It's hard enough to be a thyroid patient without realizing that some doctors out there are very misinformed when it comes to thyroid disease. Endocrinologists, whose "specialization" is the endocrine system -- which includes the thyroid gland -- are sometimes the worst offenders when it comes to providing dubious information about your thyroid diagnosis and treatment.
Get smart, and discover the five lies that your endocrinologist may try to tell you.
1. “Your TSH is Normal.”
Integrative doctors consider the Thyroid Stimulating Hormone (TSH) test to be only one of many tests to diagnose and manage thyroid disease. TSH, however, is considered the “gold standard” test by many endocrinologists. Too bad they don’t even agree on the cutoff points for the reference range for this test.
Some endocrinologists consider any number within the reference range (it’s around .40 to 4.0 at many US labs) “normal,” and others feel that TSH must be as high as 10 for a diagnosis of hypothyroidism. And many endocrinologists don’t test Free T4, and Free T3 — the actual circulating thyroid hormones — or antibodies that detect autoimmune thyroid disease. So, you could have sub-normal levels of T4 and T3, and/or antibodies that show that your thyroid gland is in self-destruct mode, but if your TSH is within the reference range, the endocrinologist may say it’s “normal.”
2. “Natural Desiccated Thyroid Drugs Aren’t FDA-Regulated, They’re Not Consistent, They’re Not Safe, They’re Off the Market, They’re Made from Cows”
Natural desiccated thyroid (NDT) is prescription thyroid hormone replacement, made from the dried thyroid gland of pigs. It’s also known as natural thyroid, thyroid extract, and is available as a generic, or as brands, including Nature-throid, Thyroid WP, Armour, and Erfa.
It’s shocking how many endocrinologists are misinformed about these drugs. Here are the facts:
- Natural desiccated thyroid drugs ARE regulated by the FDA. All prescription drugs in the US are FDA-regulated.
- These drugs are regularly checked through rigorous quality-control processes, and are as consistent as other thyroid drugs. Just as with synthetic levothyroxine drugs (like Synthroid), when inconsistent batches are detected, they are recalled.
- When properly prescribed, NDT drugs are as safe and effective as other thyroid hormone replacement drugs. (Note: A federally-funded US government study just demonstrated this recently.)
- NDT is not off the market, it’s legally available in the US, Canada, and a number of other countries.
- NDT brands available in the US are made from pigs — not from cows.
3. “Hypothyroidism Doesn’t Cause Weight Gain”
Many endocrinologists claim that the thyroid, despite being the master gland of metabolism, has nothing to do with weight. People with undiagnosed thyroid disease often report substantial weight gain prior to diagnosis, and even after diagnosis, losing weight can become difficult, if not sometimes impossible, for people with hypothyroidism, or after surgery to remove the thyroid gland. Endocrinologists often accuse thyroid patients on restrictive diets of “eating too much” and tell marathon runners with thyroid problems that they need to do even more exercise to lose weight. They simply don’t understand how the complex ways that the thyroid is linked to body weight.
Fact: The thyroid is intricately linked to blood sugar, hunger and satiety, hunger/weight loss hormones like insulin and leptin, energy, basal metabolism, and many other factors that have a firm hold on whether you gain or lose weight. Getting the thyroid diagnosed and optimally treated is required for weight loss — but many thyroid patients may also need to address insulin and leptin resistance, lowered metabolism, and other issues — before successful weight loss.
4. If You Have a Suspicious Nodule, We Need to Take Out Your Thyroid Gland”
Some thyroid patients have nodules — lumps in the gland. A suspicious nodule may be large in size, growing quickly, or have suspicious characteristics in imaging tests like a CT scan or ultrasound, or on a radioactive uptake test. Before recommending surgical removal, however, a nodule should typically undergo a fine needle aspiration (FNA) biopsy, to assess whether the nodule is cancerous. If it is cancerous, then the treatment typically does involve surgical removal. However, a substantial number of these FNA biopsies come back indeterminate or inconclusive.
If you have FNA testing on a suspicious nodule, and the result is that it is indeterminate or inconclusive, ask for a Veracyte Afirma Thyroid Analysis test, before agreeing to surgery. This test is performed on your FNA biopsy results, and can eliminate most inconclusive results, to determine quite accurately whether the nodule is cancerous. Since some inconclusive nodules are benign, this test can help you avoid surgery and a lifetime of hypothyroidism afterwards.
5. “You Need to See a Psychiatrist”
Conventional endocrinology says that if you are a patient with hypothyroidism and you’re receiving levothyroxine treatment (not a T4/T3 treatment or natural thyroid, which they claim is not needed), and you have a TSH anywhere within the reference range, and you still don’t feel well, your endocrinologist should recommend a consultation with a psychiatrist. This is what was disseminated in the 2014 Hypothyroidism Guidelines, created and promoted by the American Thyroid Association (with funding from levothyroxine manufacturers.)
If you are hypothyroid, are taking only levothyroxine (like Synthroid, Levothroid, Levoxyl, Tirosint, Unithroid), have a TSH within the reference range, and you still don’t feel well — before you head off to any psychiatrist’s couch, it may be time to find a new doctor — typically, an integrative, holistic physician — who can…
- determine whether your TSH is optimal, and not just within the range.
- make sure your Free T4 and Free T3 are tested, and optimized with medication (including T3 or natural desiccated thyroid if necessary).
- look at your Reverse T3 levels, and determine whether or not you may have some thyroid transport or conversion problems that are contributing to symptoms, and treat them.
- advise you regarding other issues, including adrenal balance, nutritional deficiencies, and hormone imbalances.
If you’ve heard any of these lies, it’s time to find a new doctor! Here are some tips and resources for finding a new thyroid doctor.