The Slippery Slope: A Bittersweet Diabetes Economy

While not directly related to bioidentical hormone replacement or natural desiccated thyroid therapy, this article is a depressing insight into the workings of the drug industry and the FDA and the money involved while concerns with the best treatment for patients seem to be side-lined.

The Slippery Slope: A Bittersweet Diabetes Economy

Special Reports: 21 December 2014

Mainstream Medicine Still Struggles to Comprehend What Women Want

We thought one of the benefits of compounded hormone therapy was that it overcame concerns of overdosing or underdosing because it can be adjusted according to hormone levels in individual blood tests. The Endocrine Society seems not to agree . . .

Pharmacist survey shows huge growth in compounded menopausal hormone therapy 

6 March 2015, The Endocrine Society

Among prescriptions filled for menopausal hormone therapy (HT) in the U.S., almost half now are custom-compounded “bioidentical” hormones, according to analysis of a recent survey of nearly 500 pharmacists. The study results will be presented Friday March 6th at the Endocrine Society’s 97th annual meeting in San Diego.

Custom-compounded prescriptions, which are mixed for an individual according to a doctor’s prescription, are not well-regulated or monitored by the U.S. Food and Drug Administration (FDA).

“Despite the increased quality risks and the lack of safety and efficacy data for non-FDA regulated custom-compounded bioidentical hormones, their use by menopausal women is higher than expected and appears to be continuing to grow,” said lead researcher JoAnn Pinkerton, MD, a professor of obstetrics and gynecology at the University of Virginia Health System, Charlottesville.

Pinkerton cited statistics from Symphony Health Solutions that there were 36 million FDA-approved prescriptions filled for HT in 2012. That number is down 61 percent from the 93 million HT prescriptions filled in 2002.

Some postmenopausal women have been seeking alternatives to traditional hormone therapy since the Women’s Health Initiative study in 2002 linked it to certain increased health risks. Since then, customized bioidentical hormones have often been marketed as natural, safer alternatives to FDA-approved HT, with purported fewer side effects. However, according to the Endocrine Society, there is no scientific evidence supporting the safety or effectiveness of compounded bioidentical hormones.

Pinkerton and her colleagues analyzed results of a survey conducted last October on behalf of the International Journal of Pharmaceutical Compounding and in Thought Research, and sent to 12,250 pharmacists who provide compounding services. From 904 pharmacists who reported working at independent community pharmacies or independent compounding pharmacies, the number of completed survey responses totaled 483 (365 responses from community pharmacies and 118 from compounding pharmacies).

Based on the pharmacists’ responses of how many custom-compounded HT prescriptions they fill and the average percentage of compounding reported by the National Community Pharmacists Association and industry market research firm IBISWorld, the researchers estimated that 26 to 36 million total prescriptions custom-compounded HT were filled last year.

Of the responding pharmacists, 69 percent reported that they expected their HT compounding business to grow over the next two years. A greater proportion of compounding pharmacists anticipated growth than did community pharmacists: 75 percent versus 52 percent, respectively. Most pharmacists projected 5 to 25 percent growth of HT compounding by 2016, Pinkerton said.

In November of 2013, Congress passed the Drug Quality and Security Act (DQSA),14,15 which clarifies the FDA’s authority to enforce provisions of the Federal Food, Drug, and Cosmetic Act (FFDCA) that apply to pharmacy compounding. However, health providers and their patients should understand the differences in and the risks associated with less-regulated treatments of compounded menopausal hormone therapy,” she stated.

Possible risks of compounded HT, according to Pinkerton, include the lack of safety and efficacy data along with possible presence of contaminants and concerns of overdosing or underdosing.

Taken from:




Previous Editor of the British Medical Journal Makes an Admission

Richard Smith, the previous editor of the British Medical Journal, recently published an article in that journal entitled Are some diets ‘mass murder’? (British Medical Journal, 15 December 2014.) While the article was related to diet (he was explaining that, after reading Nina Teicholz’s book The Big Fat Surprise,  he now feels that the dietary advice given by western medicine about saturated fat for the last fifty years or so is complete nonsense), the sentiments expressed relate to many areas of general medical wisdom handed out to the public by the FDA and various health authorities.

He states that, ”…the forensic demolition of the hypothesis that saturated fat is the cause of cardiovascular disease is impressive. Indeed, the book is deeply disturbing in showing how overenthusiastic scientists, massive conflicts of interest, and politically driven policy makers can make deeply damaging mistakes. Over 40 years I’ve come to recognise which I might have known from the beginning – that science is a human activity with the error, self-deception, grandiosity, bias, self-interest, cruelty, fraud, and theft that is inherent in all human activities (together with some saintliness), but this book shook me.”

(Bolding by HCS)

Dr. Mehmet Oz Got It Right About Thyroid Disease on ABC’s Good Morning America

Thyroid patient advocate Mary Shoman, who has  previously criticised Dr Oz for lack of clarity on thyroid issues, now feels he deserves some credit.

One of the valid statements he made, so often overlooked by doctors confronted with hypothyroidism but understood by every hypothyroid patient, is that, “When we tell you your thyroid hormone is normal, we’re really misleading you. Because what we really need to do is find out if you have any of the symptoms I mentioned. If you’ve got symptoms, even if the blood tests come back looking like you’re borderline okay, we still might want to treat you more aggressively. It’s a very important point to make. Unlike other blood tests, it’s a matter of symptom management, not about getting the right blood tests.”

(Bolding by HCS)

Hopefully such thinking will become de rigeur in Singapore, though, sadly, it does not seem promising at the moment.

Adrenal Exhaustion

Many people being treated for low thyroid continue to have symptoms. This may be because they have concurrent low adrenal function, an issue frequently overlooked by doctors who are not aware of this connection. Indeed adrenal fatigue is perhaps the commonest cause of secondary low thyroid function,  hypothyroidism caused by a malfunction elsewhere in the body.

Treating low thyroid without treating adrenal fatigue can be dangerous. The weak adrenal system will not be able to cope with the extra energy output of the thyroid and this situation may lead to a complete break down of the adrenal system. Thus when treating the thyroid it is vital to ensure that the adrenal hormones are also balanced. Many bioidentical hormone options are available for this.

See The Adrenal Fatigue Solution, Fawne Hansen, Bioidentical Hormone Replacement

The following article is an informative account of adrenal exhaustion.

The Mail Online, Wellbeing, 30 November 2014, Lucy Fry, Don’t go for the crash and burn


OECD calls for progress on thyroid disruptor testing

The mission of the Organisation for Economic Co-operation and Development (OECD) is “to promote policies that will improve the economic and social well-being of people around the world”. Recently, 16-17 October 2014, the OECD Advisory Group on Endocrine Disrupters Testing and Assessment met to discuss the development and update of Test Guidelines and related documents for the testing and assessment of endocrine disrupters.

Member countries are being encouraged to develop non-animal test methods for the detection of thyroid disruptors. Highlighting the fact that the thyroid pathway is an important endocrine system, OECD believes that more efficient methods of testing are required and that advancements in such testing should be “very high priority” in order for accurate screening and assessment of endocrine disruption in humans and wildlife to be detected.

See Chemical Watch, 22 October 2014, OECD calls for progress on thyroid disruptor testing

FDA’s Latest Testosterone Bashing Proven Bogus… TWICE

From Dr Mark Stengler’s House Calls Newsletter, 20 March 2015

(Bolding by HCS)

It’s always fun watching the FDA fall flat on its face, and it happens all the time – but it doesn’t always happen out in public for everyone to see.

But last week, the agency took a spectacular tumble in full view of the entire world.

Just one day after issuing a new warning on testosterone – just one day after claiming that hormone supplements could pose heart risks in men – two new studies proved just the opposite.

Both studies found no statistical increase in the risk of heart problems, and one of them even found no difference in the risk of heart attack, stroke and death.

Yes, on Tuesday, the FDA issued a warning claiming testosterone is dangerous. On Wednesday, it’s proven wrong . . . TWICE.

It’s almost funny, but this is no laughing matter – because the two studies proving testosterone is safe didn’t get the big headlines. The FDA’s warning, on the other hand, did. It was seen by millions of American men, including many who may need testosterone therapy and perhaps won’t get it now because of the warning.

These men will needlessly suffer from conditions such as low energy, weight gain, depression and sexual dysfunction.

Even worse, some of them may die – because testosterone therapy isn’t only safe for the heart, in some cases it could be absolutely essential to your very survival.

One study last year found testosterone therapy can cut the risk of heart attack by 30 percent in men who are at risk for cardiac problems. And just a few months ago, a major study found testosterone therapy can reduce the risk of heart attack and even death.

Low testosterone becomes increasingly common as we get older. If you’re past middle age yourself, there’s a good chance your own hormone levels have dropped – especially if you’ve been suffering from weight gain, low energy, mood disorders and erectile dysfunction.

In some cases, you can boost your levels with supplements. In others, you may need natural bioidentical hormones.

A holistic doctor can run a simple test to determine what your levels are and then help you decide the best way to increase them if necessary

The Studies:

Effect Of Testosterone Therapy On Adverse Cardiovascular Events Among Men: A Meta-Analysis, presented on 15 March 2015 at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.,d.c2E

Effects of Testosterone Supplement Therapy on Cardiovascular Outcomes in Men with Low Testosterone, presented on 14 March 2015 at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.…



The Confusion Continues

Unfortunately, in the year since this Hormone Choice Singapore (HCS) website was started, the confusion about bioidentical hormone replacement therapy in Singapore has continued, creating a great deal of stress for patients who suddenly find their hormone treatment (including desiccated thyroid) no longer available or difficult to find and for doctors who are unsure whether they are    going to be penalised if they continue to give the healthcare they know is of such great benefit to their patients.

In March 2015 the Ministry of Health (MoH) sent two new circulars  to Licensees/Managers of Clinics.

Testosterone For Hormone Replacement – eLis – Ministry 

MoH Letter 2

Moh Letter 3

There was some confusion in the first circular in that none of the doctors consulted by HCS had heard of intravenous thyroid therapy being used for the conditions listed. The second circular containing a clarification of the first seemed to underline MoH’s own confusion. It is also not clear whether this guideline refers to synthetic or bioidentical testosterone hormone replacement.

In the second circular the second sentence in the second bullet is particularly interesting: “If there is laboratory confirmation of testosterone deficiency, then the use of testosterone would not be considered as non-evidence based”.  In the opinion of both the doctors and patients HCS has spoken to, if this definition is followed, none of the bioidentical hormone replacement therapy used in

Singapore is non-evidence based, since all doctors who use it only do so with the guidance of regular laboratory blood tests. Indeed this is the joy of it, in that doses can be individually adjusted to reflect the tiniest change shown up in a blood test. This exact matching of the treatment to the individual patient is something that synthetic drugs cannot accommodate.

The circulars continue to call for “evidence based medicine”. One of the reference sources (Duke University, Introduction to Evidence-Based Medicine)  on the MoH website gives us this definition from David Sackett, the founding father of the concept of evidence-based medicine (bolding by HCS):

Evidence Based Practice (EBP) is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology.

(Sackett, D. (2002) Evidence-based Medicine: How to Practice and Teach EBM, 2nd edn. London: Churchill Livingstone.)

The Duke University website goes on (bolding by HCS):

The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.

(The analysis below is taken from Evidence Based Practice, McGraw-Hill Education:  )

Sackett acknowledges and values the different types of knowledge held by the clinician, for example, knowledge acquired through cultural and personal experiences, logical and critical knowledge gained through curriculum and the extra insight that can only be acquired through cumulative clinical expertise. He values the patient as an empowered decision maker and highlights that not all research is transferable into practice due to flaws in either design or reason.

Note that Sackett states that the best evidence is usually  found in what the MoH would call “relevant research”. However, when the evidence found in laboratory tests is responded to with finely adjusted bioidentical hormone replacement (including desiccated thyroid) there is ample evidence available provided by well respected doctors worldwide (some of it on this site) that patients are receiving the care they need and, further, the care that addresses “the patient’s unique concerns, expectations, and values”.

Since bioidentical hormone therapy is derived from a plant source that cannot be patented, little money is likely to be made available  for expensive studies to match those funded by drug companies who stand to make mega-bucks from any drug produced as a result. Nevertheless, those patients who continue to use the hormones all over the world constitute a huge body of “evidence” of their value, while well-run studies continue to point out the flaws, clinical and ethical, in synthetic hormone replacement therapy.

History of Thyroid Testing – Dr John Midgley

 Transcript of the talk by Dr John Midgley at the Thyroid UK 2014 Conference 18/10/2014

History of Thyroid Testing 

There have been long, sad and unsatisfactory developments in thyroid function testing, including up to the present day.

The first thyroid function test, in the form such tests are used today, appeared in 1960. This measured total thyroxine (T4). Before this, convenient measurement of thyroid hormones was not possible. However, breakthrough though this was, it was immediately realised that this was insufficient for accurate estimation of thyroid function.

Thyroid hormones (T4 and T3) leave the thyroid gland and in the bloodstream are bound onto transport proteins that convey the hormones to the tissues. There are three of these transport proteins: thyroxine-binding globulin (TBG), transthyretin and albumin. Of these TBG is the most important in the average person. It transports about 70% of T4 and 60% of T3.

As the transport proteins and their T4/T3 load pass by the tissues in the bloodstream, very small amounts of hormone are freed as required. These are the free T4 and free T3 fractions. As the tissues remove T4 and T3 for their own use, more is released by the transport proteins for the next tissues to use. The free T4 (FT4) and free T3 (FT3) fractions are a very small percentage of the total circulating hormones. In the case of FT4 in the average person it is about 2/100 of 1% of the total T4 and for FT3 2/10 of 1% of the total T3. Therefore, it is necessary to measure FT4 and FT3 rather than total T4 or total T3.

The problem is that we are all unique in the makeup and amounts of our transport proteins. In the vast majority of people, the TBG levels can be different by at least a factor of 2; and the same (independently) for the other two proteins. There are people with either no TBG at all, or 4 times the normal amount. Their reservoirs of T4 and T3 are therefore hugely different for the same FT4 and FT3. Also, the pregnant woman has twice the TBG and ¾ the amount of albumin she had when not pregnant. We also lose transthyretin and albumin when critically ill or with trauma like burns or septicaemia.

To try to get a measure of FT4, a test was developed in 1963-65 to try to convert the total T4 result to a FT4 result. This was the thyroid hormone uptake test. In conjunction with a total T4 result, the two tests could be amalgamated to produce what was claimed was an estimate of FT4. The test method is still used today; e.g. in certain American private labs and elsewhere. However, it is not based on sound principles and does not work properly, especially for people with extreme differences in TBG from the average. Even the pregnant woman’s results are compromised.

In the remainder of the 1960’s, commercial firms were set up to provide ready made tests for the clinical chemistry labs to use.

In about 1975, commercial TSH and T3 tests were developed and sold. The TSH test was first generation – that is, it could only measure and detect hypothyroidism (the depressed levels in hyperthyroidism were too low to be measured directly). Such was the growing demand for tests that the various companies competed with one another for business in the labs. Since the method of measurement (radioactivity) was the same in all tests, competition was such that no company would have a monopoly of business in the labs. This competition produced faster and slicker tests with shorter and shorter times – giving quicker turnover and more tests done in a given time.

In the late 1970’s the shortcomings of the thyroid hormone uptake test, arising from the variation in TBG levels in patients, were very apparent. The demand for properly formulated and soundly developed FT4 and FT3 tests was very great.

As a response, companies and individuals produced various forms of tests claiming to measure these fractions. Many of the offerings were not soundly based, and  slowly disappeared into obscurity and obsolescence. Two methods did however prevail and form the basis of FT4 and FT3 testing today.

The London researcher (now a distinguished professor – Nobel Laureate just failed), who had developed the pioneering total test 20 years earlier invented a validly based test for FT4. At the same time, I invented and my company developed and offered a method based on a different principle, but also soundly based.

My method as initially developed was not perfect – there were obscure areas of thyroidology where there were problems but we’d identified them and given advice to circumvent.

The professor’s method was sound but suffered from the fact that there were several steps to take before you got an answer, which took time and cost precision – the more handling, the more progressive errors creep in.

On the other hand, the test I had invented was, in the hands of the lab technician exactly the same in handling as the existing total T4 test – a big time/turnover/precision advantage for the busy lab.

The London professor and his group decided to try to destroy the validity and reputation of the rival test and those who had developed it. So began a long series of aggressive, long and detailed theoretical arguments as to why the test I had invented was, in its present form, unfit for purpose and could not and did not work.

In vain did we show that the practical working of our test bore no resemblance whatever to his theoretical predictions – this only invited more and more vituperative denunciation. This aggressive, acrimonious and almost libellous controversy (the worst in the history of any discipline in clinical chemistry) continued for almost 20 years before dying out in the futility with which it had started.

During this time, the average clinical chemistry worker in the average hospital was totally oblivious to all this rarefied argument and was happy that at last a reliable FT4/FT3 test was available. For example it brought into the diagnostic fold even the most TBG-extreme people mentioned earlier. For a while, there was a golden age in thyroid diagnosis where all tests (TSH, FT4, FT3 were used – especially in Germany and Japan).

In the mid-eighties, pressures on the clinical chemistry lab were beginning to be overwhelming. Such was the demand for tests that the disposal of radioactive waste was too great for licencing of disposal. Consequently non-radioactive detection methods had to be substituted. Two things happened around 1985.

First, second and third generation TSH tests were developed – now one could directly detect both hypo and hyperthyroidism. Secondly, the manufacturers produced several solutions to the nonradioactive detection methods, and integrated them into dedicated automatic analytical platforms. Now one had machines that took the place of the skilled hands-on technician – it was a case now of loading the machine, programming it and pressing the “start” button.

This led to lab monopoly – having chosen the machine, one was confined to the tests dedicated to that machine. However, the individual solutions of the manufacturers to the method of detection in tests led to problems with FT4 and FT3 test development (uniquely).

Unlike all other tests, FT4 and FT3 tests demand special and essential requirements. They must be run at blood temperature (37 degrees), they must sample only a tiny quantity of the available T4 and T3 so as not to sample the T4 and T3 bound to the transport proteins, they must use the same chemical surroundings (for example, salt content, phosphate content) as is present in blood, and they must work in the right acidity as present in blood.

The failure of the development scientists to understand these special requirements, and the compromises needed to make the detection methods work, led to great variation in the performance of the FT4 and especially the FT3 tests between manufacturers offerings. For FT4 this is at present up to 40% difference and for FT3 60%. I would expect no more than a 5% difference as a reasonable variation.

As a result, sensitive TSH tests began to have a paramount position in thyroid function testing. There exists a paradigm of thinking today which closely links FT4 and TSH as a constant relationship over the whole thyroid function spectrum. Therefore, if you do a TSH test, then why do an FT4 test because the TSH value implies an FT4 value – the FT4 test is controversial and inconsistent so why do it? The seeds of TSH only screening had started to sprout.

In 1988 I and my colleagues invented a new test for FT4 and FT3, based on the invention of 1980 but getting rid of the problems at the margins mentioned earlier. Shortly after, I left the field entirely for 10 years, only returning by accident in 1999.

On returning to the field I found it in chaos. In 1992, a group of American scientists had begun to analyse and dissect the commercial FT4 tests to understand why they were so inconsistent. They began a series of papers in the peer reviewed important leading journals which lasted until 2009.

Their findings were on the surface devastating – that is, they alleged that however it came about, all FT4 tests were influenced by the levels of transport proteins in blood – devastating because this meant that they were subject to the T4 and T3 bound by those transport proteins – and the whole point of doing FT4 and FT3 tests is to be independent of these effects.

As it turned out, the whole of this work was completely invalid and wrongly conceived from beginning to end – a completely meaningless study programme. I and a colleague pointed this out but, especially in America, their findings are accepted and further confuse today’s understanding of the FT4 and FT3 tests. Meanwhile, the cheap, easy to understand, rapid, and eminently automatable TSH test was gaining strength as a catch-all screen.

In 2005 a new group of US workers came on the scene with a specialised technique for measuring FT4 and FT3 which they alleged was superior to the commercial tests in that it more closely correlated FT4 and TSH.

In 2009 I looked into their work and found it had been done at the wrong temperature – this is important because T4/T3 binding to TBG is very temperature sensitive. On advising them of this, they merely obfuscated and blustered, and though henceforward using the right temperature, did not retract their earlier wrong work butactually included it in papers when they used the right temperature as if the wrong work somehow backed them up – scientific honesty?

Now we come to the present day. We have simultaneously in existence licensed, manufactured and used in diagnosis, tests based on the discredited thyroid hormone uptake test, tests based on sound methodology but including the earlier imperfect tests up to the modern improved ones, and tests offered that are to be run invalidly at room temperature.

This implies a complete failure to regulate by the international regulators whose job it is to ensure equivalence of results. The composite failure of the manufacturers to produce consistent FT4 and FT3 tests has already been mentioned. The failure of the medical thyroidology fraternity to ensure consistency of the tests they use is an additional factor in the diagnostic chaos that is now present. No wonder TSH only screening has gained credence in such an atmosphere.

There is a triple failure that has led to a diagnostic hiatus that urgently needs correcting. The paradigm of the TSH-FT4 relationship is wrong, especially in treatment. The whole conceptual thinking behind diagnosis thyroidology and the importance of personal diagnosis based on the patient rather than whether the numbers fall in or out of the normal range is fatally flawed. For the moment mechanical thinking has traduced medical diagnosis.

It’s not new – 2001 – Doctor Investigated for Using Basal Temperature Test and Natural Dessicated Thyroid

BBC News  – Health – May 17, 2001

Investigation into thyroid doctor

Tests for thyroid deficiency are controversial

A doctor offering controversial treatments for thyroid problems has been suspended from practice by the General Medical Council.

GP Dr Barry Durrant-Peatfield, 64, who has a practice in Purley, Surrey, has been stopped from working for 18 months so that the GMC can complete its investigation.

This may or may not lead to disciplinary action, although Dr Durrant-Peatfield says he cannot afford to fight to clear his name, and plans to retire.

He now cannot treat or prescribe medicines for patients unless the suspension is lifted, and told BBC News Online he was “outraged” by the decision.

“All the GMC wants to see is my head on a spike,” he said.

Dr Durrant-Peatfield, who works outside the NHS, is a controversial figure in thyroid medicine, offering treatments which are actively opposed by many other endocrinologists.

The complaints to the GMC allege that the private GP had failed to examine patients properly, and gone on to prescribe inappropriate drugs.

He has received vociferous support prior to the GMC hearing on Friday from a large number of past and present patients who wrote to the organisation praising him.

Many say their lives have been transformed for the better by his treatment regimes.

One, Linda Thipthorp, from Truro in Cornwall, said that treatments from other doctors, involving radical surgery, had done nothing to improve her condition.

‘My health is still improving’

She said: “After being successively treated by the NHS I could not walk, only crawl about on my hands and knees.

“To be asleep was the only way I could cope with the pain.”

“Dr Peatfield diagnosed immediately what some 20 other doctors had failed to do. After three days I began to feel alive again and my health is still improving nearly three years later.”

The controversy centres around the diagnosis, and treatment of patients with hypothyroidism – a condition in which the thyroid gland in the neck is not functioning properly.

Patients diagnosed with the condition have a slow metabolic rate and are normally given supplements of the hormones produced by the gland to make up for the deficiency.

Dr Durrant-Peatfield prescribed a “natural” form of thyroid hormone – which is derived from the glands of animals, and given in dessicated form.

This was the form in which thyroid hormones were originally produced at the turn of the century, but were phased out in this country, with many doctors now saying that synthetically-produced hormone is best.

This, they say, is because it is difficult to know exactly the concentration of hormone that is being delivered by the natural form.

In addition, Dr Durrant-Peatfield believes that standard thyroid function tests used by the majority of doctors are unreliable.

Basal temperature

He recommends heavier reliance on something called the “basal temperature test”, which involves measuring the internal temperature on waking.

Conversely, many other doctors treating thyroid patients maintain that blood tests for thyroid function are reliable and accurate, and that it is the basal temperature test that is misleading.

However, Dr Durrant-Peatfield said it was “impossible” to misdiagnose a patient if a proper clinical history was taken.

“Blood tests are appropriate in some cases, but I don’t necessarily believe them,” he said.

If patients who do not actually have hypothyroidism are given, over a long period, extra hormones when they do not need them over a long period, there is thought to be an increased risk of bone density loss – which could make patients’ bones more brittle.

There is also thought to be an increased risk of heart problems in these circumstances.

However, the GP insists that there is no evidence of any of his patients suffering physical harm as a result of his treatments.

He said: “I am totally and utterly devastated about this, both for my own sake, and for my patients, who now cannot receive their treatment.”

A spokesman for the GMC confirmed the 18-month suspension by its Interim Orders Committee.