Prof Bianco in the States has questioned the universal use of T4 monotherapy and will publishing a book on the subject in autumn 2022. The aim is in this excerpt:
Rethinking Hypothyroidism: Why Treatment Must Change, and What Patients Can Do
Antonio Bianco
Dec 10
This book will be published by the University of Chicago Press in the Fall of 2022. The book is about the treatment of hypothyroidism, its history, underlying science, and the changes that occurred over time.
Most patients respond well to daily tablets of levothyroxine, but about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing they are unrelated to the thyroid disease.
In this book, I offer an accessible overview of the disease’s treatment and make the case that the current approach is failing some patients. I call for alternatives to improve lives, and I equip patients and their families to advocate for other treatments.
Written by
diogenes
Remembering
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I also end up wondering, if ten to twenty percent are far from living a typical life, and surely need to be prioritised, could the other eighty to ninety percent actually do even better with some T3, even a tiny amount, in their mix?
True. Researchers have a habit of referencing their own papers, partly because it's their speciality and partly to increase their own reference count. Bianco's speciality is a little different but I would have expected some citations where the subject matter overlaps with diogenes papers.
Thank you diogenes Hopefully this book will help push the medics off their high horses to become grounded and to listen to the scientists because that, as we all know, is vastly overdue
Anything that helps with trying to improve the lives of the 10-20% is extremely welcome and can’t come a moment too soon. Thank you Diogenes for flagging and for all of your invaluable research, even if it hasn’t been cited by Antonio Bianco.
Remember the 10% - 15% is those diagnosed with primary hypothyroidism based on an elevated TSH. There are many others who are hypothyroid with 'normal' blood hormone levels.
I was quoting Antonio Bianco but yes, I take your point, many more people are affected by thyroid disease and are not treated effectively, if at all. Anything that raises any of the issues around thyroid disease must at least be helpful.
Well, you are your colleagues Diogenes have been working hard on the science for a long time. Maybe, just maybe, all it needs is a few more dominos to fall and then, maybe, more will come,
It is a lovely thought at Christmas time and as we move forward into 2022. I am personally going to hang onto a bit of positive thought about it.
I echo all of Helvella's comments too - about 'the patient bit' (because doctors typically don't like patients trying to have an opinion on their own treatment), and the 'other eight to ninety per cent'.
Thank you Diogenes for the info. I hope this book when it come out finally gets other practioners to see that monotherapy is definately not the solution for all.....thats its left a whole cohort of people to lead half lives unnecessarily or to go off piste & self treat.
And I thank you for the research you and the team are doing. Your research is like the beacon of light that shines out in a dark storm at sea. Its a life line. Thank u!
This is music to my ears, until some Health Professionals acknowledge that hypopatients -and hyper patients no doubt - are being given short shrift we will get nothing different.
I have never been able to understand why the only option for most of us is Levothyroxine.
Mind you, Diabetics have only insulin, I wonder if any of them can go through the same type of hell on Insulin? I never thought of that before and my brother, his son and my grandson are all Type One! That makes me feel terrible now.
However there has been a lot of innovation put into Diabetes since my brother was diagnosed in his 20's, he is 68 now.
I think hypothyroid patients are generally thought to be of no real importance in some way.
I know a diabectic who did indeed go through hell getting her treatment right. She had to fight for a piece of equipment that she desperately needed to keep her on an even keel but the NHS fought her. She got it in the end after a long battle. I suspect it doesn't matter which chronic condition you have if you don't fit the standard pattern/protocol of treatment you are faced with a battle. Depressing really lol....
Yes thats true.....she had to fight for the animal version as she said its all moving across to the synthetic which she didn't find as good and didn't stay as stable. It was also the pump she had to fight for too. So I dont think all is necessarily rosie on the other side of the fence... Id hoped it was just hypothyroidism treatment but not so....Lol..
My brother never says he has any problems and seems to be pretty stable. I have no idea which he uses and don't want to rock any boats either, so don't keep asking questions. At least it isn't just thyroid hormones which can be a pain in the rear!
If you search for "thyroid hormones" you get 16 results and some of those results are from drugs which aren't to treat a thyroid problem they are to treat something else and it has unwanted effects on thyroid hormones. (In other words there aren't 16 results to choose from for someone with a thyroid problem.)
Diabetics have options of fast-acting insulin, slow release insulin, animal-derived insulin, and lab-produced insulin. If I knew more about insulin and diabetes I could probably say more about types of insulin.
I really haven't had to think about insulin too much since my grandson was very young, diagnosed at age 3 years as was my nephew, my brother was a young adult when diagnosed.
I am pretty much out of practice now. He is 28 now, so I don't have to prick his little fingers and give him 'ouchies' in his tummy now thank God! I used to play being Cruella Deaville was it, at that time?
We need this book NOW to hit doctors over the head with… hopefully it’s hardback.
Diogenes why don’t you and your team publish a book which highlights all your research and findings. Doctors will only pay attention if we can gift them a book which is backed up be peer reviewed research, nothing else matters to them… well except their NHS medicines budget!
We already have done so as an eBook and this is the Editorial which heads it. Downloadable. It's our position in 2018 which has developed further since then but the basis is here in several articles. The overall title of the eBook is in the editorial heading. However the great and good have held their noses and looked away.
Editorial: “Homeostasis and Allostasis of Thyroid Function”
Johannes W. Dietrich , John E. M. Midgley and Rudolf Hoermann
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New Hypothyroid book
Finally being treated for Hypothyroidism. 
