Progesterone & Thyroid: A Hormonal Connection Essential for Optimal Women’s Health

Steven F. Hotze, M.D., is the founder and CEO of the Hotze Health & Wellness Center in Houston, Texas. In his new book  Hypothyroidism, Health & Happiness: The Riddle of Illness Revealed Dr. Hotze reveals how commonly hypothyroidism is overlooked, misdiagnosed, and mistreated in women and men.

An interesting video discussion of hypothyroidism and a written discussion of the role low progesterone can play in some patients  developing hypothyroidism

http://hypothyroidmom.com/progesterone-thyroid-a-hormonal-connection-essential-for-optimal-womens-health/

 

Which Type of Thyroid Treatment Is Best?

Jacob Teitelbaum, M.D., internist and author of From Fatigued to Fantastic!, researches treatments for Chronic Fatigue Syndrome and fibromyalgia.

In this article he argues that different people do better with different types of thyroid hormone, and you can tell which is best by what feels best to you. He advocates the addition of T3 or Armour (desiccated) thyroid for patients who do not respond to T4 alone. He also argues that a person may have low thyroid despite normal blood tests – it is conservatively estimated that over 50% of people who need thyroid hormone have normal blood tests.

http://www.psychologytoday.com/blog/complementary-medicine/201006/which-type-thyroid-treatment-is-best

What kind of thyroid medication should I be taking?

Often people find they do not feel normal when given T4.

Dr Robert J Hedaya is a Clinical Professor of Psychiatry at the Georgetown University Hospital and Founder of the National Center for Whole Psychiatry.

In this article he discusses the addition of T3 or Porcine thyroid to T4 in cases where patients do not respond to T4.

http://www.psychologytoday.com/blog/health-matters/201003/what-kind-thyroid-medication-should-i-be-taking

 

How Bio-identical Hormones Can Help Women Before & After Menopause – Dr Lissa Rankin

Dr. Lissa Rankin, an OB/GYN physician writes:

As a gynecologist, it breaks my heart to see how many women suffer this way when we have so many tools to help them. But they don’t teach you many of these tools in medical school.  Before I started practicing integrative medicine, I worked my butt off in a busy managed care practice where I was expected to see 40 patients/day.  Trained at high powered academic institutions, I was brainwashed to believe what I was taught and didn’t open my mind to alternatives until I ultimately quit my job because I intuitively knew there was more we could do for women than a traditional medical practice was allowing me to offer.

http://www.psychologytoday.com/blog/owning-pink/201009/how-bio-identical-hormones-can-help-women-after-menopause

Could a ‘renegade’ doctor save your life?

An extremely interesting  article from the Daily Telegraph, 27 July 2014,  describes the work of a number of  doctors operating outside the boundaries of conventional medicine. They have frequently been hounded by the  governing bodies of the profession . The article devotes several paragraphs to the work of Gordon Skinner who died in 2013:

Skinner could not have been more vocal in what he saw as a great injustice.

A former virologist based at the University of Birmingham, he argued that, in any scientific group there was always roughly five per cent that didn’t fit into the bell curve and so couldn’t be diagnosed via a blood test. If patients were showing symptoms of hypothyroidism, he was prepared to treat them. And, as evidence of the unreliability of blood tests, he pointed to the discrepancies between what was considered normal levels of the hormone in different countries.

. . .

Dr Skinner was also criticised for regularly prescribing Armour Thyroid, a thyroid replacement taken from a pig’s gland, which contains all the active hormones you need for your thyroid to work efficiently, whereas the synthetic thyroxine that British doctors are told to prescribe contains only one, T4.

Skinner thought that many people weren’t able to convert T4 into the active hormone, T3, and therefore thyroxine was useless to them. But as Armour is no longer listed in the British National Formulary, the reference book GPs use for prescribing, many don’t know it exists, something Skinner put down to the workings of “Big Pharma”. Natural products can’t be patented, he said, and therefore were not lucrative, so GPs were discouraged from prescribing them.

http://www.telegraph.co.uk/health/alternativemedicine/10985192/Could-a-renegade-doctor-save-your-life.html

A response to this article appeared in the comments below it and on the Thyroid UK website. it is reproduced below.

Dear Editor,

I am grateful to Ms Anna van Praagh for her article ‘Why are doctors being demonised?’ in the Sunday Telegraph Magazine on the 27 of July 2014.

I would like to start by quoting some statements by Panels who sat in judgment at Dr Skinner’s Fitness to Practice Hearings in 2007 and 2011.

The Panel at Dr Skinner’s Fitness to Practice Hearing of the General Medical Council in Manchester on Thursday 17 November 2011 said, and I quote ‘The Panel cannot fail to take notice of the fact that your approach to treatment, whereby both clinical and biochemical parameters are assessed, falls within the guidelines of Good Medical Practice. In this respect your assessment of your patients does not differ from Dr Akintewe. The difference of approach lies in the weight given to the respective clinical and biochemical findings’. On the same day the Panel also said ‘The safety and follow-up routine as described by you have allowed the Panel to feel confident that patient safety is not disregarded by you’.

Earlier at the Fitness to Practice Hearing in Manchester on Sunday 11 November 2007 the Panel said ‘It is clear that you (Dr Skinner) are a caring and compassionate doctor whose overwhelming concern is the care and well being of your patients’. The Panel also said ‘A large body of evidence has been submitted throughout this case demonstrating that many patients have benefitted from the medication you have prescribed’.

It is important to understand Dr Skinner’s background in order to explain his position as a doctor treating patients by applying his outstanding scientific knowledge and experience to medical practice.

Dr Skinner started his career in Obstetrics and Gynaecology then moved into research publishing extensively on herpes and other viruses, vaccine development and was one of the pioneers of research into the association of viruses to cervical cancer. The Nobel Prize given to Professor Harald zur Hausen for establishing the link between human papilloma virus and cervical cancer confirmed that Dr Skinner’s basic research idea was correct albeit a different virus was responsible. Dr Skinner was admired for his fearless and exceptional intellect, independence of thought and great analytical mind.

In his capacity as a Consultant Virologist at the Queen Elizabeth Hospital in Birmingham he was referred patients who were thought to have Chronic Fatigue Syndrome, Myalgic Encephalopathy (ME) and other problems thought to be related to viral infection; he felt that a number of these people had classical signs and symptoms of hypothyroidism and treated them with thyroid replacement with encouraging results. He then started working with a number of General Practitioners to address the possibility that there may be a group of individuals who have normal thyroid chemistry but are suffering from hypothyroidism. The British Medical Journal published a letter in 1997 from Dr Skinner and a number of General Practitioners bringing this to the notice of the medical world.

Dr Skinner’s work involved a specific group of patients who have thyroid chemistry within the reference range but clinical signs and symptoms of disease; he argued that blood tests should not be pivotal in the diagnosis and treatment of hypothyroidism as they had never been validated as a marker of optimal health. Secondly, in this particular group of patients it was not known what their blood test results were when they were healthy therefore using blood tests as the only criteria for diagnosis was not sufficient.

It must be emphasised that Dr Skinner was not doing anything new nor prescribing new medication for the treatment of hypothyroidism; patients were diagnosed and treated for this disease based on clinical signs and symptoms and medical examination before blood tests were established and thyroid replacement using natural preparations was the norm prior to synthetic preparations.

The treatment Dr Skinner used was one that has been used for many  years namely thyroxine which is the drug of choice for most patients with hypothyroidism and in those who did not respond to this he used the natural Armour or Erfa Thyroid which were used in the treatment of hypothyroidism before synthetic thyroxine was manufactured. His methods were scientifically sound and he always wrote to the General Practitioners and other medical carers to inform them of his reasoning behind the diagnosis and treatment of patients.

Dr Skinner’s clinic in Birmingham was a professionally run establishment which was registered with the Care Quality Commission with regular inspections which resulted in glowing reports of our administration and Dr Skinner’s care of his patients. All patients were given details of possible side effect of treatment both verbally by him and in the form of an information sheet. We must not lose sight of the fact that most medications have side effects and responsible doctors manage patient care by regular monitoring and follow-up as did Dr Skinner. We also have to understand that patients must be allowed to exercise choice in relation to decisions about their healthcare.

Throughout his work with this group of patients Dr Skinner tried very hard to engage with the rest of the medical profession and address this difference of medical opinion which results in lack of proper medical care in this particular cohort. As far back at 1999 he organised a conference and invited Endocrinologists, General Practitioners and representatives of the Royal Colleges and Department of Health and other medical bodies to engage and discuss their difference of opinion and formulate a way forward for the diagnosis and treatment of these patients. No representative from any organisation except an epidemiologist from the Department of Health attended. The same pattern followed all efforts including further conferences, meetings and letters by Dr Skinner to have a public discussion with medical colleagues to address this shortfall in the care of this particular group of patients.

The Royal Society of Medicine’s reply to Dr Skinner’s repeated request for a conference to address this problem was to organise a conference on thyroid disease and refuse Dr Skinner’s request to speak on his experience in diagnosis and treatment of hypothyroidism. The only Royal College which sent a representative to speak at the World Thyroid Forum organised by Dr Skinner in 2012 was from the Royal College of Obstetrics and Gynaecology to speak on fertility problems in hypothyroid patients.

Dr Skinner vigorously opposed certain aspects of the UK Guidelines at the time they were being formulated and lodged his ‘Document of Record concerning UK Guidelines for thyroid function tests’ in 2005 with all the Royal Colleges, National and Local Health Organisations, the British Medical Association and tried with the Society for Endocrinology who rejected it. He also wrote to Dr G H Beastall, Secretary, Guidelines Development Group, British Thyroid Foundation in 2005 to comment on the pitfalls in the proposed guidelines.

It is disappointing that Dr Skinner’s medical colleagues have been and still are behaving like bullies in a playground forming their gangs and stopping all others from engaging with doctors they have chosen to cast out of their inner circle. Sadly, they have neglected their duty in caring for these patients resulting in a serious shortfall in their medical care leading to unnecessary suffering and years of mental and physical ill health.

These Endocrinologists and General Practitioners have harassed Dr Skinner and doctors like him and instead of constructive scientific discussions have resorted to firing their guns from the shoulders of the General Medical Council and patients and their needs have been completely forgotten. It takes a great deal of courage and determination to persevere in the face of such adversity and Dr Skinner’s bravery and belief in doing the best for his patients brought respect and loyalty from all those who knew him.

This is borne out by numerous patients attending the General Medical Council every time Dr Skinner appeared before them and by more than 2500 testimonials from patients presented before the General Medical Council at his Hearings.

By their own admission, the majority of Endocrinologists and General Practitioners would not treat the patients who were treated by Dr Skinner so they have no experience of diagnosing and treating these patients. Dr Skinner successfully treated thousands of these patients and accumulated a vast treasure of information including blood tests and clinical signs and symptoms at their first consultation and at follow-up.

The difficulty in publishing when one has a difference of opinion from the established medical world is that the so called ‘peer review’ journals are very much influenced by these self-professed ‘Experts’ who proudly proclaim that they are on the Editorial Boards of all journals of repute thus stifling any work which is contrary to their view. This has resulted in control of what is published and what is rejected by a group of scientists and doctors who are preventing important evidence in diagnosis and treatment of hypothyroidism from being debated in mainstream medicine. A difference of medical opinion has been turned into a territorial war at the expense of the patients.

Dr Skinner was a fearless doctor who was true to his Hippocratic Oath and behaved with integrity and carried himself with dignity in the face of callous and unprofessional opposition from Endocrinologists and General Practitioners who ganged up against him and tried very hard to discredit him; the support of patients whose lives have been dramatically changed by Dr Skinner’s care bears witness to his dedication and his determination to do the best for them. I hope in time doctors will be brave enough to once again put patients before all else and stop being so fearful of ‘senior colleagues’ and litigation.

It is a great loss to the scientific and medical world that this brave, articulate and fiercely independent thinker is no longer with us.
Yours sincerely,

Afshan Ahmad PhD

 

http://www.worldthyroidregister.com/Letters–NEW-Content-.html

 

 

 

Medical Tourism – Bioidentical Hormone Replacement Therapy in Hong Kong.

Bioidentical Hormone Replacement Therapy in Hong Kong.

http://www.lifeclinic.com.hk/index.php/treatments/internal-anti-

Lauren Bramley & Partners is  a general practice which aims to provide ongoing, personal patient-physician relationship focused on integrated care and total wellness. Providing bioidentical hormone replacement therapy is one of a number of integrative approaches offered at the practice. Others include nutrition, osteopathy, hypnotherapy, homeopathy and anti-aging medicine. Dr Bramley has worked closely with some doctors in Singapore.

http://www.laurenbramley.com/service/bio-identical-hormone-therapy/

 

Bioidentical Hormones: Why Are They Still Controversial?

This is a very comprehensive, well referenced  report authored by the Life Extension Foundation. It concludes:

Given the preponderance of evidence, maturing women should feel confident that bioidentical hormone replacement, when appropriately prescribed, offers a safer and potentially even more effective alternative to conventional hormone replacement with non-bioidentical hormone drugs to help relieve menopausal symptoms and optimize long-term health. The addition of several proven nutrients to a bioidentical hormone regimen may help optimize estrogen metabolism and reduce cancer risk even further, offering an optimal, balanced approach to health maintenance.

http://www.lef.org/magazine/mag2009/oct2009_Bioidentical-Hormones_01.htm

The Truth About Hormone Therapy

In this article in The Wall Street Journal, Drs. Schwartz, Holtorf and Brownstein, three founding members of the Bioidentical Hormone Initiative, a non-profit group of physicians dedicated to patient and physician education (www.bioidenticalhormoneinitiative.org), argue that the medical establishment must stop kowtowing to drug companies and start serving women’s best interests — and that involves widely prescribing bioidentical hormones. This will lead to healthier, happier women and, in the long run, help reduce America’s skyrocketing health-care costs.

http://online.wsj.com/news/articles/SB123717056802137143?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB123717056802137143.html

 

 

Bioidentical Hormones – the Oprah Controversy

In January 2009 Oprah Winfrey hosted actress Susan Somers discussing her use of bioidentical hormones and other supplements.

After this programme aired Newsweek magazine published a less than flattering cover picture of Oprah with the heading  Crazy Talk: Oprah, Wacky Cures, & You and a blistering attack on the programme entitled Why Health Advice on ‘Oprah’ Could Make You Sick by Weston Kosova.  The article quotes, among others in the anti-bioidentical hormone camp, Dr Nanette Santoro, Director of Reproductive Endocrinology at Albert Einstein College of Medicine and head of the Reproductive Medicine Clinic at Montefiore Medical Center as saying that Oprah’s guest, Susan Somers, is simply repackaging the old, discredited idea that menopause is some kind of hormone-deficiency disease, and that restoring them will bring back youth . . .They just don’t need as much once they get past their childbearing years. Unless a woman has significant discomfort from hot flashes—and most women don’t—there is little reason to prescribe them.

http://www.newsweek.com/why-health-advice-oprah-could-make-you-sick-80201

There was much discussion after the publication of the Newsweek article.

Jumping to Oprah’s defence, Jeffrey Dach MD claims, Oprah’s TV show advocates Natural Medicine and Bioidentical Hormones in direct competition to the interests of the Pharmaceutical Industry that makes synthetic hormones.  Newsweek is merely an attack dog for the drug industry. A typical issue of Newsweek magazine contains $2 million in pharma ads.

http://jeffreydachmd.com/newsweek-attacks-oprah-winfrey-and-bioidentical-hormones/

Deepak Chopra also entered the debate with a lengthy article entitled Mainstream Medicine & the Oprah Factor in The Huffington Post . He notes, scientific medicine by and large ignores wellness, prevention, and alternative medicine in general. On a daily basis doctors don’t deal in these things; few take courses in medical school centered on them. That’s why a massive movement has arisen driven by patients themselves. Oprah serves as a public outlet for a conversation that needs to be ongoing. As long as official medicine, backed by huge pharmaceutical companies, denies the existence of the problem, much less alternative solutions, the movement will remain patient-centered and the attitude toward alternative medicine will be one of unfounded disdain, suspicion, and ignorance on the part of physicians.

http://www.huffingtonpost.com/deepak-chopra/mainstream-medicine-and-t_b_213132.html

Another interesting response came from Dr Erika, a leading national expert in the fields of natural hormone therapies, anti-aging and disease prevention who has worked with tens of thousands of patients, written four best-selling books, appeared on various news programs including CBS News, Larry King Live, CNN and MSNBC as well as The View, Oprah Radio with Dr. Oz and many others.

She recounts how, in a lecture on bioidentical hormones at Harvard, she asked the chairman of the department of ob-gyn, Isaac Schiff, MD and the rest of the physicians in the audience, “How come Suzanne Somers and Oprah are the ones to teach the public about bioidentical hormones? What has the medical profession done with the information of the Women’s Health Initiative study?  Nine years later and women are still suffering and the medical establishment has not stepped up to the plate to help women find safe solutions to menopausal symptoms. Why are bioidentical hormones still controversial?” They had no answers.

http://blog.drerika.com/2009/06/newsweeks-attack-on-oprah-will-not-help-the-public.html

 

Controversy over treatment of hypothyridism diagnosed in Olympic athletes

An article in The Wall Street Journal,  “U.S. Track’s Unconventional Physician”  (Sara Germano & Kevin Clark) focusses on the work of an “unconventional” endocrinologist, Jeffrey S Brown, who believes that hypothyroidism can be caused in young athletes by the stress of the sport. Questions are raised as to whether Brown’s treatment of this in some star athletes might constitute “doping” in sport.

http://online.wsj.com/news/articles/SB10001424127887323550604578412913149043072

However, patient advocate Mary Shoman takes issue with the article, which she calls  “a poorly researched, innuendo-filled article” on her About page – “Editorial: Controversy Over Diagnosing Hypothyroidism”. She asks “several nationally-known practitioners with expertise in thyroid and hormone balance to share their thoughts regarding this story”.

http://thyroid.about.com/od/hypothyroidismhashimotos/a/Editorial-Controversy-Over-Diagnosing-Hypothyroidism.htm