Three cheers for Dr Max the ‘mind doctor‘.

[Fruitandnutcase]

OK it’s another DM article and it’s nothing we don’t know already but it’s good to have it said again - and again - until hopefully someone will listen. Here’s what he has to say.

“In mental health outpatient clinics, it’s quite common to see patients suffering from low mood, poor sleep and concentration, low libido and lack of energy, all classic symptoms of depression.

But the antidepressants prescribed by GPs have failed to make them better, hence why they have been referred to a mental health specialist.

In cases like these, we always do a blood test, which often reveals what is really wrong: an underactive thyroid, also known as hypothyroidism.

This condition mimics depression, but it has a physiological, rather than psychological, cause.

When the hormone imbalance is corrected with medication, patients’ depression lifts.

But this week the Mail revealed there is a shameful postcode lottery regarding which medication is prescribed.

The standard treatment for low thyroid symptoms is a synthetic version of a hormone called T4. However, in about 300,000 patients this doesn’t work and they respond better to another hormone, liothyronine or T3.

Yet some health trusts have stopped prescribing it, effectively condemning patients to a life of depression no antidepressant can cure. This is all down to cost.

While T4 costs about £2 for 28 days, the price of T3 has gone up 4,600 per cent from £4.46 for a 28-day course in 2007 to £204.39 in 2017.

The manufacturers should hang their heads in shame for holding the NHS to ransom like this. The scandal needs to be addressed and T3 made available to all those who need it.”

[Marz]

They keep forgetting to mention that a months supply is only enough for two weeks for some ! I do wish someone could put them right - perhaps I should try !

[Fruitandnutcase in reply to Marz]

I know, I have pills that I take where a month’s supply is 90 but I only take it twice a day so I have 30 left over every month, another that I take for arthritis comes in packs of 60 but I only take one a day so again I have 30 left over, then I come to my blood pressure tablets, I have taken them for years and I’m highly unlikely to change to something else - that seems to be the excuse in my area for only providing a month’s supply at a time I get a named brand and they come in packets of 28! It is very annoying.

I don’t want to waste medicines by ordering a pack of each every month which I could do but sometimes I get to the point where getting my head round working out what I need to order for two months ahead is a challenge.

Last week when I took a note with me of what I thought I needed and checked to see what I was getting in my renewal - it all worked out perfectly - the girl serving commented on how organised I was to know exactly what I needed next time. It did make a change from my usual guess work.

[greygoose in reply to Fruitandnutcase]

I had the same problem when I was first diagnosed with hypo. My endo prescribed three months of levo, which came in packs of 28 tablets. But, she would always give me an appointment for three calender months time. So, there were always a few days without any levo before I got my next prescription. When I pointed this out to her, she just looked blank and couldn't understand what the fuss was about. I didn't stay with her for very long.

[DippyDame in reply to Marz]

Exactly!

[humanbean]

Do you have a link for the article? I'd like to read the comments.

[Fruitandnutcase in reply to humanbean]

dailymail.co.uk/news/articl...

When I looked most - all - comments were about the item on dementia.

[humanbean in reply to Fruitandnutcase]

Thanks. I only found one comment on the hypothyroidism part of the article, and the two replies to that comment were from the already brain dead.

[shaws]

The 'scandal' seems to have gone completely unnoticed - "out of sight - out of mind" by the majority of endocrinologists and doctors and I think it suits the Organisation down to the ground as 'at last' they had the excuse necessary to withdraw prescribing of T3. After all they withdrew NDT without notice through 'misinformation' and didn't answer Dr Lowe's Rebuttal, despite three yearly reminders. Neither have the 'House of Lords' made much difference so far (it seems to me).

On this forum alone, it has been stated more than once that 'depression' can be due to low T3 and we know that neither FT4 or FT3 are tested. We are also aware that many patients who've hypo develop disabling symptoms but are given 'extra prescriptions' to deal with these rather than making sure thyroid hormones are at an optimal and prescribing T4/T3 combination at the very least.

[Fruitandnutcase in reply to shaws]

Exactly - that’s what I thought when I read that he checks the thyroid of patients with depression.

I just don’t get it. So many people have so many symptoms of thyroid problems - hardly a surprise when you realise that thyroid function affects every cell in the body. I just can’t for the life of me understand why checking out and fixing the thyroid isn’t one, if not the first thing that doctors check, especially when their ‘cures’ don’t seem to be working.

Endocrinology and I’m counting diabetes in this really does seem to be the Cinderella field of medicine, you do have to wonder why - we know so much, the low carb, high fat and fasting approach to diabetes people know so much yet good old conventional endocrinologists have their heads buried in the sand and ‘know best’.

[DippyDame]

...while shareholders et al make a fortune and patients suffer.

All the while the law is on their side

It beggars belief

[Marz in reply to DippyDame]

I read something shocking on another Forum. Someone described their addiction to strong opioid drugs prescribed by a GP. When at rock bottom and wanting help - he was refused help from 3 re-hab clinics in his city. WHY ? - Their government funding was for street users only and did not cover GP prescribed drug addicts ... was this to protect the GP from further scrutiny ?

[Fruitandnutcase in reply to Marz]

Could be - wonder if that person would get help if he said he is now buying it on the street? Yes u hear of an awful lot of people addicted to prescription drugs, it’s frightening really.

At the moment we have a friend who had a replacement knee some months ago and is still taking morphine!

I suspect he is addicted now or certainly well on his way to being so. My husband had a hip replacement about eighteen months ago and stopped his morphine as soon as he can but our friend says he just can’t stop, he tried to cut back but couldn’t. I think that’s very worrying, I mean surely his doctor must be prescribing it for him. Why is his doctor not helping him? If he is still needing the full dose this long after his op someone not investigating the cause of his pain.

[Marz in reply to Fruitandnutcase]

He said the drugs caused more pain - so perhaps it is the same for your friend .. so sad.

[DippyDame in reply to Marz]

I once commented to a medic that if I was a drug addict I would probably get better treatment...no reaction.

This proves the totally rediculous nature of much of the NHS. As for their admin...confusion all round.

Poor man I hope someone came to his rescue.

Just been to my lovely optician, he always has amusing stories to tell. AMD and cataract haven't advanced thankfully.....so I chose some very trendy Spanish frames to celebrate!!

[Marz in reply to DippyDame]

Great news ! Yes the guy did receive help from a Charity ...

[knitwitty in reply to DippyDame]

I said the same thing to the endo I saw a few weeks back, if I was an alcoholic or a drug addict I'd get help on the NHS but because I have hypothyroidism and T4 doesn't seem to be doing the trick I'm being left to fend for myself, he just raised an eyebrow and a half smile, I felt like thumping him!

Of course I didn't , haven't got the energy to be honest!

[DippyDame in reply to knitwitty]

Know the feeling!

[shaws]

Dr John Lowe resigned his licence so that he could help people without a threat to withdraw his licence. There's few who would jeopordise their livelihood when they feel that the 'guidelines' aren't guidelines at all but dictats by those who've never had hypo or any probems with their thyroid gland.

Dr L stated that it was through corruption by payments to the medical profession if they prescribed levothyroxine and introduced blood tests. I think we believe the Pharma Companies pay for Conferences etc?

If we recovered Big Pharma would lose money if all patients recovered their health. No 'extras' would be prescribed, i.e. pain relief, anti'd's and whatever else.

[Fruitandnutcase]

I’ve noticed that when someone be it in government or at council level is given a ‘portfolio’ it is often in an area about which they have no experience at all. I came to the conclusion that that’s so that the person responsible has no knowledge of their area and so have to seek advice from ‘experts’.

When I taught the only decent Minister from Education we ever had and who understood what he was dealing with was very quickly got rid of. I worked in a library and when cuts were going to have to be made, the person who had been running libraries for years and who understood what was needed was moved out and the person was going to be responsible was moved in from somewhere like refuse collections.

That way there is no loyalty to the department they may have had some understanding of, or loyalty to or empathy with and wouldn’t put up a fight for.

Medicine and Big Pharma is different in that doctors seem to be the people who are being influenced. I suspect nowadays that the rot creeps in at training level. Maybe even at selection to study medicine level. All that newly qualified doctors know is what they are taught and if they are not taught something then they won’t know and they will will most likely never know what they are missing.

Something has happened that everyone has to fit into a sterile, humourless, mould. There’s no room for individual personality or opinion these days. Times have changed But not necessarily for the better.

[shaws in reply to Fruitandnutcase]

I agree. I think if we sit across from people in the tube or bus, that we could - just by looking at them - diagnose them as hypo or undertreated hypo.

[Lora7 in reply to shaws]

Funny you should say that, since I've had thyroid problems I am always looking at other women's necks to see if they have a goitre. I am also looking to see if they have thinning hair and are overweight. I think a well known tv presenter has thyroid problems because when I see her on tv she definitely has a swollen thyroid. She maybe keeping it private but if she did admit it perhaps she would bring it into the spotlight and something might be done to help this neglected illness.

[Fruitandnutcase]

Anyone and everyone who stands to benefit but it’s probably not just big pharmaceutical companies alone who influence what doctors are being taught. Think ‘fingers in the pie’ it’s a huge pie and there are probably an awful lot of fingers in it.

[Clarrisa]

In the states it seems the big insurance industry play a central role too on specific drug coverage. When my companion was diagnosed with cancer he waited well over a week or two before his oncologist would tell him what drugs he planned to use for treatment. The doctor was securing the insurance company’s approval beforehand.

[shaws in reply to Clarrisa]

So, instead of doctor prescribing what he thought would be best for patient, he'd have to talk to the pharma company first to get their approval? Despite having to leave a gap between consultation and prescribing.

[Clarrisa in reply to shaws]

The oncologist was making sure that my companion’s insurance carrier would pay for the medication (“approve” it) before prescribing it. It gets a lot worse too: My companion could only receive the approved medication from a specific specialty pharmacy in New Jersey (He lived in California). He was required to receive monthly patient teaching by phone from both the drug manufacturer’s staff &/or their questionnaire type phone line, & the out of state’s pharmacist. He had to stay home all day on the day of expected delivery because he was required to sign for it.

The saga goes on & on with flooding of the New Jersey pharmacy during a big storm, etc. Coordination of so much of this operation fell on our shoulders as you can imagine. As if cancer was not enough to worry about.

[Nico101 in reply to Clarrisa]

wow. this is what we in the uk have to look forward to post brexshit.

[Clarrisa in reply to Nico101]

The saddest part is this is inflicted on really sick patients irrespective of their education level, learning disabilities, comfort with the English language, patient’s age, comfort with speaking to strangers (male/female) by phone about very personal health concerns, or life long custom & practices of doing business in person.

Also if the doctor needs to make ongoing adjustments in doses as is often the case, delays are entailed getting the new dose through the mail. Major holidays like Christmas can delay by a additional day deliveries as can the weather.

Sorry for venting, it still gets my goat.

[Nico101 in reply to Clarrisa]

you vent as much as you like. you have the worst healthcare system in the developed world... and we're terrified here - well, anyone with enough sense to be terrified - that we're slowly getting the same here.

[shaws]

Oh dear ! I do wonder what you mean 😮😮

The 'old school' i.e. Dr P and Dr S I hope we get younger ones coming along that can read and research to learn how best to diagnose/treat patients and most of all 'listen' to us and show some interest in relieving symptoms. Also they should NOT be threatened by those above them in order to get them to 'toe the line' of keeping patients unwell.

Dr P in particular, will have 'Tears Behind Closed Doors' read by many who find themselves in the same boat as Diana (should say untreated and undiagnosed for years but who were given 'diagnoses' for things they didn't have) like Diana Holmes who then went on to assist Dr S and who tried their damndest but were ignored by those professionals who were invited to their Conference due to the 'parlous' situation patients now found themselves in.

I wonder when Dr S's staff will be able to publish their research?

[Fruitandnutcase in reply to shaws]

Tears Behind Closed Doors is an amazing book. It is breathtaking what Diana had to go through to cure herself. I go o a class with a younger lady who has so many things wrong with her that she reminded me of Diana Holmes. I suggested she read TBCD - alas she has complete faith in her GP - the one who hasn’t managed to make her better

I worry that there will never be a generation coming up who will read and research and have the guts and confidence not to be bullied into toeing the line.

[DippyDame in reply to Fruitandnutcase]

I have a friend like that....it is clear she is hypo but "my doctor has done lots of tests" is the only response I get when I suggest she takes charge.

She won't even ask for a copy of test results.

She has now been referred to a psychiatrist! I've know her for over 60 years and it wasn't a psychiatrist she first needed!

This is an intelligent well educated woman but she lacks "the guts" to question her care.

[Lora7]

When I worked in a hospital pharmacy many years ago the drug reps were always turning up to take the Chief Pharmacist out for lunch. Usually a couple of Doctors would be asked out as well. I don't know if it happens now but it was a quite common a few years ago.

[Marz in reply to Lora7]

Ooh I am sure it does I read somewhere that knowledge gained by Docs after Med School came from Drug Reps - a US report .. but a global issue for sure.

[DippyDame]

The academics who develop the lectures, but who influences them....

So much of it is down to politics, high finance or big business.

The struggling patient in the waiting room may actually concern the GP but his/her hands are tied behind their back by dictats from the above and/or by inadequate training.

But I guess we all know that to our cost....