's Paper sent to the President of BTA and many others today

[Guest guest]

I have today sent out the paper written by Pritchard (one of our members) entitled 'Hypothyroidism Mimics Require Consideration' and for those of you who have not yet read this paper, I would suggest you do this. It is excellent. I have placed a copy in our FILES, so scroll down to the 'H's' where you find his paper. If possible, take a print out of this paper to your GP and endocrinologist, even though I have sent this to NHS endocrinologists as some may say they are too busy to read it, and they MUST read it. Below is the covering letter I have sent to Professor lyn (President of the British Thyroid Association) and I hope she will have the courtesy to write back with her comment, but I won't hold my breath, as she has still not responded to my other papers, neither have the BTA who promised they would, after their meeting of the Trustees in June.

You can see at the end the people I have sent copies of 's important paper to.

Luv - Sheila

________________________________________

Professor Jayne lyn

President – British Thyroid Association

Queen Hospital

Edgbaston

Birmingham

West Midlands

B15 2DH

28th July 2008

Dear Professor lyn

As you are aware, for the past four years, I have been running the website ‘Thyroid Patient Advocacy-UK and alongside, an Internet campaigning and support forum for sufferers of thyroid disease and its mimics - a place where sufferers can discuss their particular thyroid problem and get the help and support they are not receiving within the NHS. During these 4 years, I have done research and gained information from patients, doctors, and various studies, and know thatI am putting some of the pieces of the jigsaw into the right spaces and seeing parts of the picture that are giving me insight into some of the reasons why many sufferers are not being given a correct diagnosis, are not being treated with the level or type of thyroid hormone that would give them back their normal health, or are being refused the diagnostics and therapy they need.

The diagnosis and treatment of hypothyroidism should be straight-forward: a few blood tests and visits to a GP, after which many should be helped to regain their normal health. However, other patients and their doctors find it a mystery that is inappropriately excused with “nonspecific symptoms” or “functional somatoform disorders.” Amazingly, the symptoms that prompted the assays in the first place are not regarded as sufficient for further investigation - but the mimics of hypothyroidism require consideration too and must not be ignored. Ignoring medical science has produced a 13% failure rate amongst those treated for hypothyroidism as indicated in one study, and yet more, in another.

Is the “ism” in hypothyroidism the deficient secretion by the thyroid gland, or the deficient thyroid hormone levels? If the former, do the guidelines apply to post-thyroid effects on thyroid hormones? And if not, why isn’t this stated in the guidelines to eliminate any risk of misinterpretation? If the latter, why do the guidelines recommend diagnostics and therapies that only apply to the thyroid gland, and why don’t the guidelines contain any diagnostics and therapies for any post-thyroid operation, which are known to medical science, and have been known for the past 38 years?

The problem appears simple. Hypothyroidism and hypopostthyroidism deficiencies are not the same, although they have the same symptoms, and the overarching name that is given to them - hypothyroidism. Medical ethics, the protocol of differential diagnostics, and the regulations upon valid consent require that the T3-requiring post-thyroid deficiencies be considered. They are different physiologically. They occur in different places. The dominant hormone is different. The feedback “mechanisms” are different. The appropriate assays are different.

I am enclosing a paper written by Pritchard, a US researcher, entitled ‘Hypothyroidism Mimics Require Consideration’, and I hope that you will be able to devote sufficient time to read it.

Pritchard makes the point that many patients appear to be suffering from “thyroid” deficiencies when, in fact, they are suffering from replaceable post-thyroid hormone deficiencies, i.e., deficiencies of peripheral metabolism of T4 to T3 or the reception and use of T3 by cells and their nuclei.

There are seven arguments for the proper diagnosis and treatment for the other causes that produce symptoms, which could suggest hypothyroidism:

1. Medical science (Braverman, Refetoff et al) discovered the mimics of hypothyroidism around 1970.

2. The TFT guidelines are NOT pertinent to these mimics.

3. The support for thyroxine-only therapy is NOT pertinent to these mimics.

4. The protocol for differential diagnosis requires consideration of known causes with similar symptoms, prior to concluding ‘non-specific’ symptoms or ‘somatoform’ disorders.

5. Informed consent for any proposed medical treatment should be a matter for full discussion between doctor and patient, covering all the potential courses of action, not just the preferred therapy.

6. Declarations concerning patient’s care, as issued by the General Medical Council, must be strictly adhered to.

7. Ignoring certain elements of proper care is probably a civil rights issue.

Thus, the proper diagnosis and treatment of these mimics of hypothyroidism is paramount. They MUST not continue to be ignored. The needless suffering of undiagnosed, untreated, and under treated patients must stop.

Please will you help?

Yours sincerely

Sheila

Thyroid Patient Advocate

www.tpa-uk.org.uk

Copies to:

Members of the BTA Executive Committee

NHS Endocrinologists

Trustees, British Thyroid Foundation

Rt Hon Gordon Brown PC MP, Prime Minister

Nicholson, NHS Chief Executive

Sir Liam son, Chief Medical officer

Mr Alan MP, Secretary of State for Health

Lord Sir Ara Darzi

Dr Fiona Adshead, Deputy Medical Officer

Ms Whittington, Head of Long Term Conditions

Professor Boyle, National Clinical Director – Heart Disease/Stroke

Professor Beasley, Chief Nursing Officer

Flora Goldhill, National Director of user Experience and Involvement

Harry Cayton, National Director Patient and Public Involvement

Dean and Head of all UK Medical Schools