By Dr Barry-Durrant Peatfield.
This topic has been raised on some Internet Thyroid forums recently, and provoked alarms and anxieties which are inappropriate and unnecessary.
Because the diagnosis and treatment of thyroid and adrenal disorder is so badly managed by doctors and endocrinologists, web sites, like ours, are there to help people out of the morass; and by providing information and guidance help them to diagnose and treat themselves. This is the whole basis of the many, many support groups throughout the world; since to seek medical advice may be to have the diagnosis denied, and treatment given, to be either wrong or inadequate.
The fact is that in seeking knowledge about their illness, people are perfectly able to think for themselves, and to make decisions about their treatment. The immense amount of self help medication available in chemists and supermarkets means that people can be left, perfectly safely, to work things out. To suggest that they cant, and that its too dangerous, is quite insulting.
With any medication, there are inevitably some risks, but they are vanishingly small with thyroid and adrenals, and people can learn a great deal from the patient information leaflets.
With thyroid, the dose is worked up gradually, whilst monitoring how one feels, and checking temperature and pulse. If the dosage is too much (or too little) the patient becomes quickly aware of it and can act accordingly. Seeking out the advice of a doctor, who may have denied the diagnosis, or given wrong or insufficient treatment, is not going to help, and could be harmful.
The problem of rapid pulse rate, irregular pulse, or atrial fibrillation DOES occur but it is very rare, and though it may be uncomfortable, certainly doesnt warrant the charges loudly proclaimed in some quarters, partially by doctors who should know better. We know of no fatality. Usually people take the common sense approach and stop medicating for a few days, restarting at a lower dose. Usually effective guidance can be obtained from Internet thyroid forums and thyroid web sites.
Since many doctors misdiagnose, and consequently mistreat patients with the symptoms of hypothyroidism, the latter are left with NO OPTION but to learn, for their own salvation, about thyroid and adrenal problems and self medicate.
I am particularly sad because many people have been so frightened by what they have read that they have stopped treatment. Finding, as has been suggested, an alternative doctor is frequently quite impossible so people have simply no alternative but to self medicate both natural support and prescription medication.
To make them feel frightened and guilty for doing so is unkind and unjust. Its the sort of thing patients have come to expect from doctors, not those who have dedicated themselves to helping those to educating and helping sufferers.
We can look at some medications, in particular: the use of adrenal glandular supplements, for example, Dr Wilsons Adrenal Rebuilder, or Nutris Adrenal Glandular Support in the UK , is perfectly safe in any context. Hydrocortisone is a bit different, of course, but few people with adrenal issues are going to utilise more than 20 or 30mgs daily doses which are well within the physiological range. Prednisolone, also widely used, is limited to 5mgs or 7.5mgs daily.
Natural desiccated thyroid is built up gradually, monitoring symptoms, temperature, pulse, until optimum response is obtained. The patients know how they feel and need no advice (or unnecessary blood tests) from doctors. If the optimum dose IS exceeded well, as I said, you, the patient, will know.
Thyroxine is another and quite similar case in point; and the dose will be decided perfectly safely by the patient, following a slow and careful appraisal of, lets face it, how one feels.
Doctors get very excited about liothyronine (T3), since it has a rapid effect in the system. If you increase the dose, like a bull at a gate, ignoring guidelines written everywhere, an inadvertent high level may indeed cause palpitations or, rarely, atrial fibrillation. So you stop it, or reduce it for a few days. No need to panic, no alarms about heart attacks, a favourite frightener used by doctors to bully patients into submission. Seeking the advice of a doctor, who may have denied the diagnosis, is not going to help one bit.
Whether doctors like it or not, or if it is disapproved of in other quarters, patients can be left to make decisions on their own; it is not dangerous or damaging. Promoting fear, alarm and despondency has no place in helping people to find relief from their illness.