Prioritise quality of life: I just read an... - Thyroid UK

Thyroid UK

144,199 members•169,640 posts

Prioritise quality of life

helvella•

1 year ago•13 Replies

I just read an article based on Chris Whitty's speech.

Just remove some focus on old-age. And re-focus on all too many of us almost regardless our ages.

Prioritise quality of life over prolonging it for elderly, Chris Whitty tells medics

England’s chief medical officer says more realistic conversations needed about some treatments’ side-effects

England’s chief medical officer, Prof Chris Whitty, has called for a cultural shift in medicine away from maximising lifespan and towards improving quality of life in old age, arguing that sometimes this means “less medicine, not more”.

theguardian.com/society/202...

I suggest that the improved quality of life argument applies so very clearly in thyroid treatment. Most obviously regarding prescribing of T3 (liothyronine) and even adequate doses of T4 (levothyroxine).

We have had quite a number who, having seen major improvements from T3 and/or simply better dosing of T4, have expressly said they would favour a few years feeling relatively well over more years feeling awful. I don't think that is a surprise.

And, in the case of thyroid, adequate treatment might also maximise lifespan.

With the "less medicine" argument possibly being applied to statins and anti-depressants which are prescribed all too readily and without proper consideration of quality of life.

Written by

helvella

To view profiles and participate in discussions please or .

Read more about...

13 Replies

•

RedApple1 year ago

Chris Whitty is talking a lot of sense here. Whether the medical profession will take any notice and action is an altogether different issue of course.

helvella• in reply toRedApple1 year ago

Someone has to turn the wheel to shift the rudder to change the direction of even the largest tanker. However long it takes to have any impact.

And he is at least quotable - no-one can say "Who?"

(A transient fit of optimism overtook me.)

RedApple• in reply tohelvella1 year ago

'However long it takes to have any impact.'

I agree with your optimism, but we need this to happen now! Too many people are already affected by the 'prolong life at all costs' approach.

helvella• in reply toRedApple1 year ago

Maybe if we all took one of these... ?

NHS prescription form FP10

RedApple• in reply tohelvella1 year ago

No, it's not us that needs this prescription, it's the medics.

waveylines1 year ago

Exactly my thoughts Thankyou Helvella for raising this.

The only doctor I've ever met who does this as part of their routine practise is my Oncologist. Their daily practice is all about QoL. I think long-levity is a much over rated aim. QofL even if shorter is much preferable to extended but long suffering. Many doctors do not even discuss side effects of drugs they prescribe...never mind interactions. It's left to patients to find that out or read up the patient info sheet before taking or talk to the pharmacist. This means when agreeing to new medications implications are not discussed so I fail to see how it's informed consent.

This nonsense about T3 causing damage is used to dissuade it's use but in reality there is no large body of evidence that categorally proves this. The numbers used in research are incredibly small in comparison to most large studies in other fields. There is evidence that TSH testing and treating by this leads to under treatment, poorer QofL and who knows what long term damage. But it has become the norm in daily treatment despite this....

There is now this nonsense that NDT is unproven despite it being around for over a hundred years, and the main treatment up till the 80s. The decision to make T4 the main treatment was based on a study of no more than 80 patients in the 70s Even though the patient preference back then still showed a preference for NDT.

I think a lot of health driven policies are in reality governed by politics of the day rather than proven science. I think science research also has too narrow a brief.... Often it's true it can demonstrate improvement with it's original focus but the consequences in other areas isn't considered and is often discovered years/decades later.

Tythrop1 year ago

Yep, I agree , Chris might like to be reminded(a) that t3 used to be regularly prescribed and was only stopped when the corrupt pharmaceutucal monopoly took place ..and

(b).that with the demographic time bomb ticking away ,it might be a good idea to start prescribing it again so that many of us old ladies ( most affected are in that category) will feel more like going out and about ,be active and keep.our bones muscles and heart in better nick so as to save NHS £££ ...stopping T3 is incredibly shortsighted .

HealthStarDust1 year ago

In medicine, there is much logic to this. However, I worry that quality of life is impacted not just by medicine and access to health care although this is of course a big factor, but also ones social, environmental and of course economic capital. Until these broader areas are addressed, I worry such a move will deepen health inequalities.

With to thyroid disease, of course adequate treatment would lead to a better quality of life, and indeed likely a longer one.

McPammy1 year ago

I read this article too. I found it uplifting as I’ve been saying this to my partner of recent years. I’ve been focusing on QoL rather then longevity. I think we will probably die at an age we are meant to but want to have as active lives until the end. Ive already started that lifestyle in my 60’s now and setting my health up now can bring better outcomes possibly going forward. I dont think medics are proactive enough. They just tend to firefight. Or even ignore abnormal results. So we check our own healths. We both get our bloods checked regularly to manage our own health issues. We try to keep our cholesterol down and vitamins optimal. We both check our thyroid’s even though my partner doesn’t have a thyroid issue. We try to eat as healthy as we can and exercise by brisk walking daily. We don’t want to be a burden to anyone getting older and hope not to be. Who knows what the future can bring but at least we can try and keep out of hospital or any homes for the elderly. Everything in moderation and feel happy and content best you can. Laughing is a tonic too 😀

1 year ago

No argument with Prof Chris Whitty's advocacy for, ´“less medicine, not more” and to “shift…medicine away from maximising lifespan and towards improving quality of life in old age”.

-Have always maintained my right to quality, rather than quantity, of life. And I'm willing to ensure my end. That is my choice.

But my choice should not be inflicted upon others.

As with governments getting involved with implementing guidelines (such as Prof Whitty's) for non-treatment shortening lifespans of the elderly: it's usually financially motivated and a cost-saving exercise.

And where does it end? First it would be the elderly because they can no longer work and pay taxes, then it would be the disabled who cannot work and pay taxes, and then it would be the poor with not enough to pay taxes, and then it would be....?

waveylines• in reply to1 year ago

Yes but the elderly do pay taxes! It's a myth to say they don't. All pensions and investments are taxable in the same income band thresholds as salaried people. The only difference is once of state pension age you no longer have to pay NIC. Some bright spark will no doubt change that....

I do wish whoever is peddling this myth that when you retire you are no longer contributing taxes, needs knocking on the head.

It's an excuse to explain things like why the government is struggling to fund the NHS & services. On health care support in the home etc most elderly folk eill be expected to pay for it. Very little free!!

RedApple• in reply to1 year ago

Dioryth, 'First it would be the elderly because they can no longer work and pay taxes, '

I don't know where in the world you are, but here in the UK this is not true. 'The elderly' most certainly can work, if they are able and wish to. And 'the elderly' pay taxes just like anyone else does, according to their income, whether that be from pensions, self employment, interest on savings, investments etc.

• in reply toRedApple1 year ago

First, waveylines & RedApple, let me wish you both a Merry Christmas and a Happy New Year.

As for your detailed rebuttals of my examples and rhetorical question, -you both appear to have missed my points, entirely.

Or simply chosen to ignore them.

For example:

"Have always maintained my right to quality, rather than quantity, of life. And I'm willing to ensure my end. That is my choice."

But my choice should not be inflicted upon others."

"As with governments getting involved with implementing guidelines (such as Prof Whitty's) for non-treatment shortening lifespans of the elderly: it's usually financially motivated and a cost-saving exercise."

Of course, in answer to both of your cherry-picking my statements and erroneous public presumptions of stupidity, my very-clear but-should-not-have-to-justify-such-basic-misapprehensions-answer is:

there-has been-and-always-will-be-retirees (and disabled, too!)-who-are-capable-of-working-and/or-paying-tax.

While I have been subject to both of your presumptions, I don't believe there's anyone on this forum with such ignorance.

Also, plenty of people on here write of the postcode lottery when it comes to treatment or lacks thereof, and no one ever argues that point.

Nor has anyone argued Healthstardust's post, "However, I worry that quality of life is impacted not just by medicine and access to health care although this is of course a big factor, but also ones social, environmental and of course economic capital."

-Which is also a beautifully simple and succinct statement of my point.