I just found this great article by a US doctor (why don't we have doctors like that in Europe?) discussing, among other things, why the TSH is useless once on meds containing T3, and who would most likely do better on NDT or T3 only drugs (I don't think I've ever seen anyone make that distinction before, but most doctors working with NDT seem to consider it the ultimate solution). Warmly recommended for anyone feeling confused about these issues!
This doctor also stresses that a TSH >2 means you are hypothyroid. Even though he talks about Naturethroid, that could easily be interpreted as meaning = any brand of NDT.
I believe that, for better or for worse, the reason there are more docs like this in the US (or the reason they are more visible) is because there is an unimaginable amount of profit there for the taking when it comes to helping people feel well. No shade to Dr Childs but if these articles are not sponsored in some way I'll eat my hat.
We all know there are two sides to this coin. This field is open to anyone who has something to sell, whether or not it works.
Speaking broadly about doctors (not drug companies, ha), there is no profit to be made here on the nhs, the culture is different, the priorities are different and the parameters are different. Even private medicine is different here (largely more conventional). The kind of guru-like grandstanding you see in the US (and other parts of the world, Australia being one) doesn't work in quite the same way here.
Having been treated in both the US and the UK my impression is that the edges are more blurry in the US, there are more doctors who are willing to try more unproven methods. That means that there are more options open to you but you have access to both (mixed metaphor warning) the cream of the crop *and* the bottom of the barrel and it can be hard to tell the difference.
I won't even get into how much it costs. We certainly pay for our health care in tax though it is free at the point of delivery. I'm not sure how you'd quantify the difference.
I know what you mean...but it's just so refreshing to see a doctor actually say things like "you should not go by the TSH once on NDT or T3" and "a TSH above 2 warrants treatment". So many people suffer needlessly in Europe just because doctors cling to the belief that your TSH needs to be out of the lab's reference ranges in order to warrant treatment, and that T4 only drugs are all you need to make all symptoms go away...so all we can do to change that is to either see a so called hormone specialist who charges several hundreds of € per visit (not to mention labs and unregistered drugs such as NDT which you have to pay for out of your own pocket), or self-diagnose and self-treat (by ordering drugs from Thailand, for instance). I combine the two methods, BTW.
I completely agree with everything you say about the US vs Europe...for better or for worse.
And I guess this will make no one feel better but this is the party line for most Americans too. The average American doctor treating thyroid issues is only interested in what the average UK doc is interested in. If I remember correctly the previously more liberal treatment guidelines have now been narrowed to more or less match the ones we have here in the UK.
The main difference is that there are some very visible US outliers and US docs are not likely to be sanctioned if they colour outside the lines.
Just to be clear I found your post interesting and I had some thoughts about what you said about why we don't have docs like this in Europe, but I wasn't trying to take anything away from your post. It is an interesting difference in culture to me.
I know, and did not see it as criticism at all, just as a useful addition/clarification to what I had previously said. I don't know anything about how things work in the UK (shame on me), so it's very interesting to hear about that as well. Thanks for this very interesting info
Another thing I don't think I've ever heard any European so called top doc say is that some do better on T3 only...the Hertoghe doctors claim NDT is right for everyone. I know a former patient of H's clinic who did not feel well on any amount of NDT, and she got the same discouraging results when she tried to combine NDT with T4...she ended up desperate enough to order T3 from Mexico, stopped NDT and T4 and went on T3 only and, within a week, she was feeling much better. That was two years ago, and she is still on T3 only and doing so much better on it. T3 drugs are not available in Belgium, so the only option is to order them online.
Most doctors seem to think you need some T4 as well, as that is how the thyroid gland works when healthy...I cannot explain why some patients feel optimally treated when on T3 only (I certainly don't), but I know they exist, and I also find it refreshing to see a doctor acknowledge the existence of that category of thyroid patients.
Here is another article by the same doctor, explaining how Hashimoto's messes up not only your thyroid hormone levels, but other hormone levels as well, thus making weight loss more difficult. I find the link between Hashi's and insulin resistance particularly interesting as I have been diagnosed with both, and was unable to lose weight until I had addressed the insulin resistance:
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but this is the party line for most Americans too. The average American doctor treating thyroid issues is only interested in what the average UK doc is interested in. If I remember correctly the previously more liberal treatment guidelines have now been narrowed to more or less match the ones we have here in the UK. 
Doctor has reduced my does based on TSH
Low T4, Normal TSH but symptoms
Possibility of Hypo diagnosis based solely on symptoms and poor T4 to T3 conversion?
Family planning and treatment options (Graves)
TSH after RAI treatment. 
