. For example, my
doctor once told me that he could NOT refer me to a specialist unless he
had blood tests, X-Rays or urine tests to prove that the referral was
needed. Of course, there are exceptions such as recent referral for a
colonscopy.

www.emedicine.com/med/topic1145.htm

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00doc - 29 Apr 2007 02:43 GMT

>I just finished reading this book:
>
[quoted text clipped - 6 lines]
> The information in the book was mostly based upon those records and the
> research projects that he conducted related to hypothyroidism.

The problem with this, other than the fact that it has nothing to do with
asthma, is that we know shockingly little about what temperature range is
normal. The commonly quoted 98.6 figure is first of all a conversion from 37
degrees Celcius and so should properly be 99 degrees (you only have two
digits so it is improper to imply more precision than there is by adding a
third).

More imporantly the figure was derived in the 1800's by a man named
Wunderlich who used 6-8 inch home made thermometers. The one that survives
today is known to be a degree off (it is at the Mutter museum in
Philadelphia). He took his temps at different cites. Most of the
thermomerters were too large to put under the tongue so he used mostly
axillary (arm pit) temperatures which are about a degree lower then oral
temps (which are a degree lower then rectal and tympanic membrane temps.

More recent research done with modern thermometers suggests that the normal
range is probably lower than 98.6. Most of that has been done on populations
such as VA hospital inpatients, who are not represenative of the general
population. Most of those people who think they have lower than normal temps
(and the people who study them) are laboring under a false delusion. This
guy's subjects were probably completely normal and so any findings he
derived from studying them was probably a fantasy.

> Hypothyroidism is associated with about a dozen different diseases such as
> Skin Diseases; psychological problems such as depression and anxiety;
[quoted text clipped - 3 lines]
> those diseases. Many of the patients that already had any of those
> diseases were helped in a major way by taking thyroid hormones.

I can assure you that I personally know many people who are on thyroid
medication and have diseases such as those.

> The medical establishment had determined that the TSH (thyroid related
> blood test) should be 0.27 to 4.2. I downloaded a report which indicated
> that really healthy people have a TSH score of 0.5 to 1.5 MMOL/L.

There is also research that suggests that in elderly people keeping the
range between 4 and 6 is associated with less mortality than lower figures.
The optimum TSH range for supplementation is not well understtod and the
subject of active debate. There is no credible research that shows that
people with TSH's in the lower half of the normal range are healthier. many
experts advocate not initiating thyroid hormone until the TSH is greater
that 10 (I'm not interested in defending that particular cut-off, or any
other. I'm just pointing out the breadth of the controversy).

> It's MY
> opinion that the reference range for TSH should be 0.5 to 1.5 instead of
> 0.27 to 4.2.

Oh boy! You are feeling rather grandiose these days. It is really nice how
with a few minutes of "Googling" you can resolve with such confidence a
debate that has been perplexing some of the best specialists we have (see
below).

Let me guess - you have a TSH somewhere between 1.5 and 5 and now you are on
a campaign to have your doc give you thyroid hormone but he refuses saying
that your TSH is normal. I guess we can add weak thryoid to your weak
kidneys.

> If that happened--millions of people would be prescribed
> thyroid hormones. Most of those people would NEVER develop any of the
> diseases or disorders mentioned above.

If it sounds too good to be true......

> The drug companies would lose
> billions of dollars.

Huh? Uh.......are you forgetting the makers of thryoid hormones?

> Specialists that treat the disorders mentioned above
> would lose billions of dollars.

And the endocrinologists would make those billions instead.

> Needless to say, the TSH reference range
> will NEVER be changed to 0.5 to 1.5 because the medical establishment is
> more concerned with making money than helping people.

Why would the parts that stand to win cooperate?

If this was really true why would the docs ever cure anybody?

> Of course, I know
> that some doctors really do care about their patients but they have to
> follow the rules established by the medical establishment.

Like???

I am perfectly free to prescribe thryoid hormone if I think there is
credible reason to do so. This rule giving establisment you are speaking of
is the product of conspiracy theorist's imaginations.

> For example, my
> doctor once told me that he could NOT refer me to a specialist unless he
> had blood tests, X-Rays or urine tests to prove that the referral was
> needed.

We've talked about this before. Your doctor was giving you a line becuse he
didn't want to look like a jack-a.s by referring a perfectly healthy person
to a specialist to evaluate a problen that does not exist.

> Of course, there are exceptions such as recent referral for a
> colonscopy.

Maybe that is not an exception and just shows that he is free to refer
whenever he sees the need.

> www.emedicine.com/med/topic1145.htm

Emedicine is a good site. This article has this to say:

"Significant controversy persists regarding the treatment of patients with
mild hypothyroidism. Some have argued that treatment of these patients
improves symptoms, prevents progression to overt hypothyroidism, and may
have cardioprotective benefits. Recent reviews by the American Medical
Association and US Preventive Services Task Force have found inconclusive
evidence to recommend aggressive treatment of patients with TSH levels of
4.5-10 mU/L."

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00doc

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Jason - 29 Apr 2007 03:58 GMT

> >I just finished reading this book:
> >
[quoted text clipped - 128 lines]
> evidence to recommend aggressive treatment of patients with TSH levels of
> 4.5-10 mU/L."

`````````````````````````````

doc,
You made some excellent points. I am a member of this newsgroup:
alt.support.thyroid
I have seen at least a dozen posts from people that claim they only feel
normal when their TSH levels are less than 2.0 MMOL/L. My TSH level on my
last blood test was 7.56 MMOL/L. My doctor believes it was a lab error
since the TSH levels on former blood tests were less than 2.2 MM0L/L. I
will get another Thyroid function blood test next week. I would like to
get medication if my TSH level is still over 7.00 MMOL/L. Of course, if my
THS level on the next blood test is less than 2.2--I do not want any
thyroid medication. I was really healthy for most of my life so I know
what it is like to be healthy. For the last two years, I have had fatique
problems, depression problems, edema problems, and memory problems. I
would like to know the reasons for those symptoms. I am 56 years old. One
doctor told me not to be concerned with the reason for those symptoms. I
disagree. If I did not have the symptoms mentioned above, I would not be
concerned about medical problems. Since I do have those symptoms, I would
like to know the reason for those symptoms. My doctor believes that I have
no major medical problems and is no longer concerned about finding the
reason for my symptoms. He did refer me for a stress test since he
believes a weak heart was the reason for the edema. the cardio told me
that my heart is working great. In relation to kidney problems, my
creatinine level on one of my blood tests was 1.7 but it has came back
down to 1.0 as a result of a low protein diet.
You made this point:

> I can assure you that I personally know many people who are on thyroid
> medication and have diseases such as those.

Doctor Barnes also had patients that had those diseases. His point was
that they would NOT have developed those diseases if they had been taking
thyroid hormones every day--several years before they developed those
diseases. He stated that NONE of his many pateints that took thyroid
medication developed any of those diseases while they were under his care.
I believe he was telling the truth. Of course, we both know that those
patients did not live forever. If you do not believe me, read the book. I
seem to recall that he believes that a perfectly working thyroid gland
will prevent people from developing major diseases that are associated
with thyroid function. He even believed that thyroid hormones will even
help people that already have those diseases. I don't recall any of the
case studies indicating that thyroid hormones CURED any of those diseases.

Since body temp. is no longer used by doctors to screen for thyroid
disorders, it does not matter. Dr. Brody believed that body temp. was
related to matabolism. He had problems with a test that was used at that
time that was called the "basil metabolism test."

Have a great Sunday,
Jason

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00doc - 29 Apr 2007 15:58 GMT

> I have seen at least a dozen posts from people that claim they only feel
> normal when their TSH levels are less than 2.0 MMOL/L.

If you are going to thyroid newsgroups then I am sure you have also seen
posts from people who claim that T3 must be given because T4 doesn't work
and the TSH should be suppressed to zero. I've seen plenty of people myself
who continued to complain of all the orginal symptoms despite thyroid
supplementation to low TSH's and then were pisssed of when I advised them to
lower their dose rather than increase it further. I'm not saying that there
is not a group of hypothyroid people who need to be supplemented to a TSH
below 2 to feel better. I don't pretend the science on the subject has that
degree of accuracy. I'm just saying that in general you can't take every
clain made in usenet posts at face value. The symptoms of thyroid disease
are so vague and subjective that this is especially so.

Most people who come in complaining of symptoms that could be from thryoid
disease have totally normal thyroids. I personally think most of it is from
lack of sleep, lack of exercise, stress, deitary and weight issues and
unrealistic expectations about how good they are supposed to feel. These
things are much more common than thryoid problems so even when it turns out
that some of them do have a high TSH the odds are that the thyroid is not
the whole issue if it is any of the issue at all. That explains why you get
so many people claiming all the things they do about the inaccuracies of
thyroid testing and the inadequacy of typical thyroid supplementation. They
simply have the more common reasons for fatigue etc instead of, or in
addition to, the less common condition of thryoid disorders.

As I said above - if the person feels better at a TSH of 1 than a TSH of 4
I can buy that and have no discomfort with trying to keep them there
(provided they were found to be hypothryoid in the first place). I think the
people who insist they need a TSH of less than 0.5 should look elsewhere for
the cause of their symptoms.

> My TSH level on my
> last blood test was 7.56 MMOL/L. My doctor believes it was a lab error
> since the TSH levels on former blood tests were less than 2.2 MM0L/L. I
> will get another Thyroid function blood test next week. I would like to
> get medication if my TSH level is still over 7.00 MMOL/L.

Like I said in the other post you are in a grey area. It is clear from a
very large and consistent body of evidence that 95% of normal people will
have TSH's between about 0.5 and 5. Anyone telling you that TSH's in the 3-5
range reflect disease is simply talking out of his hat without reasonable
evidence to back him up.

7 is clearly abnormal. That is easy to say, however, it is much harder to
prove that you will benefit from having it reduced to the normal range. The
studies that have been done on people with TSH's in the 5-10 range have been
inconclusive and it has been surprisingly hard ot show a benefit of
treatment. As I mentioned before there is even some liturature that
sugggests treatment may even be harmful at least in elderly people. The
vast majority will have normal thyroid hormone levels when they are directly
measured and so will be termed "subclinically" hypothyroid. I always found
this term to be somewhat perplexing since presumably if they were not
showing clinical signs of hypothyroidism they wouldn't have been tested in
the first place (or shouldn't have been). Perhaps "subchemically"
hypothyroid would be more accurate.

Personally, I believe in treating the patient rather than the numbers. That
is not to say that I would completely ignore the numbers and continue to
escalate the dose based solely on symptoms despite a TSH of less than 0.5.
However, in your case I would give a trial of thryoid hormone and see if you
get better. If so, continue them and if not stop them and see if you
suddenly go back to feeling worse.

> You made this point:
>
[quoted text clipped - 5 lines]
> thyroid hormones every day--several years before they developed those
> diseases.

1) That is one of those assertons that needs some proof.

2) How would that even be practical? Who would we start the thryoid hormone
on as a preventative?
Everyone?

3) My expericens is that people who are on thyroid hormone do get those
problems with at least the same rates as everyone else.

> He stated that NONE of his many pateints that took thyroid
> medication developed any of those diseases while they were under his care.

I'd loved to see the proof of that. Frankly I find it hard to believe. What
I can believe is that he was zealous about his theory and just closed his
eyes to it in his patients. Probably what happened was that he told them
they couldn't have those problems since they would not get them while in his
care. Some believed him and stayed and attributed their symptoms to other
things (possibly things he suggested) and some left and didn't come back. I
believe that he and his patients did not believe they had those problems. I
don't believe none did.

A common example of this is allergies in young children. Many pediatricians
believe that a child under 1-2 years old cannot develop seasonal allergies.
I am currently successfully treating many of their former patients with
allergy meds. Those docs will still point to their practices and tell you
they have never seen a case of it. I think an old saying in medicine is apt:
"It saw them they just didn't see it."

> I believe he was telling the truth.

I'm sure both that he was not knowingly lying and that he was not telling
the truth.

> If you do not believe me, read the book.

I read the Wizzard of Oz and don't believe a word of it either. I'd believe
it if he bothered to publish his findings in peer reviewed journals and if
they were replicated by others. For some reason these guys with 100%
response rates never want to submit to rigorous study. Instead, they just
write books in the lay press and claim their truths are being ignored or
actively suppressed.

> Since body temp. is no longer used by doctors to screen for thyroid
> disorders, it does not matter.

It also renders any research based on body temp used to determine thyroid
function suspect at best.

> Dr. Brody believed that body temp. was
> related to matabolism.

It is a balance between heat produced and heat expended. Many things affect
both sides of the equation.

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Jason - 29 Apr 2007 19:01 GMT

> > I have seen at least a dozen posts from people that claim they only feel
> > normal when their TSH levels are less than 2.0 MMOL/L.
[quoted text clipped - 28 lines]
> people who insist they need a TSH of less than 0.5 should look elsewhere for
> the cause of their symptoms.

~~~~~~~~~~~~~~~~~~~~~~~~~

doc,
Believe it or not, I agree with you.
jason
~~~~~~~~~~~~~~~~~~~~~~~~~~~

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