Monthly Archives: October 2009

Armour Crisis Creates New Alliances


Good things can develop during a crisis situation. For me it was the eye opening experience I had this week by participating in The Thyroid Patient Community Call. The Thyroid Patient Community Call is a group internet telephone call hosted by Janie Bowthorpe, author of Stop The Thyroid Madness. During the 90 minute session I was able to interact with dozens of callers as well as Janie herself. Needless to say, Janie’s audience is mostly individuals who are deeply committed to maintaining Armour Thyroid as a treatment option and who are equally angry with the field of Endocrinology which backs the ban on dessicated thyroid hormone. I knew this audience wanted answers to some very tough and troubling questions. For a few days before the call I needed to review for myself just how this crisis developed, and how I became a lightning rod for the growing controversies. I believe this process was necessary and therapeutic.

Being a strong advocate of t4 plus t3 therapy and of Armour Thyroid, I was in sync with most of the topics being discussed on the call. What was hard for me was hearing the out pouring of stories describing how endocrinologists had alienated (infuriated) so many thyroid patients. How to explain but not excuse the inflexibility, wrong headedness and arrogance of a whole field of medicine on a topic central to its mission, my own field for the past 25 years? My head still hurts thinking about it. For those wanting to hear how this played out can visit Talkshoe.com which hosts these shows and follow the instructions for listening to past episodes of Janie’s show. Perhaps Janie can give more specific instructions by posting them here.

I came away from Janie’s session with a firm recognition that the field of Endocrinology is in serious need of a make-over. Imagine a Democrat walking into a room full of staunch Republicans and asking everyone to join him in a sensitivity training program. It is a lonely job.

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Eric Pritchard Brings Historical Perspective to “T4 Only” Treatment Bias


Eric Pritchard brings great insight showing how, for years, the field of endocrinology failed to acknowledge growing evidence of the inadequacy of “t4 only” therapy for hypothyroidism. Eric puts together the historical clues that should have paved the way for acceptance of t4 plus t3 therapy . We are now seeing almost irrefutable evidence ** (http://www.metabolism.com/2009/10/03/breakthrough-discover-t3-genetic/) ** that t4 by itself cannot in all cases provide enough active thyroid hormone to treat hypothyroidism. This is occurring at precisely the same time the practical solution to t4 plus t3 replacement therapy (dessicated thyroid hormone) is being chased from the shelves of pharmacies around the world.

Thanks Eric, for bringing your knowledge and insight to this crucial debate.

Eric writes to metabolism.com :

It is quite amazing that after 50 years of abusing some patients with the T4-only therapy, that medical is beginning to recognized that some patients do, in fact, require T3. It is about time for the practice of medicine to catch up with medical science. In 1960 Dr. Marshall Goldberg published a paper entitled “The Case for Euthyroid Hypometabolism,” which recommends a T3 therapy. About that same time researchers like Refetoff were noticing a resistance to T4. Refetoff, et al., discovered the cause, peripheral cellular hormone resistance in 1967. Subsequently, Braverman, et al., discovered peripheral conversion in 1970 and determined that 80% of all T3 comes from peripheral conversion. However, not to be swayed from the old thyroid-gland-is-directly-connected-to-symptoms paradigm, endocrinology has declared peripheral conversion to be fault free (really amazing) and simply ignores the potential for increased hormone reception. To support this wacky notion, they produced questionable studies that proved their old paradigm. These studies showed that the active hormone, T3, was ineffective and the inactive hormone, T4, was effective in spite of knowledge of the relative activity discovered by Gross and Pitt-Rivers in 1952.

All of this reminds us of medicine’s rejection of the empirical antispetic discoveries by Drs. Semmelweis and Lister. Why it was not minute particles of the cadavers that were being disected prior to surgery and child birth, it was the bad humors in the air. The post surgical infections and deaths could not upset the bad humors paradigm. Only after concerned heads of surgury demanded washing up before operating, the invention of the microscope, and Pastuer’s discovery of bacteria, did the merchants of death and illness realize reality.

Endocrinology laughed and dismissed Dr. Goldberg a half century ago, just as medicine drove Semmelweis to his death.

There are physicians who believe that medicine is an art. I have come to that conclusion as well, but not for the same reasons. I believe that medicine is an art because medicine does not have the discipline to be a real science. Real sciences react to counterexamples. We have seen counterexamples to the thyroid gland only diagnostics and T4-only therapy prescriptions. However, endocrinology and thyroidology have dismissed these suffering souls with diagnostic excuses such as “nonspecific symptoms” and “functional somatoform disorder” to blame medicine or blame the patient for the patients continuing suffering. Both of these diagnoses could be avoided if the differential diagnostic procedures had been followed — including all possible causes for the patient’s symptoms, euthyroid hypometabolism, deficient peripheral conversion, deficient peripheral cellular hormone reception. But in a perversion of the logic underlying differential diagnostics, medicine claims that the thyroid gland is first the only possible cause of the symptoms and second, when it fails, the symptoms have many causes — which were not tested.

Medicine is an art because it does not have the discipline to use clear language. In spite of demands for clarity of definition dating back to the 18th Century and undoubtedly earlier, and demands for clarity in medical guideline authorship protocols, “hypothyroidism” may be restricted to only the thyroid gland or may embrace the entire greater thyroid system. In either case, the diagnostics and the therapy recommendations are only applicable to the thyroid gland. Those who suffer from extra thyroid deficiencies in the greater thyroid system are simply allowed to suffer in spite of the existence of proven therapies.

Medicine is an art and not a science because it ignores counterexamples. There are patients who require T3 without any T4 as they will become thyrotoxic on the T4, but require the T3 to overcome hormone reception resistance.

There are patients who have had unsuccessful therapies with all synthetics but live well on desiccated thyroid. The laughter at the use of desiccated thyroid is a reminder that medicine does not have courage to recognize counterexamples and does not have the will to deal with them. Thus, endocrinology is really an art pretending to be a science as ignores suffering patients — perhaps a million in the UK and another 5 million in the US.

One could only wish that those laughing fools develop a thyroid related malady that endocrinology chooses not to recognize and then suffer the slings and arrows of mass medical malpractice that has been in vogue for the last half century.

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Sandra Keeps Us Posted on Armour Reformulation


Sandra posts vital information for those who want to do something about the reformulated Armour Thyroid product, while she brings us up to date on related issues. Thanks Sandra!

Sandra writes:

I too have had a wonderful experience with Armour thyroid after years of struggling with synthroid and have been symptom free of my Hashimoto’s for the last three years – until now. Lethargy, muscle aches, hair loss, temperature disregulation, digestion problems, and just feeling like a 60 watt bulb only able to muster up 15 watts of energy. After reading what everyone has said I called Forest Labs and spoke with a pharmacist, a nurse and customer care. They were very interested in what I had to say and would like anyone who is having problems since the reformulation to contact them. The reason for the change is a supposed bioavailability increase with the change between sucrose (why the original tasted sweet) to cellulose. Doesn’t make sense to me as cellulose in indigestible and if the active ingredient is binding to it, it may be less available than with the sucrose formulation. Any thoughts? I also asked about the rumored FDA requirements – NO the FDA is not requiring them to go through trials as they are grandfathered in under the “generally recognized as safe” ruling. They have also just released a large amount of the one grain size (60mg) to pharmacies so it should be available. He said that if the pharmacy didn’t have it yet to call Forest Labs again. He also wanted me to speak to a nurse to document the symptoms I was experiencing. The transfer was quick – no getting put on long holds, and she was very thorough and pleasant. The pharmacist, Pat, and the nurse that I spoke to want to hear from the people who are having difficulties with the change in formulation – so Call, Call and Call again. The only way to get the formula back to where it was is if we let them know it now doesn’t work. Call 800 678 1605 ext 66297 for medical input and 66298 for customer service and quality control. One voice is a whisper, many voices is a shout to be acknowledged.

I too have had a wonderful experience with Armour thyroid after years of struggling with synthroid and have been symptom free of my Hashimoto’s for the last three years – until now. Lethargy, muscle aches, hair loss, temperature disregulation, digestion problems, and just feeling like a 60 watt bulb only able to muster up 15 watts of energy. After reading what everyone has said I called Forest Labs and spoke with a pharmacist, a nurse and customer care. They were very interested in what I had to say and would like anyone who is having problems since the reformulation to contact them. The reason for the change is a supposed bioavailability increase with the change between sucrose (why the original tasted sweet) to cellulose. Doesn’t make sense to me as cellulose in indigestible and if the active ingredient is binding to it, it may be less available than with the sucrose formulation. Any thoughts? I also asked about the rumored FDA requirements – NO the FDA is not requiring them to go through trials as they are grandfathered in under the “generally recognized as safe” ruling. They have also just released a large amount of the one grain size (60mg) to pharmacies so it should be available. He said that if the pharmacy didn’t have it yet to call Forest Labs again. He also wanted me to speak to a nurse to document the symptoms I was experiencing. The transfer was quick – no getting put on long holds, and she was very thorough and pleasant. The pharmacist, Pat, and the nurse that I spoke to want to hear from the people who are having difficulties with the change in formulation – so Call, Call and Call again. The only way to get the formula back to where it was is if we let them know it now doesn’t work. Call 800 678 1605 ext 66297 for medical input and 66298 for customer service and quality control. One voice is a whisper, many voices is a shout to be acknowledged.
sandra52525@gmail.com
Sandra
1

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Can Growth Hormone Treatment Make Me Taller?


At metabolism.com we receive a lot of questions from members wondering whether growth hormone therapy will help them grow taller. Lorraine’s question, posted below, is typical. The single most important factor determining the effect of growth hormone on improving height, is whether the bone still has growth plates that are “open” because when the growth plates close (or fuse), the bone cannot get any longer. If the bone’s in the legs cannot grow full adult height has been achieved and taking growth hormone won’t change that.

Here is Lorraine’s question and below that is my response.

Lorraine writes to metabolism.com:

I’m 21 years old and am only 4 “10. Is there any way that HGH injections could help me grow a couple of inches? Please respond back to my question because I need to know if its too late since I already hit puberty.

My response to Lorraine is the following (I’m assuming Lorraine is really 21…not 12)

Lorraine:

From the time of birth we grow rapidly in good part due to the action of growth hormone which is released from the pituitary gland.

At puberty the release of testosterone in boys and estrogen in girls begins the process of final bone maturation. Children often experience a period of rapid growth known as a growth spurt at this time. Girls usually complete their growth spurt within a year or two of their first menstrual period. Boys tend to finish their growth phase when they are older compared to girls.

Growth ends because the areas of the bones known as the growth plates become sealed or fused. After that growth hormone has little effect to cause increased height. Bones in the face, feet and hands may still be susceptible to growth effects of growth hormone, with not particularly desirable results.

An adult who has not grown in a few years cannot generally get taller in response to growth hormone due to the fusion of their long bones. Taking HGH is unlikely to make you taller.

Aside from controlling height, growth hormone is likely to have other non-growth related benefits like preserving muscle and soft tissue and perhaps other general maintenance functions in the immune and central nervous systems. These benefits of growth hormone can be lost during aging since the pituitary production of growth hormone usually declines in later years.

I hope this information is helpful for you.

Disclaimer: This information does not substitute for the advice of your own physician and is for general learning purposes only.

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Breakthrough Discovery: Need For t3 Could Be Genetic


Do you wonder if you need t3 (Cytomel, triiodothyronine, liothyronine) added to your thyroid hormone treatment to feel normal again? The answer could be in your genes.

Recent discoveries reviewed by Antonio C. Bianco, M.D., Ph.D. at the recent American Thyroid Association meeting, reveal how genetic differences influence the effectiveness of thyroid hormone replacement. Dr. Bianco’s lecture focused on studies pinpointing inborn differences in the way people metabolism thyroid hormone to explain why t3 treatment of hypothyroidism is probably required by some to restore normal functioning of their brain, muscle and heart.

The most frustrating problem for people with hypothyroidism is being unable to convince their doctor that treatment with Synthroid, Levoxyl or similar pure t4 product, isn’t working. Continued symptoms of fatigue, weakness, inability to concentrate or think clearly, and inability to lose weight despite really trying, result in tension between the doctor and the “complainer”. When assessing the adequacy of thyroid hormone replacement therapy most doctors rely on the blood tests known as the Thyroid Function Panel. Typically this includes a measurement of t4, t3, t3RU, and TSH. Some panels may also include free t4 or free t3 measurements. If the hormone levels on these tests are “within normal limits” the doctor will often insist that the treatment is a success but it is the patient who fails to recognize this. A minority of endocrinologists know many of these “failures” can be turned into success by the addition of t3, the less utilized but much more powerful form of thyroid hormone.

Most of the biological effects of thyroid hormone in the body are due to the action of t3. The most common forms of thyroid hormone replacement however, involve giving t4 in the form of Synthroid, Levoxyl, levothyroxine etc. The t3 required by our tissues is produced by specific enzymes which convert t4 to t3 in the cells of the liver, kidney, brain, muscle, heart etc. These converting enzymes are known as deiodinases and under normal conditions they are responsible for about 80% of the body’s t3. The process
by which t3 is produced from t4 is known as peripheral conversion.

It has long been the contention of the leaders in thyroid disorders that based on their arithmetic, t4 replacement is sufficient to provide all the t3 the body needs via peripheral conversion and giving t3 supplementation doesn’t make good medical sense. Now, based on the new information provided by researchers like Dr. Bianco, the “arithmetic guys” will, in my opinion, need to revise their thinking finally allowing the way for acceptance of t3 replacement approaches.

I will continue the explanation of the new breakthrough in genetic control of thyroid hormone replacement treatment in Part 2 of this post.

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Molly Offers Advice to Smokers Who Fear Weight Gain When They Quit.


Molly has seen the light as far as coping with mood and metabolism changes occurring when getting off cigarettes. Here is her story as posted to metabolism.com:

I smoked regularly (pack a day) for 13 years–from 14 until 27. Then I became a social smoker, smoking occasionally, but not on a regular basis. Now, I haven’t smoked at all for a few months and I am 30. After I quit smoking (at 27) I slowly became very depressed and put on 30 lbs. I wasn’t exercising, but I wasn’t eating more either. Changing the kinds of foods I ate is what helped me lose weight. When I cut out alcohol and switched to a high vegetable (lots of cruciferous veggies) and whole grains diet and started walking, 15 lbs came off quickly. I modeled my diet after one that would lower estrogen levels–high estrogen levels lead to excessive tummy fat and breast cancer. Also, I started taking St. John’s Wort and I think it uplifted my mood. I think everyone who quits smoking should take St. John’s Wort. It’s only side effect is slight sensitivity to the sun and it helps curb the depression quitting can cause. People who quit smoking need to be patient with themselves. Smoking does mess with the metabolism and the people who say calories in calories out are not fully understanding the issue. It might take time for your body to get used to its new way of operating without the constant dose of nicotine. I am proud of all of you who quit smoking. I am really proud of myself. I seriously thought I would never be able to quit. So, good luck with your weight loss, but a few pounds are worth not smoking! And after all of the abuse we gave our bodies, we should focus on loving and appreciating them–even if they are a little chubbier than we would like, they are still beautiful!!!!

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Obama Not to Blame for Armour Shortage, Says New Member


Will S., a new member of metabolism.com, offers these sensible comments on who to blame for the sad state of FDA oversight of prescription drugs like Armour Thyroid.

Will argues:

Gatekeeper: Just a suggestion to do a little more research on this situation before blaming it on Obama. It was several years ago, at the end of the Clinton and beginning of the Bush administration, that the FDA began to investigate and reveal that Armour Thyroid had never been officially approved by the regulatory agency. Membership on the FDA consists partially of highly paid executives that came from pharmaceutical companies. It makes sense that they have an interest in making sure that only the big pharmaceutical companies have the money to get their drugs approved. Situations like this are why we need health care reform now. Yes, you certainly can and should bring this issue to the attention of the current administration, but please place blame where it is due, as finger pointing in the wrong direction is unhelpful to those who are suffering.

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