Originally Posted by Bobbi67
There is a HUGE difference between what is normal in a lab range and what is optimal for that patients health. Also, lab values were changed in 2002, but labs are currently using very old ranges that are out of date. This is taken from the American Endocrinology Association's website regarding lab values for TSH. Here is the website American Association of Clinical Endocrinologists
(http://www.aace.com/public/awareness/tam/2004/tsh.php - broken link)
In November 2002, AACE published revised guidelines that provided a new range for normal thyroid function. Until this time, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. AACE encouraged doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.04. AACE believes the new range will result in improved accuracy of diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated.
Here is another website from the Society of Endocrinology regarding new researching finding that a suppressed TSH isn't as bad as once thought.
New research shows it may be safe for patients taking thyroxine to have lower TSH levels than currently recommended.
Mainstream docs are so busy with patients that they are not keeping up with the latest information.
It is also a fact that eating gluten creates more antibodies, and if you have an autoimmune disease, such as Hashimoto's, you already have antibodies that are attacking you thyroid. So by eating gluten, which is creating more antibodies, your thyroid becomes under attack even further.
Traditional doctors treat by labs and symptoms only until the labs show you should be feeling fine. If you're still not feeling well, they give up on you. I have had 3 traditional doctors tell me to see a holistic doctor because they are better educated to treat me. So if holistic treatments are so bogus, why are traditional doctors telling me they aren't educated enough to treat me and that I should see a holistic doctor instead?
I have also never had a traditional doctor treat me for my Hashimoto's or try to find what's actually causing my symptoms and treat that. All they do is throw drugs at you and take labs that aren't even accurate.
Bobbi67 et al.,
I'll make these comments and then make no further comments.
1. I agree that there is a difference between what is normal in a lab and what is optimal for a patient's health. In fact, I was making this same point. My exact
point is that because of the way "normal" is defined, 5% of "normal" or "healthy" patients will NOT have a normal test. An abnormal test does not by itself necessarily warrant treatment.
2. I don't disagree with anything you have stated about the AACE, but rather, offered very similar data in my post. Read the language, closely
however, and see that the "AACE believes
the new range will result in improved accuracy of diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated."
There are two issues here. First, the AACE is in part, an advocacy organization for the business of endocrinology, and by defining the normal range in more narrow terms, they will have created tens of thousands of new patients (AKA "customers") who will now be defined as "abnormal" and who may therefore warrant treatment. However, you rightly argue that labs must be interpreted with caution when determining what is optimal for a patient's health. You must realize, therefore, that in now defining tens or possibly hundreds of thousands of new patients as "abnormal," that many such patients, who otherwise feel perfectly healthy, will start receiving possibly unnecessary treatment. Patients who have elevated TSH values, but who otherwise feel perfectly well, are said to have "subclinical hypothyroidism." The decision to treat should be made on an individualized basis, much as you suggest.
Secondly, the use of the word "believes" indicates that it is their opinion,
and while their opinion is certainly based on scientific evidence, my point was only that the opinion is controversial, in part because of the reasons I just listed above, and which I mentioned in my original post. Changing a range of normal for a very common disorder has enormous consequences to the public and is not something that should be done lightly or quickly. Furthermore, there is a dearth of outcomes-based research to indicate what might improve or worsen should this group begin therapy.
3. You stated: "It is also a fact that eating gluten creates more antibodies, and if you have an autoimmune disease, such as Hashimoto's, you already have antibodies that are attacking you thyroid. So by eating gluten, which is creating more antibodies, your thyroid becomes under attack even further."
This is not true.
Eating gluten does not create "antibodies" in normal individuals.
Celiac disease is considered an immune disorder that is triggered by an environmental agent (the gliadin component of gluten) in genetically predisposed individuals. For those patients with celiac disease, eating gluten triggers the production of auto-immune antibodies against a specific component of smooth muscle (not the thyroid) in the intestine, which in turn leads to their symptoms.
There is an increased incidence of both autoimmune hyperthyroidism (Grave's disease) and autoimmune hypothyroidism (Hashimoto's) among patients with Celiac Disease.
There is a slightly increased incidence of Celiac Disease among patients with Hasimoto's but the increase has only been scientifically shown in those patients older than 65 and is limited to 3.6% of the population in that group (i.e. only 3.6% of patients with Hashimoto's Thyroiditis over age 65 have concomitant Celiac Disease) [Experimental Gerontology. 38(5):589-95, 2003 May.]. Other studies have shown the rate to be as high as 4.3% [Italian Journal of Gastroenterology & Hepatology. 31(4):283-7, 1999 May.]. In those patients, a gluten-free diet makes sense.
There is no scientific evidence, however, to indicate that a gluten-free diet improves Hashimoto's disease for patients without concomitant Celiac disease.
That doesn't mean that trying it is a stupid idea since it's harmless, though costly.
However, there's no evidence that it works.
4. I agree with those who have said (in so many words) that Big Pharma is primarily interested in the bottom line (money money money).
5. I stand by my comments, however, that Duke and other similar institutions are entering alternative medicine for the same reason. It has nothing to do with being "progressive" but rather attaching a strong brand (Duke) to an increasingly popular trend to attract patients and dollars.
6. I agree with those who have implied that medicine, as it is currently practiced in this country, is a business. Thus, the goals and conflicts of a "traditional" physician are no different than those of an "alternative" physician. Patients seem to ignore, however, that money could play any role in the goals of an alternative medicine practitioner.
7. I appreciate that your experience with "traditional medicine" has been frustrating. As I stated initially, alternative medicine practitioners have capitalized on one very important failure of "mainstream" medicine: focusing time spent with a patient on the patient. All practitioners should do this, but since insurance reimbursement steadily declines daily (private or government), the allotted time to see patients becomes more and more brief, and the focus on the patient, which should be paramount, is sacrificed. Patients seek care from providers who respect them as individuals and who offer them time and attention.
Perhaps if one of those doctors had done that, your outcome would have been different. However, their failure to do so does not render all that traditional medicine does useless or misplaced. Remember also, that your impression of the system as one that is only interested in "throwing drugs" at the problem, is largely created by the patients themselves (see: gastric bypass surgery, fat loss pills, et cetera). Patients want a "quick" fix, and often don't have the will to make the changes that will really improve their health.
Best of luck to you and your health.