"You may never need another thyroid test again"

Listening to the patient. Empirical medicine. Sir William Osler would approve....

From the page:
“These blood tests – they don’t work for you. They didn’t help you over the last 15 years you’ve been having problems, even when your problems became worse over the last two. It is because these thyroid antibodies variably bind up the hormones you have. There is no way to tell how much thyroid hormone you need based upon blood tests.”

Michelle’s eyes were rolling back into her head and her mouth was sagging open.

She obviously needed more of an explanation. “Let’s try another analogy. When a traffic helicopter flies overhead, it sees all the cars on the road – and says, ‘There’s plenty of transportation to take people around the city.’ But what if a meter maid noticed they didn’t pay their parking tickets and put a red parking boot on some of them. They wouldn’t be able to go anywhere. In order to have enough transportation for the city – you might need twice as many cars. Unfortunately – there is no way to know how vicious that meter maid is – we just know that she is there. There is no way to know how much of a negative effect those thyroid antibodies are having, we just know that they are there. The presence of thyroid antibodies throws off every thyroid test, including the TSH.”

Michelle was exasperated. Slumping back in her chair, “Then how will I ever know how much medicine to be on?”

“You forgot, there is one more type of testing that will be most effective for you.” Michelle became interested again and leaned forward. “We should test the effect that thyroid hormones have on your body. With hormone resistance, it is often easier and more effective to test the function of the hormone, not the actual level. This idea isn’t new. In Type II Diabetes, we know there is insulin hormone resistance. We don’t check insulin levels – we check what it does by monitoring your blood sugar levels. There are many different types of thyroid hormone resistance. In addition to the Reverse T3 phenomenon and Thyroid Antibodies, some people are deficient of essential fatty acids or other vitamins, limiting thyroid hormone’s ability to get into the brain or other cells to have its full effect.9,10 We just have to check what thyroid hormone does in your body.

“Though active thyroid hormone is needed to lower cholesterol and blood pressure, to raise blood sugar when hypoglycemic, and to convert beta-carotene into Vitamin A, there is no specific blood test to show whether thyroid hormone is working properly or not. Dr. Broda Barnes, MD, PhD, who wrote one of the first books on hypothyroidism, ‘Hypothyroidism: the unsuspected illness,' described a simple temperature test using a mercury thermometer.11 Mercury thermometers are more accurate than digital ones, and because they are hard to find nowadays, I’ll sell one to you for a dollar (that’s all they cost me). Here is a handout to describe how to do the test.

“Lastly, I want you to take this sheet of paper that has ten, 10-point scales on it. I want you to write down the ten things most important to you. For the first line, fill in ‘Energy Level.' Zero will be where you can’t get out of bed, ten being where you are excited about travel and are planning a fun trip. If you are spending money you don’t have, you might be at a twelve. Please call me before they take away your credit cards.” Michelle smiled. “Fill in the other nine items with the things most important to you: weight, skin, and mood are three things you’ve already mentioned. Many people also put down constipation, hair growth/loss, nail quality, and cold/heat intolerance, menstrual periods, and libido. Lastly, there are checkboxes at the bottom for ‘Palpitations’ (sensations of your heartbeat) and ‘Anxiety.' If you feel like you have too much coffee or caffeine in your system, you might be getting too much medication. Every so often, scale yourself. If you are getting better – then we know you are on the right track.”

“I think I finally understand these tests, so what do we do now? You said I would have options in choosing my own care.”

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Sir William Osler tailored treatment for optimum patient wellness.