An Open Letter to Dr. Drew
Dear Dr. Drew
Congratulations! In a brief statement to a political rag, you managed to reveal one of the biggest misconceptions about thyroid treatment, while at the same time serving as a prime example of just how ignorant the medical profession has become when it comes to treating thyroid disease. I am sure you are now searching for what it is you could have said that pissed off thyroid disease survivors everywhere, especially since this is certainly not your area of expertise. So, let me remind you.
You recently claimed that Hillary Clinton’s medical care is somehow substandard; pointing to the fact that she is on Armour- a drug you say was standard in the 50s. Now, before I explain to you why you are absolutely wrong, let me make clear that this letter has nothing to do with politics. I honestly couldn’t care less what your political motivations are. What I do care about is your criticism of Armour and the fact that your statements are woefully inaccurate and misleading. This is where I can educate you- and trust me, you desperately need it.
First, just like penicillin, some of the best available medications used today have been around for quite some time, and continue to be used because they actually work. Natural Desiccated Thyroid (NDT) medications are no exception. For well over 100 years, NDT medications, like Armour, have saved countless patients from significant health issues because of the fact that NDT is bio-identical and actually provides all five of the hormones your thyroid naturally produces (T4, T3, T2, T1 and calcitonin). What is even more impressive is that when you examine the substantial length of time that patients have been using Armour (one type of NDT), Armour has only had 9 recalls. In sharp contrast, in the relatively short time Synthroid and Levothyroxine have been on the market, they have had over 2000 recalls. Although Armour and the other NDTs are very reliable, consistent, and countless thyroid patients actually PREFER NDT compared to other thyroid medications, doctors like you nevertheless continue to push Synthroid or Levothyroxine as somehow being the “gold standard” of thyroid care. Nothing could be further from the truth and you do an enormous disservice to the thyroid community by perpetuating this myth. So what does Hillary’s doctor know that you don’t?
Well, for starters, Armour is given to HYPOthyroid patients, which means Hillary is not HYPERthyroid as you inaccurately state. While I am sure this was merely an oversight on your part, it does reflect just how little many physicians understand about thyroid disorders. I can only surmise that this is also why so many doctors continue to perpetuate the misconception that T4 only medications are a better form of thyroid hormone replacement, even going so far as calling T4 only medications “bio-identical.”
T4 only medications are not bio-identical. Not even close. As you can see here, structurally, NDT is almost identical in cell structure to what a natural human thyroid produces, whereas synthetic T4 only medications are significantly different.
Source: Synthroid, Manufacturer's Full prescribing information
As you can see here, the molecular structure of human thyroxine (T4) and porcine thyroxine, as found in almost all brands of Natural Desiccated Thyroid medications is identical:
The human thyroxine molecule is displayed on top (Source: Chemical and Engineering News). The porcine thyroxine molecule is displayed on bottom (Source: Nature-throid prescribing information).
Another advantage of NDT over T4 only medications is that NDT provides direct T3, in addition to the 4 other hormones a thyroid naturally produces. Unfortunately, when doctors continue to push T4 only medications, thyroid patients who have trouble converting T4 to T3 are basically out of luck. Of course, as Hillary’s doctor likely knows, the only way to determine if a patient has a conversion issue is to run a complete thyroid panel (TSH, Free T3, Free T4 and Reverse T3). Sadly, many doctors refuse to run a full thyroid panel, and instead, rely solely upon TSH (thyroid stimulating hormone- which incidentally is produced by the pituitary gland) to treat thyroid disorders. If doctors actually examined all of the key thyroid hormone levels, they just might discover that their gold standard of thyroid hormone replacement is nowhere near as effective as they want to believe. Ignorance apparently is bliss. Instead, many of these doctors dole out antidepressants to try and mask their patient’s complaints, leaving a patient to continue suffering as a result of not having the right form of thyroid hormone replacement.
What is even more important is that patients who are on NDT, or even direct T3 therapy, report a much higher quality of life. Why is that you ask? Because they are getting the direct T3 their bodies so desperately need in order to function. There have been numerous studies that not only show that T3 is essential for a healthy heart, metabolism, and emotional well-being, but that T4 monotherapy is actually detrimental to the patient’s health. But please, do not take my word for it. As we tell our members of the Thyroid Survivor Network, it is imperative that you do your own research in order to become your own advocate, and in doing so, go right to the studies to see for yourself. Here are just a few:
http://www.ncbi.nlm.nih.gov/pubmed/18221125 (the administration of synthetic triiodothyronine (T3) was well tolerated and induced significant improvement in cardiac function without increased heart rate and metabolic demand).
http://circ.ahajournals.org/content/107/5/708.long. (low T3 concentrations are a strong independent predicative marker of poor prognosis in cardiac patients and might represent a determinant factor directly implicated in the evolution and prognosis of these patients).
http://jcem.endojournals.org/cgi/content/abstract/93/7/2486 (reported that long-term levothyroxine (T4) replacement therapy in young adults is associated with cardiovascular abnormalities).
There are numerous other studies that demonstrate the importance of T3, and as a result, that T4 monotherapy is actually substandard. Perhaps Hillary’s doctor knew this, or simply listened to his /her patient’s preference when it comes to her own body. I know I am thankful I found a doctor who actually listened to me, rather than sweeping my symptoms under the rug. You see, I lost my thyroid to Hurthle Cell Carcinoma and Papillary Carcinoma (two forms of thyroid cancer), and have managed to get my life back because my doctor not only examined all of my thyroid levels, but also prescribed a combination of Nature-throid and T3. So for me, and thousands upon thousands of patients like me, this is personal. I, along with other thyroid patients, formed the Thyroid Survivor Network in order to empower other patients to learn more about their options and encourage them to be their own advocates when it comes to their care. When we see a doctor like you perpetuate the myth that Armour (and NDT) is somehow substandard care, we have to speak up so that your ignorance does not deprive a single patient of their right to decide which thyroid hormone replacement therapy is right for them. While this may seem like an insignificant issue to many, it is a matter of life or death to those of us who depend on this form of treatment to survive. Now that you understand the seriousness of this issue, please do not take offense when I say, stick to your day job.