Lazarus causing confusion.

[Guest guest]

Seems the experts are so tired they are having a day off. However, this,

from Professor Lazarus made me see red because this is what I have been suspecting

now for quite some time. I will go back and respond (if it opens up again) with

the following

Luv - Sheila

Re:

Standards Inconsistent - Thyroid Symptoms

http://www.talkhealthpartnership.com/forum/viewtopic.php?f=185 & t=2103 & start=10#p6076

by Professor

Lazarus on Wed Jan 25, 2012 1:12 pm

" I believe that the guidelines from The British

Thyroid Association together with the statement issued by The Royal College of Physicians

of London are the appropriate documents to guide all clinicians in the

management of hypothyroidism at this time. Of course medicine is a

profession where continuing advances based on evidence are being made all the

time and it is not possible to predict these. I would also add that 'the art'

of medicine is an important consideration when managing hypothroid patients as

well as the science. "

Professor

Lazarus, thank you, thank you, thank you! You have hit the nail on the

head and we now understand why doctors are getting their knickers in a twist.

If you believe that the RCP Statement is about the diagnosis and management of

hypothyroidism, that explains why other doctors believe this too. The RCP's

statement is NOT the " appropriate document to guide all clinicians in the

management of hypothyroidism " at this time, or any other time. The RCP

statement is about the Diagnosis and Management of PRIMARY hypothyroidism and

PRIMARY hypothyroidism ONLY.

Oh dear!

Members

of the RCP and BTA should read the paper by Pritchard http://www.tpa-uk.org.uk/pritchard1.pdf

" The

Linguistic Etiologies of Thyroxine-Resistant Hypothyroidism " to get a

clear picture of many patients are being left suffering symptoms of

hypothyroidism - without them ever regaining their normal health.

This

is a very

serious problem - and endocrinology continues to ignore it. This very

serious problem is the two completely physiologically different definitions of

'hypothyroidism' given by the BTA and the RCP. Look these up on their

respective websites.

·

The RCP

(London) defines ‘hypothyroidism as " the clinical

consequences of insufficient secretion by the thyroid gland " -

meaning 'hypothyroidism' is ONLY associated with the thyroid GLAND. This

definition is the correct and narrow definition and can hopefully, be treated with

levothyroxine sodium-only.

·

The BTA

however, define hypothyroidism as " the clinical consequences of

insufficient levels of thyroid hormones in the body " . This

‘broad’ definition is associated with peripheral metabolism and

peripheral cellular hormone reception, which produces insufficient thyroid

hormones in the body. Therefore, this is the broad definition and

should not be called ‘hypothyroidism’. It should be

given a diagnosis of ‘Clinical Euthyroidism’, ‘Euthyroid

Hypometbolism' or 'Impaired

Cellular Response to Thyroid Hormone' - and peripheral thyroid hormone deficiencies

would be treated with T3 and not T4.

Why are these two

physiologically different definitions of 'hypothyroidism' not being resolved

once and for all so that people needing different treatments are treated

differently and properly.