The Thyroid Paradox , livre ebook

Turner Publishing Company - James K. Rone

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95 pages

English

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Readers who suffere from low thyroid, or think they might, can find the missing answers. For the person who's been told it's not your thyroid, without then being told convincingly what the problem is. This book provides readers with the knowledge needed to communicate and work with their docteors to get the treatment they deserve.

Sujets

Complementary Medicine

Alternative Medicine

Medical

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Publié par	Turner Publishing Company
Date de parution	01 juin 2007
Nombre de lectures	0
EAN13	9781591205401
Langue	English

Informations légales : prix de location à la page 0,0948€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

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How to Get the Best Care for Hypothyroidism
J AMES K. R ONE , M.D.
The information contained in this book is based upon the research and personal and professional experiences of the author. It is not intended as a substitute for consulting with your physician or other healthcare provider. Any attempt to diagnose and treat an illness should be done under the direction of a healthcare professional.
The publisher does not advocate the use of any particular healthcare protocol but believes the information in this book should be available to the public. The publisher and author are not responsible for any adverse effects or consequences resulting from the use of the suggestions, preparations, or procedures discussed in this book. Should the reader have any questions concerning the appropriateness of any procedures or preparation mentioned, the author and the publisher strongly suggest consulting a professional healthcare advisor.
Basic Health Publications, Inc.
28812 Top of the World Drive
Laguna Beach, CA 92651 949-715-7327 • www.basichealthpub.com
Library of Congress Cataloging-in-Publication Data
Rone, James K.
The thyroid paradox : how to get the best care for hypothyroidism / James K. Rone.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-59120-540-1
1. Hypothyroidism. I. Title.
RC657.R65 2007
616.4'44—dc22
2007003190

Copyright © 2007 by James K. Rone, M.D.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written consent of the copyright owner.
Editor: John Anderson
Typesetting/Book design: Gary A. Rosenberg
Cover design: Mike Stromberg
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
C ONTENTS
Introduction
CHAPTER 1 Thyroid Boot Camp
CHAPTER 2 When to Think Low Thyroid
CHAPTER 3 Low-Thyroid Diagnosis
CHAPTER 4 Human Error in Thyroid Testing
CHAPTER 5 Atypical Hypothyroidism: Central Defects
CHAPTER 6 Atypical Hypothyroidism: Peripheral Defects
CHAPTER 7 Thyroid Replacement
CHAPTER 8 Monitoring and Troubleshooting Thyroid Replacement
CHAPTER 9 Escaping the Paradox
Epilogue
Glossary
References
About the Author
A CKNOWLEDGMENTS
For inspiring this book, I thank my patients: they have been and are my greatest teachers. Many physicians and professors shaped me, through the facts and skills they taught or urged me to learn, and through their professionalism, which I continually strive to emulate. I cannot name them all, but a few (in no special order) are: Eugene Mayer, Abdul Ghaffar, Uwe Fohlmeister, Rob Perlstein, Bob Dons, Steve Breitzke, Kevin Tong, O’Neill Barrett, Paul Graham, Ed Quinones, and Charlie Reasner.

For editorial assistance, Meredith Wogan.

For life and commitment, my mother.

For all things, the late William E. Rone, Jr.—writer and father.

For love, support, and friendship always, Susan.
Paradox 1. A seemingly contradictory statement that may nonetheless be true. 2. One exhibiting inexplicable or contradictory aspects. 3. An assertion that is essentially self-contradictory, though based on a valid deduction from acceptable premises. 4. A statement contrary to received opinion.
— American Heritage Dictionary of the English Language,
4th edition

Hypothyroidism Diminished production of thyroid hormone, leading to thyroid insufficiency.

— Illustrated Stedman’s Medical Dictionary,
24th edition
I NTRODUCTION
D
rawing from my personal and professional experience with hypothyroidism, The Thyroid Paradox scrutinizes a healthcare system tacking off course. The intended destination is the quality care of lowthyroid patients. The opposing forces? To quote Captain Reneau from the film Casablanca, “Round up the usual suspects.” Suspects that include insurance carriers, government oversight and interference, and litigation run amok. These oft-blamed villains wreak as much havoc in the thyroid clinic as anywhere. But more egregious obstacles to identifying and treating hypothyroidism arise from within medicine itself, in the form of scientific stagnation and clinical simplism.
By scientific stagnation, I mean doctors thinking in overly dogmatic terms—the thyroid is this way, no other, and won’t ever change. Among respected doctors at universities and research institutes who teach future and current doctors how to practice medicine, I see a pervasive resistance to entertaining any possibility that established thyroid doctrine might be, if not wrong, at least not entirely correct. Worse, I have witnessed a “conspiracy of silence” about the weaknesses of current thyroidology practice, despite supportive data published by that same academic elite.
The second half of the problem—clinical simplism—is embedded in the close-mindedness of the first half—and in the natural human tendency to follow paths of least resistance. If thyroid disease travels over a single metaphorical railroad track, then doctors in the trenches of real-world medicine need not waste much of their limited time per patient wondering where a particular thyroid train is headed. Similarly, they needn’t expend any imagination thinking beyond the obvious.
I allude here to honest but mistaken assumptions about the intricacies of thyroid disease. Some clinical simplism, though, is deliberate, imposed from outside the ranks of doctors, nurses, and other direct caregivers by institutions with agendas not necessarily devoted to your getting the most benefit out of your doctor-patient relationship.
HYPOTHYROIDISM IS UNDERDIAGNOSED
If you suffer from low thyroid, or think you might, and want to learn more—especially if you’re dissatisfied with the answers you’re getting from your doctor—this book is for you. We will not wallow in medicosocio-economic esoterica. The extent to which these matters occupy coming chapters will be offered only to postulate explanations for why modern health care in America so often, incongruously, does a lousy job—even fails, in some cases—at finding and fixing a relatively straightforward condition. What follows is an overview of thyroid physiology and the disorder resulting from thyroid hormone insufficiency— hypothyroidism. A condition known to be common that paradoxically may be rampantly overlooked.
How common is hypothyroidism? One summary of studies published between 1977 and 1995 indicates that almost 1 percent of women in the United States, Europe, and Japan suffers from hypothyroidism. Men too are affected, but less often. More recent research claims that 5.8 percent of females and 3.4 percent of males above the age of twelve in the United States are hypothyroid. Yet, hypothyroidism is underdiagnosed. Peer-reviewed research supports this fact. In my opinion, though, the problem is even worse than mainstream research indicates. The question is not whether we miss hypothyroidism, but rather how much of it do we miss?
Many people have complaints consistent with low thyroid (fatigue, for example), yet they have never been tagged with a thyroid diagnosis. Two possible reasons are that they don’t have a thyroid problem, or they do and it’s been overlooked. Perhaps their doctors never checked, never measured blood thyrotropin levels (which is how almost all hypothyroidism is found nowadays). Or perhaps they did blood work and declared it “normal.” In any given case, of course, the doctor might be right. Fatigue, for example, has many dozens of possible causes, ranging from the normal physiologic response to overexertion to deadly malignancies. In fact, all chronic diseases are probably associated with some degree of fatigue. Sometimes, however, the thyroid system is defective in these people, but in a way too subtle or obscure to be easily detected. In other words, the doctor could be wrong.
Remember the 1 percent to 6 percent of women that research says are hypothyroid? That data came from studies labeling people low thyroid only when blood tests proved it. How accurate are those tests and do they miss anybody? I think they do. Low thyroid is common, everybody knows it’s common, yet cases are missed.
That is the titular paradox.
MY EXPERIENCE AS BOTH PHYSICIAN AND PATIENT
Much information about hypothyroidism is at your fingertips via the Internet, libraries, bookstores, magazines, and word of mouth, not to mention your doctor. As a user of such resources, this book included, you owe it to yourself to be critical. Consider the source and make certain there is adequate reason to trust that source. If you’re reading this, you’re probably not a person with unquestioning faith in your doctor’s opinion. If you’re skeptical or just want to explore alternatives, I suggest you seek out several references so you don’t wind up following anything too radical or dangerous. My wife won’t buy a toaster without scouring Consumer Reports. At least as much caution is warranted when seeking health advice.
Why listen to me? I am a practicing physician, licensed in two states, and board certified in endocrinology—the subspecialty of internal medicine dealing with hormone disorders. The focus and passion of my practice since 1990 has been thyroid disease. I am a member of the American Thyroid Association and the Endocrine Society, and a Fellow of the American College of Endocrinology and the American College of Physicians. I have authored textbook chapters and published in national and international journals. And, I’m a low-thyroid patient myself. My diagnosis was based on mild blood-work irregularities that many doctors, even today, ignore. No doubt exists in my mind, however, that thyroid pills have benefited my health and well-being.
My experience as a patient has made me more sensitive as a doctor to the idea that mild or barely recognizable thyroid irregularities can be significant and worthy of treatment. My scientifically grounded colleagues might dismiss my