Posted on twitter by Antonio C Bianco @Bianco_Lab from #ENDO2024 meeting of the Endocrine Society @TheEndoSociety.
Most importantly, 62% of the doctors in the audience already use LT4+LT3 in their practice!!
(Image stretched to try to make it more readable.)
I suspect the doctors replying are (mostly) not from the UK.
Or the 22% that said it doesn't have a role, and the 15% that said they don't know how, are the UK doctors?
I wonder what percentage of doctors actually follow through and update their knowledge by attending such meetings ?
We do have a major problem. Only a small percentage of endocrinologists would both attend and be the ones focussed on thyroid.
Hopefully, many of the rest will read, watch videos, etc.
But getting the information from them to GPs, into guidelines, approved by those who control funding, etc., is a huge difficulty. Especially, I suspect, ordinary GPs who may have other areas they have involved themselves with.
And we always seem to hit the inability of NHS procurement to get hold of liothyronine at a comparable price to even European countries (France and Germany being obvious examples). And obtain in a wider range of dosages (to allow split dosing when on fairly low doses).
but getting the information from them to GPs, into guidelines, approved by those who control funding, etc., is a huge difficulty.
well...... the sackler's managed it quite effectively with oxycontin. "come to our weekend seminar , it's at an exclusive resort in the Caribbean.... "
maybe we should get them on the case to promote T3 prescribing .... only half joking.
I was in the GP waiting room a long time the other week and started reading the walls, there was a manufacturer ‘pain chart’ that’s always there, made me think about the OxyContin scandals one, and also whether if I added a thyroid/T3 poster whether it would stay there as long? …
i have often contemplated a 'guerrillla' campaign of printing up some official looking posters about thyroid conditions/ treatment and getting folk to surreptitiously stick 'em in NHS waiting rooms.
has anyone... anywhere... ever ... seen ANY information about thyroid conditions in an NHS waiting room .. i haven't.
Never ever, not a dickie bird, as if it doesn’t even exist
Nope! But would be happy to post something in my local surgery if someone produced it!
The sheer number of patients taking thyroid meds within each practice, you would think might make them look twice at dealing with thyroid (or at the hypo end of treatment) in a more ‘entrepreneurial’ style. A nurse at my practice said she saw 10 thyroid patients every day for blood testing. Presumably this is their annual check ups, most likely on their Co-morbidities, due to lousy thyroid treatment.
Crikey that’s a huge number! And if 20% are the moaning minis, you would think it would be worth their while to set up a clinic purely for thyroid issues and make at least one GP in the practice, an ‘expert’.
Such is the thyroid patient bottom of the heap in popularity, we have little chance of this happening.
Except if your view is simplistic - just take that pill every day and a) that is all you need; b) nothing else is possible.
What possible reason for studying and looking further. They are a burden, but that's how it has always been...
I think the question is more one of having an interest and trying to make a difference - and in my experience whether it be the guidelines., the cost, or the sheer weight of the job - it easier just doing nothing outside of the necessary -
Realistically if you knew a better way, you would be frustrated and better off mentally, emotionally and psychologically opening your own clinic, specialising and having some job satisfaction.
But didn’t you know it’s so simple to treat with a daily Levothyroxine tablet they’ve got it completely licked 🙄 in their dreams more like
for a minute there, i though it meant 62% of them were taking it .... !
They just might realise that they rarely have much impact in modest doses - and even more rarely are they dangerous.
I wonder what percentage do take thyroid meds.
Ironically, we suspect the anti-T3 endo does take thyroid hormone. But clarity and certainty would be good.
T4 monotherapy might suit him but what about the ones it does not suit especially those of us without any thyroid function at all. The arrogance of it.
I would say something along the lines of ‘God help us all’. Arrogance does not cover it. It’s something much dirtier.
If you are talking about who I think you are talking about - he has attached himself to some T3 research recently. Could be deadly having him onboard though. Other research of his (or his students) is very poor indeed.
And we know he is the source of comments saying the research results for T3 is “inconclusive”. I don’t know what he is reading - nothing probably, unless it’s something political inflating his prominence. He certainly not helping patients.
Shudder worthy
Intriguing. However when one takes into account the dismissive and patient-blaming attitude, particularly towards women in GP practice in general, it becomes obvious that to deride women just because they are women is overt sexism by any other name. We know that such an attitude pervades many areas of life but in medicine, it can impact morbidity and mortality too, not to mention well-being in the broadest sense.
They like to blame everything on me taking NDT at my practice. The fact it’s given me a good quality of life for 8 years seems to be irrelevant and that any health issues might actually be just that, after all other people get the same issues who never even sniffed a grain of NDT. They can try and bully me all they like I am not going back to T4 monotherapy to live a life of pure misery and suffering. If they’d actually got their finger out and diagnosed me earlier I might not have these other health issues instead of them spouting the menopause line and proferring antidepressants at every opportunity. Too darn lazy and ignorant to run a thyroid function test.
surprised that the ‘UK representative’ thought he had an argument to present. Shows how much his personal opinion that is backed up by only fairly irrelevant data is pandered to over here.
I must have missed that. Who was the UK representative?
The Bianco vs SP debate for and against T3 at endo24 … or good vs evil ….
Prof Simon Pearce was 'against' T3 and Prof Antonio Bianco was 'for' T3 in a debate format. Though we know that's what they think outside a debate format!
We sure do. So no extra homework for him. Still trotting out the same old, same old.
So, ummm, did the bar chart change post-debate?! And yes, since I came off NDT when I finally caved to GP bullying, my health problems have got worse and worse. And yes, they're blaming menopause...
Afraid I don't know! Maybe they will publish something but a lot of their stuff is behind paywalls...
I've just looked up Bianco Labs Twitter/X account and saw this :
x.com/Bianco_Lab/status/159...
He refers to this Norwegian paper
Title : Effect of Liothyronine Treatment on Quality of Life in Female Hypothyroid Patients With Residual Symptoms on Levothyroxine Therapy: A Randomized Crossover Study
Link : frontiersin.org/journals/en...
with this comment :
Provocative Norwegian randomized crossover study comparing mono-therapy with LT4 vs. LT3 in 59 women with residual hypothyroid symptoms. The use of LT3 for 3 months improved QoL without biochemical or clinical signs of thyrotoxicosis (most preferred LT3).
I don't know where I read this (probably on this forum but my memory is complete pants these days) but someone pointed out today or yesterday that healthy people are on combination thyroid treatment all the time from birth to death, and nobody thinks it strange.
'healthy people are on combination thyroid treatment all the time from birth to death, and nobody thinks it strange.'
The difference is, that the thyroid understands what it's doing and how to manage the treatment of the human under it's care, whereas the medics do not!
helvella, Can I ask...
Where did you get that picture of a slide at Endo24?
I'm finding info on Endo24 when I search but all of it seems to be dated before 1st June 2024, and there is nothing interesting on them. I don't have a Twitter account and am not really interested in getting one but I would like to see what is (or was) being discussed at the conference.
Here:
Antonio C Bianco
@Bianco_Lab
Most importantly, 62% of the doctors in the audience already use LT4+LT3 in their practice!!
6:35 PM · Jun 1, 2024
x.com/Bianco_Lab/status/179...
Letter to my doctor re: using TSH to guide dosage
Experiences of using functional medicine doctors? 
Proposed book on treating hypothyroidism
