Re: On line clinic Contradiction

[Guest guest]

I would be very temped to post one of the answers from one of the 'experts'

under the others reply and ask if they are making it up as they go along?

>

> I posted a question entitled " Subclinical Hypothyroid Treatment " as Jane123

and in the answers Dr Kerbel states " Abnormal thyroid levels can increase

your cholesterol by about 2 ........ Treating you thyroid can normalise

cholesterol " .

>

[Guest guest]

Jane, you could respond by quoting from the following

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949076/

" The dangers of statin use in hypothyroid patients have been illustrated and

the necessity for appropriate biochemical monitoring has been emphasized. "

There are a ton of references to show that taking statins can caused

numerous problems as not only does it lower bad cholesterol, it also lowers

good - which we need

http://www.whale.to/b/cassel3.html#Statins—the_honey_in_the_poison_flower

Yg, Li. Zhang F. Wang ZT. Hu ZB. Identification and chemical profiling of

monacolins in red yeast rice using high- performance liquid

chromatography with photodiode array detection and mass spectrometry. J

Pharm Biomed Anal. 2004 Sep 3;35(5);1101-12.

, . Foundations for blockbuster drugs in federally sponsored

research. The FASEB Journal. 2001;15;1671-1676.

Schupf. nn Costa. Luchsinger, Ming-Xin Tang, ph H. Lee.

Mayeux. Relationship Between Plasma Lipids and All-Cause

Mortality in Nondemented Elderly. Journal of the American Geriatrics

Society. Volume 53 Issue 2 Page 219 - February 2005

doi:10.1111/j.1532-5415.2005.53106.x.

 

I posted a question entitled " Subclinical Hypothyroid Treatment " as Jane123

and in the answers Dr Kerbel states " Abnormal thyroid levels can

increase your cholesterol by about 2 ........ Treating you thyroid can

normalise cholesterol " .

A later reply from Professor Colin Dayan states " Treating subclinical

hypothyroidism doesn't lower cholesterol very much in most people and taking

a statin is more effective " .

I really want to respond to this but am not sure what to say. Any ideas?

Anyway it'll be interesting to see if there are any further posts from Dr

Kerbel on the subject.

Jane

________________________________________

No virus found in this message.

Checked by AVG - www.avg.com

Version: 2012.0.1901 / Virus Database: 2109/4770 - Release Date: 01/27/12

[Guest guest]

Taking statins can cause all kinds of other health problems and I wouldn't go near them! Amongst the many potential side effects: muscle pain and damage, liver and kidney damage, etc. There are natural ways to reduce cholesterol! Another thing the doctors won't tell you because it won't make the pharmaceutical companies big bucks if you treat yourself with natural products!

From: thelwallj <thelwallj@...>thyroid treatment Sent: Friday, January 27, 2012 7:48 PMSubject: On line clinic Contradiction

I posted a question entitled "Subclinical Hypothyroid Treatment" as Jane123 and in the answers Dr Kerbel states "Abnormal thyroid levels can increase your cholesterol by about 2 ........ Treating you thyroid can normalise cholesterol".A later reply from Professor Colin Dayan states "Treating subclinical hypothyroidism doesn't lower cholesterol very much in most people and taking a statin is more effective".I really want to respond to this but am not sure what to say. Any ideas? Anyway it'll be interesting to see if there are any further posts from Dr Kerbel on the subject.Jane

[Guest guest]

Thank you Sheila

I've concocted a reply which I know will not be as erudite as yours would be and

I will post it in a moment.

Jane

>

> Jane, you could respond by quoting from the following

> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949076/

>

> " The dangers of statin use in hypothyroid patients have been illustrated and

> the necessity for appropriate biochemical monitoring has been emphasized. "

>

> There are a ton of references to show that taking statins can caused

> numerous problems as not only does

>

> ________________________________________

> No virus found in this message.

> Checked by AVG - www.avg.com

> Version: 2012.0.1901 / Virus Database: 2109/4770 - Release Date: 01/27/12

>

[Guest guest]

…and the best two natural products are coEnzymeQ10 and niacin (Vitamin

B3

Taking

statins can cause all kinds of other health problems and I wouldn't go near

them! Amongst the many potential side effects: muscle pain and damage, liver

and kidney damage, etc. There are natural ways to reduce cholesterol! Another

thing the doctors won't tell you because it won't make the pharmaceutical

companies big bucks if you treat yourself with natural products!

I posted a question entitled " Subclinical Hypothyroid

Treatment " as Jane123 and in the answers Dr Kerbel states

" Abnormal thyroid levels can increase your cholesterol by about 2 ........

Treating you thyroid can normalise cholesterol " .

A later reply from Professor Colin Dayan states " Treating subclinical

hypothyroidism doesn't lower cholesterol very much in most people and taking a

statin is more effective " .

No

virus found in this message.

Checked by AVG - www.avg.com

Version: 2012.0.1901 / Virus Database: 2109/4770 - Release Date: 01/27/12

[Guest guest]

Sheila have they removed your questions from the online clinic.

I cannot see that they have done much in the way of answering questions.

I have to wonder which one of us thought of the online name of nhsdoesntcare,

which is very apt.

Are they getting paid for doing this clinic by any chance.

Kathleen

>

> …and the best two natural products are coEnzymeQ10 and niacin (Vitamin B3

>

>

>

>

>

> Taking statins can cause all kinds of other health problems and I wouldn't go

near them! Amongst the many potential side effects: muscle pain and damage,

liver and kidney damage, etc. There are natural ways to reduce cholesterol!

Another thing the doctors won't tell you because it won't make the

pharmaceutical companies big bucks if you treat yourself with natural products!

>

>

>

>

>

>

>

>

[Guest guest]

HI SHEILA

I don't remember seeing your answer, but will go back and have another look.

Have they removed your questions and comments because they know who you are.

I ask why I have been classified as a deluded hypochondriac, but no answers so

far.

So far I have received three responses back out of the four complaints, but will

email you later too see what you would do.

Kathleen

>

> Which question are you referring to Kathleen. They have removed most of what I

have written. This morning, I even went on to answer a question and gave them a

lot of information because it is a fact, the thyroid experts certainly are not

doing this and leaving many, many questions unanswered. They will probably

remove that too. It is under the Hypothyroid section and the subject heading is

(ab)normal tests.

>

> Sheila

[Guest guest]

HI SHEILA

I have been back on this online clinic and I think I recognise your two under

Shetur with the heading (ab) normal tests.

I have also had a response to why I have been informed that I am a deluded

hypochodriac, and the response was that it is because I am on the correct dose.

However this contradicts the fact that my GP wanted me to take 50mcg of T4, so I

have gone back on this answer they have given with strength.

Kathleen

>

> Which question are you referring to Kathleen. They have removed most of what I

have written. This morning, I even went on to answer a question and gave them a

lot of information because it is a fact, the thyroid experts certainly are not

doing this and leaving many, many questions unanswered. They will probably

remove that too. It is under the Hypothyroid section and the subject heading is

(ab)normal tests.

>

> Sheila

[Guest guest]

Go on then .

Luv - Sheila

I would be very temped to post one of the

answers from one of the 'experts' under the others reply and ask if they are

making it up as they go along?

>

> I posted a question entitled " Subclinical Hypothyroid Treatment "

as Jane123 and in the answers Dr Kerbel states " Abnormal thyroid

levels can increase your cholesterol by about 2 ........ Treating you thyroid

can normalise cholesterol " .

>

No

virus found in this message.

Checked by AVG - www.avg.com

Version: 2012.0.1901 / Virus Database: 2109/4770 - Release Date: 01/27/12

[Guest guest]

I hope that this bit with online questions to and answers from establishment

endocrinologists does one thing: produce some resolve to find a higher decision

maker - much higher.

Have a great day,

[Guest guest]

I have received a lengthy response from Dr Kerbel

http://talkhealthpartnership.com/forum/viewtopic.php?f=194 & t=2284

I am not sure how to respond and it would be interesting to know if the others

will respond. If anyone here would like to contribute, it may start things

rolling.

The topic was 'For the Experts...'

Sorry for not getting back to all the posts sent to me yesterday (thank you all

and will respond) - I overdid it yesterday and am feeling the pain!

Love

Jacquie x

[Guest guest]

I received a reply from Dr Lazarus, to my question 'TSH 4.2, what should I do?'

- and it's exactly what I expected.

http://talkhealthpartnership.com/forum/viewtopic.php?f=185 & t=2142 & p=6606#p6606

What boggles me is that, not only do they suggest absolutely nothing but more

TSH tests till you get nearer to the magic number - they don't even suggest

doing anything else, like checking iron or B vitamin levels! They literally want

to do NOTHING even if you are more or less bedridden! How can a doctor do this?

I am luckily not as ill as that, but many are, with TSH well below 10, and they

get the exact same response. It baffles me that a doctor wouldn't a) want to get

to the root of the problem, and feel an obligation to try!

[Guest guest]

Polite words fail me!

>

It baffles me that a doctor wouldn't a) want to get to the root of the problem,

and feel an obligation to try!

>

[Guest guest]

Helen, now is your chance to put this to Professor Lazarus. Unless

we challenge these doctors, how can we expect anything to change? This is your

chance to tell him what you think and to ask more questions. After Wednesday,

they will be gone and we will have missed our chance.

Luv - Sheila

=

I received a reply from Dr Lazarus, to my

question 'TSH 4.2, what should I do?' - and it's exactly what I expected.

http://talkhealthpartnership.com/forum/viewtopic.php?f=185 & t=2142 & p=6606#p6606

What boggles me is that, not only do they suggest absolutely nothing but more

TSH tests till you get nearer to the magic number - they don't even suggest

doing anything else, like checking iron or B vitamin levels! They literally

want to do NOTHING even if you are more or less bedridden! How can a doctor do

this? I am luckily not as ill as that, but many are, with TSH well below 10,

and they get the exact same response. It baffles me that a doctor wouldn't a)

want to get to the root of the problem, and feel an obligation to try!

No

virus found in this message.

Checked by AVG - www.avg.com

Version: 2012.0.1901 / Virus Database: 2109/4772 - Release Date: 01/28/12

[Guest guest]

I would like to ask a question but when I manage to find it I just cannot find where to ask the question.Can someone give me the link to it and some instructions on where to click on or where I can ask the question please.

Lilian

[Guest guest]

I did indeed reply, you should get taken to the thread if you click the link -

http://talkhealthpartnership.com/forum/viewtopic.php?f=185 & t=2142

X H

>

> Helen, now is your chance to put this to Professor Lazarus. Unless we

> challenge these doctors, how can we expect anything to change? This is your

> chance to tell him what you think and to ask more questions. After

> Wednesday, they will be gone and we will have missed our chance.

[Guest guest]

Well i'd write something like this....it sounds like he is quite reasonable in

some ways - better than the doctors i've seen anyway. I suppose we're not

supposed to write anything other than a personal question, but as he has not

answered your question, and said so, i thought i'd answer his points. I can't

post as it's locked....but i felt annoyed at his response so i feel a bit better

for writing this...

>

>

> I am not sure how to respond and it would be interesting to know if the others

will respond. If anyone here would like to contribute, it may start things

rolling.

----

>Unfortunately you are not alone and frustrations are clear and anger the

outcome.

Are you surprised when people are unnecessarily being condemned to ill health?

Many doctors do not listen and will only treat on blood tests, and disregard any

lingering symptoms as 'depression' or 'ME'. There are many accounts of patients

who have had to take their health into their own hands and have recovered,

perhaps pushing hard for T3 to be prescribed, or self medicating with T3 or

Natural thyroid extract. These patients can have a miraculous recovery from

their 'depression' or 'ME'.

>2) Starting treatment and getting to a therapeutic dose.

>Many doctors were taught to start levothyroxine (T4) at 50mcg. This supplements

your natural thyroxine but often will not block production. The pituitary picks

up that there is >now adequate T4 in system so slows its own production -

negative feedback. Your Dr checks TFTs and finds you need more T4 so increases

by 25mcg - this intensifies negative >feedback and lowers your own T4 production

further...

>It should now be standard practice to " block and replace " . This means using a

large enough dose of T4 to block the bodies own production and provide enough

for the body. The >trouble is that we are all different with different T4

requirements.

>Current standard practice & teaching is to start at 100mcg of T4 - in BNF

(British National Formulary) now, unless patient has angina or is elderly when

should start at 50mcg >for 2w & increase to 100mcg after 2w.

>These guidelines apply to all patients - so thin eldery ladys may only need

50-75mcg & will end up having their doses reduced. Most however will need higher

doses. Larger " traditionally build " ( McCall - No 1 Ladies

Detective) ladies (hypothyroidism affects F:M 10:1)

As many patients need 175mcg - 200mcg this will take a year to build up to

therapeutic doses in an ideal world. The reality is that blood tests may be done

late, some may be inconclusive, results go astray or dosages not increased

immediately or medication not be available etc. It took my wife 2 years to get

to a steady state... (2 yrs of hell feeling tired all the time.)

I note that at no point do you mention asking how the patient how they feel.

If your wife had 'optimal' levels of T4, and TSH, but still felt bad, what would

you have said to her? Furthermore, what would you have told her if she advised

you she'd taken more thyroid than prescribed, in a desperate attempt to get

well, and had got well, but now was 'hyperthyroid' based on the blood tests and

her doctor wanted to reduce her dose? This is the situation many people face,

especially when outdated reference ranges are being used, with no good

explanation.

>I did read that an Evidence Based Medicine expert looked at literature & there

isnt actually evidence supporting current guidelines on increasing T4, practice

is based on expert guidance & clinical experience. He took as much T4 as he felt

he needed - then checked TFTs 3m later and his levels where normal. The problem

is he was a physician & new what he was doing. What do I as a GP tell patients

to take when they ask how much to take? We desperately need some new ideas &

guidance on getting T4 to therapeutic levels earlier (perhaps a formular based

on weight or BMI) - perhaps the BTF can help commission some?

Your colleague listened to how he felt first and foremost - he took as much T4

as he felt he needed - he went by his symptoms. Why are patients not afforded

this luxury? Being hyperthyroid is uncomfortable - do you and your colleagues

really think that a patient will not know if they are hyperthyroid based on how

they feel, and need a doctor to tell them? This seems to be the conclusion and

it is very insulting. Patients are not idiots nor are they just blood tests,

anymore than GPs are just 6 figure salaries, paid to argue with their patients

and condemn them to a lifetime of misery.

Doing the same thing in a different way won't help. There is no need for the

BTF to create new formulae based on the same treatment. All treatment options

need to be considered, including T3 and Natural Dessicated thyroid.

Furthermore, any new treatment guideliness would have to include relevant tests

for vitamins and minerals - if any of these are deficient then a patient will

not have an optimal response to thyroid. Can I suggest the revolutionary new

method of listening to patients and working with them, listening to what

patients have learnt, looking at research (which is frequently discounted) and

not fobbing patients off saying it's their age, depression, or ME, or any of the

other things people are told on a daily basis?

>Current recommended treatment and advice is to use levothyroxine & get to a

therapeutic dose biochemically.

>Generally patients do feel better on proper therapeutic doses.

>Unfortunately a small percentage don't.

>Referral to an endocrinologist specialising in thyroid problems may be

necessary as this will now be beyond GP management skills.

Part of the problem is the outdated reference range -people are being refused

treatment when they would get treatment in other countries. Another part of the

problem is that many patients cannot get past their GP, who refuses to believe

them that they don't do well on T4 only, and certain endocrinologists will not

listen to these patients either. Some patients can only recover by taking their

health into their own hands. Some people - the lucky ones who can afford it -

even have to travel abroad to get treatment! Do you think that is right?

>Yes - T4 is cheap and T3 extremely expensive.

It is only expensive in the UK; the NHS has enormous buying power yet chooses to

pay a premium price for a generic medicine. Please review the prices of T3 in

other countries, eg France, Belgium, Mexico - all made by well known companies.

You'll be familiar with hydrocortisone - you may also be familiar with the story

how Auden Mackenzie increased the price the NHS pay nearly 10 fold - they were

£5 in 2008, now according to the BNF, they are £43. Why do we pay Auden

Mackenzie to make hydrocortisone when there are many generic versions of it?

Even the original Cortef brand is cheaper than Auden Mackenzie. There are many

brands and manufacturers of T3; if the NHS chooses to buy from the dearest

source, then patients should not suffer for this. Don't complain about the

price of the medication but instead try to bring the price down through correct

procurement and economies of scale. Please do not try to justify keeping people

ill for £26 pounds a month.

>I would insist that a patient first tried T4 and that there TFTs were in normal

range before referring for T3 treatment.

Why do you not consider natural dessicated thyroid too, when some people only

regain their health on this?

>This is an evolving field and I am sure things will evolve and change.

An evolving field? Thyroid therapy has been established for over a hundred

years. Why is it necessary to disregard all of this evidence about what works,

in favour of devotion to TSH and T4, and synthetic thyroid medication that does

not work for everyone? I refer you to - " Murray GR. The life history of the

first case of myxoedema treated by thyroid extract. Br Med J 1920;i:359-60 "

Note the publication and the date!

[Guest guest]

Excellent - please post this when the 'door is unlocked'.

I would add where you have mentioned depression and ME, CFS and FM also, along

with " functional somatoform disorder " .

After Wednesday, the door will be LOCKED to us permanently and

we will have lost our chance to say what we feel or ask more questions.

- how do you feel about responding to this one - you have

the eyes and ears of the BTA 'experts' here? This particular question and Dr

Kerbel's response is in this thread http://www.talkhealthpartnership.com/forum/viewtopic.php?f=194 & t=2275

Luv - Sheila

Well i'd write something like this....it sounds like he is

quite reasonable in some ways - better than the doctors i've seen anyway. I

suppose we're not supposed to write anything other than a personal question,

but as he has not answered your question, and said so, i thought i'd answer his

points. I can't post as it's locked....but i felt annoyed at his response so i

feel a bit better for writing this...

[Guest guest]

I don’t manage to follow forums very much – but I’ve followed much more over this last week – it has been fascinating following the Online Clinic.

It’s a bit like watching a soap opera!

(I posted a question about TSH and monitoring my thyroid replacement. And the reply from the expert only partly addressed the contradictions I am faced with.)

I’m going to try to follow the TPA message forum more consistently from now on.

Thank you all.

Lynne