Re: It's all in your head!

[Guest guest]

Hello Alan

It might help if you read part of my response to the Presidents

of the RCP and the BTA, to the Deans of all Medical Schools and all NHS endocrinologists.

I am covering quite a few angles, and this is only one.

Systematic

and Institutionalised Abuse

The

RCP state:

" We set and monitor standards of medical training to ensure that patients

are treated by fully trained and capable doctors”…REALLY?

According

to the RCP, BTA and others, the moment TSH becomes ‘normal’, a

patient, effectively, is no longer suffering hypothyroidism, in the proper

‘narrow sense’ and ‘definition’ of hypothyroidism,

which the RCP uses, and the BTA effectively uses.

The

conventional, mainstream approach to the treatment assumes that T4-only

preparations convert peripherally to T3 in fairly standard amounts and at

fairly standard rates. If that does not occur, it is considered to be because

of extra-thyroidal illness, which is of no concern to the doctor, who is there

to correct thyroid dysfunction. Clinical experience shows this is not true for

the majority of patients.

Quarter

of a million sufferers in the UK are dissatisfied with the way they feel. They

are told their blood tests (often only TSH is measured) are

‘normal’, and that their symptoms are ‘not specific’, or due to depression,

over-eating, or they have some other patient-blaming condition, such as a

functional somatoform disorder. The fact that mental issues cannot be

tested with objective tests, requires that they be the diagnosis of last

resort.

Many

patients report that when their GP performed serum TFT’s, they showed

‘normal’ results, so their thyroid function was fine and then

prescribed Prozac for their depression; amitriptyline for their fibromyalgia;

anti-inflammatories for their musculoskeletal pain; oral contraceptives for

their irregular menses; low levels of antibiotics for their acne; Viagra for

the loss of libido; Ritalin for their ADD; Allopurinol for their gout; and/or

Lipitor for their high cholesterol. One questions whether doctors are in the

employ Big Pharma!

The

universally accepted differential diagnostic protocol requires the

examination of ALL the physical issues, as indeed, the evidence based

medicine does too and recommends that ALL potential causes for the

patient's symptoms should be listed and scientifically tested, but neither

the RCP or the BTA appear to be aware of this .

The RCP admits that (see (d) in their

Statement- “(d)

Patients with continuing symptoms after appropriate thyroxine treatment should

be further investigated to diagnose and treat the cause”, yet both

of these organisations fail to discuss, or disclose what tests should be

done to carry out these further investigations.

Deficiencies

of iron, ferritin, vitamin B12, vitamin D3, folate, magnesium, copper and zinc

deficiencies are the most common causes of patients with residual symptoms. One

should also look into sleep apnea, depression, adrenal insufficiency,

pre-diabetes (or diabetes) or undiagnosed coeliac disease. Other causes for

their continuing symptoms could be failure of the mitochondria, or the

existence of peripheral metabolism and peripheral cellular hormone reception.

The RCP is failing doctors and patients by not disclosing these possibilities

in their Curriculum.

Ideally,

when such tests are done, there is only one cause left, and that cause is

treated. If there are none, then the list of potential causes should be

checked for completeness before a diagnosis of “functional somatoform

disorder” is decided upon. Failure to address these issues is a failure

to meet the diagnostics standard of care.

One

only needs to check the overwhelming number of UK local and Internet Thyroid

Support Groups, whose membership runs into thousands. to realise the enormity

of this problem and note their dissatisfaction in trying to find the answer to

their difficulties - difficulties often caused by their GP or endocrinologist,

who has little, to no, understanding of the greater thyroid system (see

Pritchard’s Table of ‘The Greater Thyroid System’ enclosed).

This Table clearly shows that inadequate testing is being recommended by the

RCP and BTA for those potential victims suffering with euthyroid

hypometabolism.

So why does endocrinology make

excuses? These excuses for their failures do not meet the standard of ethics

for honesty. ”A physician shall act only in the patient’s

interest when providing medical care which might have the effect of weakening

the physical and mental condition of the patient”. World Medical

Association (1949, 1968, 1983)

Hi all. Joined up yesterday as my partner is

already on here and is trying to get her obvious (to me) thyroid problems

addressed. My mum also had a partial thyroidectomy 9 years ago and was put on

50mg of thyroxine, and hasn't had her dosage changed since then, because her

test are 'within range'. I'll post a few questions about this some other time,

but I want to pose a question about something else.

I don't know if this has been brought up before, but I have noticed that a lot

of people here and in other places are told their problems are 'all in your head',

when tests show levels within range, despite symptoms. If gps/endo's seriously

think this, why aren't they refering their patients onto a psychiatrist or

other mental health specialist? I think patients should challenge their gp/endo

to actually refer them on if they think that is the case and see what the

response is.

I know from experiance that waiting times for mental health referals are

horrific, but if the patient got a diagnosis from a psychiatrist saying there

was nothing wrong with their actual mental health, gps/endos would have no

choice but to deal with the physical symptoms.

What does anyone else think?

Alan

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[Guest guest]

I know from experiance that waiting times for mental health referals are horrific, but if the patient got a diagnosis from a psychiatrist saying there was nothing wrong with their actual mental health, gps/endos would have no choice but to deal with the physical symptoms.

Hi Alan and welcome,

You are absolutely right with what you are saying, but going down this route also poses a risk. Once a GP refers a patient to a psychiatrist there will be a "mental illness" query on the patient's medical notes... and it only takes a rubbish psychiatrist to not rule out any kind of mental health problem and set the records straight, and the patient will be tarred with the "mental" brush for life ... and that can have the dire consequence that none of further health problems might be taken seriously .... often the patient hasn't even got a clue why he or she are fighting windmills.

Before I was `officially' diagnosed with Hashimoto's by my GP, I went through a very tearful phase... not surprisingly, since I had been plagued with debilitating hot flushes every hour on the hour 24/7 for about 10 years non-stop. GP said it was menopause, I later realised it was down to untreated Hashi's. It had wrecked my life, my social life and my confidence... I was rock bottom back then, fighting against fainting and was mopping myself dry every hour. GP told me I was clinically depressed and would I like to see someone... I sobbed `NO, just check my frigging (didn't say that!) thyroid function again; I know I am hypothyroid'..... since I was in floods of tears, he did – and I struck it `lucky'; finally my figures were in the red..... a few years later I asked at the surgery to look at my medical records.... and there is was – "Patient is clinically depressed, thinks she has a thyroid problem (TFT normal)", ?somatoform?, chronic malaise!" .... things like that kept popping up in my notes pre Hashi diagnosis. So I made notes of all those comments and dates and an appointment with my GP; I insisted that he should delete everything that referred to my not being compos mentis ... he did.

I would advise anybody who has gone through the process of seeing a psychiatrist and has been "cleared" to request looking through their medical records and check if there are any damning comments about the patient's mental health. GP's are quick to put such queries into the notes, but usually don't bother to correct the records to the effect that the patient is just as mentally sound as the doctor when the psych report comes back as `clear' .

I've forgotten what the NHS called the scheme, but I understand that most patient records have now been made available to a central computer, so those records are available to just about anybody in the health profession in case of an emergency. We were all given the choice, and I opted out of that scheme at the time, but most people probably have just accepted it. So if any of them finish up in a hospital for tests or in an emergency... presumably there are your GP's notes up on the screen for all and sundry to nose around in.... and, although in an ideal world it should not, I bet that any comments about mental health queries or a verdict of "somatoform disorder" will colour the mind of the doctor who happens to treat you.

But in principle you are correct, Alan. Psychiatrists are often better equipped to diagnosed hypothyroidism than our GP's... but I still would not have much confidence that any GP these days is willing (or even capable) to diagnose hypothyroidism on the basis of anything other than a clear cut blood result. Once somatoform disorder is ruled out, it'll be down the diet/exercise/ME/fibromyalgia and what-have-you-route rather than diagnose and treat the obvious thyroid condition that is staring them in the face.

Best wishes,

[Guest guest]

Hi Sheila,

Thanks for that. Very interesting reading. Methinks it might be worthwhile doing

some research on the difference between supposed ethical medical behaviours and

protocols and ACTUAL ethical medical behaviours and protocols!

Alan

>

> Hello Alan

>

> It might help if you read part of my response to the

[Guest guest]

Hi ,

You are, of course, absolutely correct about going down the mental health

assessment route. My partner is having that problem now because of past mental

health treatment (none, except depression, having any bearing on her current

physical symptoms.)

It seems her gp is another one of those doctors being blinkered by the TSH test,

and has no real proper knowledge about thyroid dysfunctions. At least she has

managed to get an appointment to see an endo, but to be honest, I'm not holding

out much hope if some of the stories on here are anything to go by.

Alan

> Hi Alan and welcome,

>

> You are absolutely right with what you are saying, but going down this

[Guest guest]

AB-SO-LUT-ELY Alan!

Sheila

Hi Sheila,

Thanks for that. Very interesting reading. Methinks it might be worthwhile

doing some research on the difference between supposed ethical medical

behaviours and protocols and ACTUAL ethical medical behaviours and protocols!

Alan

>

> Hello Alan

>

> It might help if you read part of my response to the

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Version: 2012.0.1913 / Virus Database: 2112/4817 - Release Date: 02/18/12

[Guest guest]

Hi Alan

>I don't know if this has been brought up before, but I have noticed that a lot

of people here and in other places are told their problems are 'all in your

head', when tests show levels within range, despite symptoms. If gps/endo's

seriously think this, why aren't they refering their patients onto a

psychiatrist or other mental health specialist? I think patients should

challenge their gp/endo to actually refer them on if they think that is the case

and see what the response is.

I asked my GP to do this, given the 'chronic fatigue service' said i was

depressed. I asked for an independent evaluation by a psychiatrist, given that

GPs were not experts.

I got the answer 'i disagree with that, GPs are experts'. So i didn't get the

assessment. I had a long history of depression and this was different

symptoms, but they wouldn't listen... i should have argued more with them and

said if you are experts why can you not manage all patients and start all drug

treatments, but i didn't. (I would readily disagree with them now!). I did

consider getting an assessment from a private psychiatrist, but i decided not

too. i did see someone privately a few years before and he didn't feel there

was much wrong with me.

The problem is fatigue etc are symptoms of depression and if you go to a

psychiatrist, you may be labelled depressed. If your only tool is a hammer,

everything will look like a nail.

I think people could go down that route and it may work but otherwise people

will be labelled as not wanting to get well (because of the attention they get

from being unwell - ignoring the fact they're in sheer hell), and somatising.

yes, that happens. diabetes is linked to depression, and i was told by one

mental health professional of a patient who blamed his depression on diabetes.

He was 'somatising' because 'in his community it's not ok to be mentally unwell,

so he has to blame his illness'. Ok, but: diabetes has long been linked to

depression: " An English physician wrote in 1674 that " diabetes is caused by

" melancholy. " http://diabetescure101.com/depressed2.shtml

As another example, Dr Mcleod - a psychiatrist has found that chromium helps

some patients with depression, and it maybe something to do with insulin

metabolism. so, some doctors just won't listen to what people have to say,

that it's a physical problem.

I think it'd depend on the doctor the person saw. and depending on the GP, they

may disregard the expert opinion anyway. When I saw NHS psychiatrists the

evaluation was very short, not long enough to do a proper assessment, i don't

think. Private psychiatrsits have much longer of course...

Chris

>

> Hi all. Joined up yesterday as my partner is already on here and is trying to

get her obvious (to me) thyroid problems addressed. My mum also had a partial

thyroidectomy 9 years ago and was put on 50mg of thyroxine, and hasn't had her

dosage changed since then, because her test are 'within range'. I'll post a few

questions about this some other time, but I want to pose a question about

something else.

>