Power, Drugs, and Living Well

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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.