Re: a must-read on Derry
That book is chock-full of good info, have you read it? All women should read>
I had read that his medical license was suspended some time back, but was never able to find follow-ups on that. Well, here 'tis, turns out he's retired. I wonder would he have retired had he not been under attack...
good info here on the pitfalls of thyroid hormone testing, & the inadequacy of synthetic thyroid hormone as well...also, the incredible powers the drug companies have.
He sounds as though he was a hell of a good doctor. We all owe him a debt of gratitude. It's a shame that he was hounded out of practice.
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http://www.wordsweave.com/portfolio/livingwell.html
Power, Drugs, and Living Well
The following article was written in 2002. The doctor in the article has since retired.
Saturday afternoon and I have work and deadlines, but my energy and focus have fizzled like a limp balloon. Over the span of a few hours, this hard-working person who was just the other day described as indefatigable becomes a blob in front of the boob tube.
Later in the kitchen, I notice the bottle on the counter. I'd forgotten to take my usual afternoon drug. I take my afternoon amount at dinner time, and within minutes, I have energy and can focus again.
If the College of Physicians & Surgeons of British Columbia had their way, I wouldn't be able to take that drug. They've been trying to put a doctor who treats patients like me out of business for over a year. On September 27, they upheld the suspension of his medical licence.
Speed? Cocaine? No — I'm on thyroid medication.
So are a lot of people. Depending on the estimate, hypothyroidism, or an underfunctioning thyroid gland, affects from five to up to 40 percent of the adult population in Canada and the United States. But just how are those estimates made? By how many people are taking thyroid replacement hormone?
The thyroid gland sits above the Adam's apple and produces hormones used in every cell in the body. When the body doesn't get enough of these hormones, the list of possible symptoms includes fatigue, feeling cold when others don't, weight gain without a change in eating habits, depression, dry skin, hair loss, constipation, high cholesterol, menstrual problems, impaired memory, and the inability to think clearly. Think about what happens to a car if you drive it when it's low on oil, and you get the picture.
Until about 1975, doctors diagnosed and treated hypothyroidism by observing and listening to patients' symptoms. If the patient looks hypo, sounds hypo, and walks hypo, the patient probably is hypo. Give the patient some thyroid medication, and watch what changes. Keep raising or lowering the dose until you find the amount that the patient needs. Not exactly rocket science, but it wasn't scientific enough for those who prefer to make their diagnoses from a piece of paper, so the medical profession came up with a sure-fire test called the TSH test.
TSH stands for Thyroid Stimulating Hormone. This hormone is supposed to tell the thyroid gland when it needs to pump out more thyroid hormone, so a high TSH level should mean that the thyroid gland is underproducing, and vice-versa. Perfect. Never mind that the medical profession had already been through several other tests that were also supposed to have been unfailing methods of diagnosing hypothyroidism, or that this one hadn't undergone any testing to prove whether or not it actually correlated with how patients felt. It was idiot-proof.
To make a test useful, you need to establish a range of "normal." But if up to 40 percent of adults have thyroid problems, is there any chance that only people with optimally-functioning thyroid glands are included in the sample groups used to establish lab ranges?
The medical world still doesn't have a consensus on the acceptable range for the TSH test. The usual high end of the range is about 5.5 mU/L, some labs have their high number somewhere around 4.5, and a few labs go as high as 6. This means that a person could be diagnosed with hypothyroidism based on a blood sample at one lab but not with the same sample at another lab. It's also inconvenient that the American Association of Clinical Endocrinologists came out and said in 2001 that a TSH level over 3 should be considered suspect, and that back in 1997, the prestigious British Medical Journal questioned a TSH level over 2. Never mind, though; a number is a diagnosis, and that's what the medical profession wants.
Numerous thyroid patients don't feel well until their TSH level is under 2, often well under 2. Most labs haven't changed their TSH ranges, however, and with most doctors, a patient who has symptoms of hypothyroidism but a TSH level within the lab's "normal" range is not given treatment for hypothyroidism.
And for a lot of patients who are treated for hypothyroidism, the treatment itself is not adequate.
Imagine you work for a pharmaceutical company. Your company makes drugs to treat depression, weight gain, muscle aches and pain, constipation, hair loss, infertility, menstrual irregularities, high cholesterol, and many more common conditions. Your products meet the needs of the market. Now, it turns out that for up to 40 percent of the people who suffer from these problems, a single cheap pill could solve all of them. Which would you push at the doctors — the cheap pills, or the range of pills that help pay your mortgage?
Pushing pills is big business. The pharmaceutical industry spends more money on marketing than it does on research and development, with thousands of dollars budgeted per physician for direct-selling marketing efforts.
To be fair to doctors, most want to help their patients, but those who attended medical school after 1974 were taught that the TSH test is the gold standard for diagnosing and treating hypothyroidism. They don't know what else to do except to treat each of the symptoms individually, like trying to tape over all the holes in a hose that's sprung leaks along its entire length.
They were also taught that synthetic thyroid medication containing the thyroid hormone T4 only is superior to natural, desiccated thyroid containing all of the thyroid hormones, including fast-acting T3. Sales reps tell doctors that their synthetic brands are more stable and effective than the natural (and less expensive) product, when in fact there is no basis for this claim. A great many thyroid patients have found relief from their hypothyroidism symptoms only after switching from synthetic T4 medication to desiccated thyroid. Many doctors have never even heard of desiccated thyroid, however.
Dr. David Derry of Victoria, British Columbia, Canada, is one of those doctors who listens to patients and treats hypothyroidism mainly by paying attention to symptoms. Having gone to medical school in the 1960s, this is how he was taught to diagnose and treat patients. He observed that when the TSH test became the trendy tool to use, many patients who had symptoms of hypothyroidism did not have a newly-requisite elevated TSH level. Sometimes their TSH level rose after a few years, and sometimes it never rose at all. Yet when he continued to treat these patients the way he'd been taught at medical school, these patients continued to get better.
He observed too that after the advent of the TSH test, the average dose of thyroid replacement medication dropped by two-thirds. This drop occurred without a single study to determine whether or not the lower doses were adequate. Patients who were on thyroid medication but who still had symptoms of hypothyroidism were told that their symptoms must be from something else, because their TSH levels were in range.
Dr. Derry's clinical experience had shown him that treating patients with a high enough dose to alleviate their symptoms worked, and that desiccated thyroid was the most effective medication for the majority of patients with hypothyroidism. In addition, his library of over 5000 books and articles indicated that it had worked for 80-plus years with no harmful effects. He saw no reason to change. If it ain't broke, don't fix it.
The College of Physicians & Surgeons of British Columbia saw differently. In July 2001, a patient who had gone from an endocrinologist to Dr. Derry got better on Dr. Derry's treatment. The endocrinologist complained to the College about Dr. Derry, and the patient complained about the endocrinologist.
The College began an investigation of Dr. Derry. Ignoring the hundreds of letters of support for Dr. Derry's treatment, the College removed his thyroid prescribing privileges in November 2001. After assuring an Appeal Court judge in December that they would investigate Dr. Derry's approach to treating hypothyroidism, they instead went through his files of patients with other conditions, dug up a couple of situations in which patients had died, declared that Dr. Derry was responsible for those deaths, and suspended his medical licence effective June 11.
On June 25, a Supreme Court judge agreed with Dr. Derry that the means didn't justify the end. The judge ordered the College to hold a full investigation by September 30 of this year. If they didn't, Dr. Derry's medical licence and thyroid prescribing privileges would be automatically reinstated. Thyroid therapy was going on trial.
During the hearing that took place on September 14 and 15 in Vancouver, the College Executive Committee focused on Dr. Derry's procedures. He didn't write down patients' blood pressure every time he took it if it was normal. He didn't prescribe the latest, more expensive drugs for pneumonia, but instead prescribed drugs that had continued to be effective for 30 or so years, saving his patients money. He hadn't recited five symptoms of
Depression on demand when the investigating committee had asked him to. The fact that he named all nine symptoms of
Depression in his discussion of depression, and that he spent time listening to his patients to determine the cause of the problem rather than simply writing a prescription for Prozac, didn't appear to be significant to the investigating committee. Nobody asked whether or not he was successful in treating depression.
The College Executive Committee dismissed all the medical references that Dr. Derry had provided to support his treatment for hypothyroidism. They claimed that the benefit Dr. Derry's patients received from his treatment was from the placebo effect and the "euphoria" that supposedly comes from hyperthyroidism, or too much thyroid hormone. They omitted to mention that these patients did not have any symptoms of hyperthyroidism, and that many of them had already been to several other doctors before going to Dr. Derry. If the placebo effect worked on them, it would have kicked in with earlier treatment.
With the College's powers virtually unchecked, any current or future treatments that don't fit within the College's limited vision may no longer be available to us. Our health was also on trial.
My health and my life have improved enormously since I started taking that cheap little pill. This afternoon was a reminder of the direction my health would go if I weren't on this replacement hormone. Maybe someday, a doctor will look at my medical records and say, "Hmmm. I see your TSH level was only 4.2 when you began taking thyroid medication. That number is In Range. Yes, I hear that you've been feeling much better and have been living life as a productive citizen again since you started taking the medication. But really, feeling better is not an accurate way to measure well-being. Sorry, you can't have thyroid medication any more."
A few hours after taking my thyroid medication, I still have energy. But I also have fear.