As credentialed health providers with a "whole person" orientation, we would like to weigh in on the escalating and long-overdue controversy regarding hypothyroidism, diagnosis, and use of Armour thyroid medicine and alternative diagnosis and treatment methods. While we will share some of our own views, we also wish to draw from the long historical perspective regarding appropriate technology in medicine versus vested entrenched financial interests, as this is a topic that must be addressed at this time.

Throughout the history of health care, the establishment patriarchy has sought to control all facets of diagnosis and treatment, often ridiculing the so - called "lay practitioners" as criminally deluding the hapless public. This goes back to the days of ancient Greece and Rome, as widespread as to encompass the Kahunas in early Hawaii. These "pillars of the establishment" were known to deride and browbeat a patient who came to them only after first utilizing "alternative" healers and their remedies.

The Popular Health movement of the 1830's and 1840's typified the interest on the part of the public in having an alternative to the standard establishment care. This health movement reflected the larger upheaval in the society stirred by the rise of feminism and working class movements.

In this country, by the early 1800's, there was a growing number of formally trained doctors who took great pains to distinguish themselves from the variety of lay practitioners. The professional distancing became particularly acute after the Civil War, as a result of industrialization. By this time, drug companies had begun to support the American Medical Association by advertising in its prestigious new journal.

This medical-industrial complex type of collusion was the forerunner of how the medical profession would eventually establish its authority to dictate practice standards by a group of self-proclaimed "experts", and to monopolize the field through governmental regulation. In reality, these "regular" doctors were far outnumbered by lay practitioners, who considered them an overpaid profession. The doctors, however, arranged to make it more and more difficult for the lay practitioners and those trained by apprenticeship to be taken seriously. This tendency eventually culminated in a frenzy of "witch" burning during the Middle Ages!

A similar example of such thinking occurred in the early 1900's when Dr. Abraham Flexner, on the staff of the Carnegie Corporation, was commissioned to go on a national tour to evaluate all the medical schools, then in 1910 set standards for all of them that made them adhere to the standards of Johns Hopkins and Harvard Universities. These top schools received foundation funding, and were allowed to flourish, while other schools, including 6 of America's 8 black schools, and the majority of "irregular" schools for women, were destined to close.

Also in 1910, 50% of babies were delivered by midwives; in state after state, new licensing laws sealed the doctors monopoly on medical practice, forcing midwives and homeopaths to practice underground. This was despite the fact that a study by a Johns Hopkins professor in 1912 showed that most American doctors at that time were less competent than midwives to deliver babies. For poor and working class women, this actually meant worse obstetric care, or perhaps none at all.

Technology and drug production have advanced remarkably since the early 1900's. Nevertheless, in our own time, a century later, the old issues are still being played out. There are a minority of physicians, and a great many non-physician practitioners, who realize that the continued collusion of establishment medicine and the corporate drug companies is not always well serving of the general public. Frequently they see it as "self-serving" in terms of profits - and elimination of competition.

For instance, in Phoenix AZ, (where we lives years ago) the state board of medical quality assurance was in the basement of the AMA building. As recently as last year, the American Association of Clinical Endocrinologists received substantial funding -  and it's members a variety of perks - from Abbott Pharmaceutical Company, makers of top-selling and high profit margin Synthroid.

It's no different now than it was one or two hundred years ago. Individuals - even sympathetic medical doctors - who reveal to the public these kinds of collusions, and who provide ways for consumers to take better charge of their health, are often maligned and ostracized by the establishment. Worse yet, many physicians are harassed by their state medical boards for not practicing up the local "standard of care" set by the medical-industrial complex, and can be forced to relinquish their licensure, despite decades of successful practice with no patient complaints.

Let's consider the issue of Armour thyroid as a current example of what's wrong with this system. We have recommended Armour thyroid for many years with a great deal of success in certain people. Just like with any other thyroid medication, not everyone finds it the best for of all possible choices for their needs, but it is often so successful - when other prescription medicines have failed - that it should absolutely remain as one choice available to people.

Our point is - optimal thyroid care requires freedom of choice from among the wide variety of prescription medicines available. There are four or five different brands of desiccated thyroid, of which Armour is just one. There are four or five varieties of thyroxine available to be prescribed, of which Synthroid is simply one.

T3 thyroid hormone, whether as compounded time-released or the more common Cytomel, is available to be used by itself or in conjunction with any of the previously-mentioned thyroid products. Optimal dosing sometimes requires not just the right size pill of the right medicine, but the right mix of two or more medicines. Every health consumer is unique, and deserves professional expertise in figuring out which medicines suit their particular needs ideally.

This is the kind of freedom of choice that would result in better control of thyroid-related symptoms than simply having everyone follow the AMA or AACE guidelines and get a modest dose of Synthroid.

The above discussion has been about treatment; there is even more controversy about what constitutes optimal diagnosis. Let's take one small example from this enormous field: many millions of health consumers in the state of New York are not allowed, by law, to have anything to do with saliva testing of their hormones. This is in stark contrast to the enormous medical literature regarding the benefits, easy availability of home testing, lower costs, and frequently more accurate results of this method.

Recently the World Health Organization approved saliva home testing for HIV/AIDS, thus granting elevated status to this method. NIH researchers have, for years, been using saliva testing as a quick and accurate way of determining adrenal and sex hormone levels.

What we - as practitioners - find most insulting is that endocrinologists can ignore people with obvious thyroid abnormalities, treating only the test and not the patient - and physician-caused death is estimated to be approximately 100,000 people per year, by modest standards, yet people in New York cannot spit into a test tube to help them evaluate the status of their hormones. How can these rules possibly be protecting people? Or is it a matter of laboratories and pharmacies dictating care based on their bottom line? If so, this is an affront to all we treasure in our country, freedom of care.

In our own practice, blood TSH results have shown themselves to be inferior to saliva TSH results in many cases of borderline hypothyroidism. Even a home fingerprick test for TSH is often more accurate than a laboratory-obtained specimen, because the home test analyzes a fixed dried blood spot while the laboratory sample analyzes serum that may have been sitting for hours at room temperature, allowing the thyroid stimulating hormone to degrade. Therefore, this may not be as reflective of the true patient status.

A blood spot test is considered alternative, or "irregular" according to the dictates of the funded establishment; but the long pull of history is liable to show that it is a more accurate, more economical, and therefore more appropriate technology. This is what is at stake: appropriate technology in health care, optimization of patient lives, not just corporate profits.

Robert F. Kennedy Jr. is eloquent in his new book Crimes Against Nature, saying that the society should no longer be held hostage to the profit motive of corporate polluters. And - by the way - it's often this subsidized and government-condoned corporate pollution that is creating and disseminating into our air, food and water so many of the hormone distruptors that we now need thyroid medication to counter! More about this latter topic in our next article.

For now, we believe the time has come to have healthy dialogue, with endocrinologists, medical doctors and other medical practitioners, and the public to determine how the millions of people with mild endocrine disruption can be improved. In our humble view, it needs to be an open-minded discussion, not a dictate by any medical group.

After all, the endocrinologists are frequently refusing treatment to patients with clear and multiple symptomatology, and need to open their eyes to the realities of how millions of American feel, being doubly wounded first by years of inattention to their many uncomfortable symptoms, then by being discounted by the very specialists to whom they have paid large sums of money and entrusted their care.

It is time for the specialists, in addition to reconsidering TSH ranges of normal, to reconsider how to optimally diagnose and treat borderline and mild endocrine disruption. Perhaps it may involve them first realizing that their present standard of care is suboptimal, and that you- the American public - deserves to be heard on these issues impacting the quality of your daily lives.

Then they might also consider opening dialogue with the internists, family practitioners, and GP's, who are often seeing these patients every day, and trying to help them with their symptoms. After all, if the endocrinologists were doing a great job with these problems, patients wouldn't be seeking out family doctors to help them, would they?

And let's not forget that as we blossom into a more open-minded medical culture, there are thousands of other practitioners, well-trained and educated, whose knowledge can also help us to feel more whole. Acupuncture, homeopathy, naturopathy, osteopathy, chiropractic, massage therapy, and many other tools can be useful to the person made anxious and irritable by this medical standoff.

Our professional oaths guide us to be sure we cause no harm. If patients are properly and more readily diagnosed at earlier stages, we can do exactly this. It is up to the consumers and practitioners to create forums for healthy dialogue. As for us, a doctor-nurse team, count us in!

We're ready to talk with everyone, and to share our rationale for our new program in the book Feeling Fat, Fuzzy or Frazzled? Our intention is to create an avalanche of interest in this important corner of medicine, and to inspire patients to be less patient and more proactive!

Wishing everyone health on the journey. Let the larger dialogue begin!

Karilee Shames PhD, RN, A-HNC
Richard Shames MD
www.FeelingFFF.com