New Article - Diagnosis and Treatment of Hypothyroidism

An extremely good paper has been written by Mel Rowe, Rudolf Hoermann and one of our trustees, Peter Warmingham. The paper was written to meet the needs of both patients and their doctors in respect of suggestions for more effective diagnosis and treatment of hypothyroidism.

This is a must read for patients who can then discuss their findings with their doctor to aid them in finding the best course of action .

16 Replies

  • Thank you Louise.

    This is definitely the best paper that I have read, as it very effectively covers things that are misleading and ignored in the so-called guidelines.

  • It is a good read Louise. Will this be "rolled out" to the NHS?

  • It will be sent to all relevant bodies. Please spread the word far and wide to any thyroid groups that you belong to! 😀

  • Hi Lyn

    This is fantastic news that it will be sent to all relevant bodies but the million and one dollar question is will it be implemented by them or is it a non compulsory read? I'm sorry if i am coming across negatively particularly as this is a well written document and in our favour, i just wish with all of this information that it was compulsory or at least thats what im trying to say!!

  • Unfortunately, it won't be a compulsory read but along with other recent papers by our advisers, we hope that they will do further research in a different path that will show why so many patients aren't feeling well on levothyroxine alone.

  • Thanks for clarifying Lyn. Shame its not compulsory but at least if they are willing to read it they might explore other avenues as you say.

  • “Hypothyroid patients whose thyroid hormone replacement dose is being regulated against the TSH reading alone are being maintained in an under-treated state and are correct to assert that they feel better on a higher dose.

    Therefore, hypothyroid patients should not have their thyroid hormone dosages set by reference to their TSH readings.” ...stated Peter Warmingham, six years ago.

    And still we row on, backs against the tide... :(

    Great article. The NHS / BTA will be hunting for a large enough rug to sweep it under :X

  • is another hint that some endos maybe consider coming to their senses?

    Bianco has good research. Jonklaas one claiming that due to conversion T4->T3 Levo is the only necessary medication

  • Thank you Louise plus grateful thanks to these scientists who research and publish their findings which are in our favour.

    However - why is it that the BTA and RCoP constantly ignore up-to-date research findings and also the continuing complaints of the sufferers. Neither are doctors informed that they should change their very out-of-date methods of TSH alone and who are also unaware of clinical symptoms.

    Why did every single one of the Endocrinologists in the UK refrain from accepting Dr Skinner's invite to a Conference to discuss the Parlous Situation of Patients:-


    This book was written to draw attention of the medical profession to a major faux pas in the care of patients with hypothyroidism. This arises from the inexplicable refusal of the medical profession to recognise that patients can suffer from hypothyroidism when the thyroid chemistry is deemed to be ‘normal’ if the free thyroxine or the thyroid stimulating hormone lie between 95% reference intervals. There is a further problem that when a patient is diagnosed as hypothyroid many patients receive too low level of thyroid replacement through servile reliance on thyroid chemistry with (often) cavalier disregard of how the patient feels accompanied by an implicit and bizarre belief that a level of thyroid hormone is a better index of wellbeing than the patient’s own view of his/her wellbeing.

    This situation has arisen from the mindless deification of ‘evidence-based medicine’ which usually means laboratory-based-medicine where one chooses the evidence which suits and ignores evidence which doesn’t suit. There is no evidence that the efficacy of thyroid replacement is better correlated with levels of thyroid chemistry than with the initial clinical picture nor clinical outcome and in a small pilot study the author has provided preliminary evidence of this assertion.

    Instead of attending Dr Skinner's Conference (was it because he was a Virologist and not an Endocrinologist) not one had the courage to accept. Instead Dr Skinner had to face the the GMC (I believe about 7 times) and it wasn't his patients who complained but he did prescribe NDT if patients weren't recovering, either through undiagnosis or levothyroxine.

    Dr S also stated:

    A second issue concerns use of a porcine thyroid extract (Armour Thyroid) which was used extensively in the United Kingdom until introduction of synthetic hormones but was removed from the British National Formulary for reasons which remain unclear. Dr Skinner argues that there is a place for this preparation in a number of patients and practitioners who use all three thyroid preparations namely thyroxine, triiodothyronine and natural thyroid extract (Armour Thyroid) have all seen patients who benefit from Armour Thyroid. It is often posited that the matter has not been put to placebo controlled trial which is true and there has never been a clinical trial comprising different preparations; it is therefore nothing short of presumptuous to proclaim blanket condemnation for a product on the bizarre assumption that if a comparison between this product and another product has never been made the more recently developed synthetic products are de facto more efficacious; proposition that the composition of recent batches of Armour Thyroid is not known seems unlikely given that the product has been under scrutiny for many years in both the United Kingdom and The United States.

    Would it appear that Dr Skinner's pleas were ignored because he was not within an 'Old Boys Network'! In fact how many of the doctors would have given their life for a cause which struck them as ludicrous - as Dr S died of a stroke. Many of his patients believe it was due to stress brought about by appearing before the GMC although no charges were ever confirmed as he did nothing wrong.

    Dr Peatfield was yet another pursued as well as others. They were trained in a different era when the patients and symptoms were the priority.

  • Whilst this is great, what are the odds of the NHS/GPs taking any notice? I'd happily take a copy to my GP (who just might read it, maybe) but on what basis would I put it forward to him? I really would love him to take this on board but what reason would I give him to give this credit?

  • Hi Lyn/Louise

    Great paper. Is there any way to get more publicity for it? I will merrily send it on to my current GP (who is fab) and the bunch of quacks from the previous surgery (who weren't fab) but the former (who doesn't need to read it probably will and the latter who need to read it probably won't....)

  • Hi, the link to the paper doesn't seem to be working for me. I've tried two different browsers. Is there a different way to view it?

  • Sorry, we have a problem with the website today - drop me an email and I can send it that way.



  • It's working again. Thank you!

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