55 Steps: A movie with applications to thyroid therapy

55steps-meme

In this 2017 movie’s portrayal of a patient’s true story, Elanor Riese was given medications that damaged her quality of life and made her appear more mentally incompetent than she was to begin with.

Elanor initially sought psychological help because of her fear of death, but she was  forced into abusive medical treatment that limited her freedom, her mobility, her dignity, and ultimately shortened her life.

Elanor Riese’s lawyer, formerly a psychiatric nurse, fought for this psychiatric patient’s right to be involved in decisions regarding her medication.

Few lawyers were willing to take on a case like Elanor Riese’s due to the slim odds of success and the high workload.

But Riese’s lawyer made the ethical decision to take on her case.

Riese represented the rights of 150,000 patients like herself in the state’s medical system.

As a result, Riese was empowered and set free to live the rest of her short life with more dignity, until she ultimately died from the side effects of her medical therapy.

Elanor Riese’s situation was unique and extreme, but I’d like to point out the need for a similar fight for patients to go through a process of fully informed consent.

We may need lawyers, not just good doctors, to win back the rights and freedoms that thyroid patients have lost. We have lost the right to advocate for our own quality of life and freedom from chronic, debilitating hypothyroid symptoms.

DIAGNOSED BY SIDE EFFECTS

First of all, Elanor was mistreated by doctors partly due to the psychiatric side effects of the drugs they gave her. The medication’s side effects even distorted her facial expressions and gave her nervous tics that they interpreted as psychiatric symptoms.

In a similar way, doctors sometimes misdiagnose treated thyroid patients for having mental health problems of depression, anxiety, and cognitive decline. They mistakenly offer them psychiatric medications when a shift in their therapy could have alleviated the mental health problem.

In a treated thyroid patient, one should first suspect the Free T3 levels remaining too low despite normalized TSH on standard T4 monotherapy, given this common distortion that is proven to cause hypothyroid symptoms.(1)

IGNORING THE PATIENT’S EXPERTISE

Many patients know from experience what the genuine symptoms of hypothyroidism truly are.

  • Many of us have experienced chronic hypothyroid symptoms prior to therapy.
  • We may occasionally experience hypothyroidism when we go through phases of forgetting to take our medication.
  • We experience hypothyroidism during phases of therapy when our dose is lowered too far out of our doctor’s fear of suppressing the TSH, or when our dose is not raised enough after our thyroid gland has suffered a steep decline.
  • Some of us also experience hypothyroidism during phases when our T4 dose is too high, because above the set-point for T4, the human body begins to induce thyroid hormone inactivation, paradoxically leading to T3 depletion.

Hypothyroidism is a chronic condition. Patients have years, even decades, to learn its symptoms by experience.

Despite this hard-won expertise, many thyroid patients are not given the right to choose an alternative therapy modality or participate in dosing decisions.

“SHE SAID” vs. “TSH SAID”

Imagine a court case in which the patient stands accused of psychosomatically exaggerating their hypothyroid symptoms. “This person is a hypochondriac.”

(This is what it often feels like to be a thyroid patient in a doctor’s office.)

Unseen and unvalued in the accused patient are the years, even decades, of experience of an intelligent human being.

The accusation calls the TSH test result as evidence. The TSH level is then interpreted by the medical priests.

Based on the healthy non-thyroid patient’s reference range, they arrogantly divine that “If the pituitary’s secretion TSH is normal, the patient’s thyroid hormone levels must also be just fine for their entire body.”

Case closed.

The medical system’s blind faith in TSH, and society’s blind faith in the medical system’s interpretation of TSH, is a clear and obvious insult to the expertise of the patient. It’s also a lack of compassion for the reality of their ongoing suffering.

The accusers have suppressed the fact that a normal TSH in thyroid therapy can hide hide a distorted T3/T4 ratio that can maintain a state of hypothyroidism.

How many doctors are aware that under the artificial conditions of orally dosing T4 hormone medication, the TSH becomes blind and insensitive to the most powerful thyroid hormone, T3.  The pituitary gland, which secretes TSH, will be satisfied as long as it has enough T4 supply from blood. Meanwhile, the patient is being forced to live with a lower metabolic rate and their brain and other organs have less access to T3 hormone directly from bloodstream.

If the judge were given the full facts of the TSH witness, who would they believe?

How does the pituitary gland repay our doctors for the special treatment it receives from them?

The trust in TSH is not only an artifact of medical blind faith, but a professional shield.  It is an impersonal number that the doctor can hide behind while the patient cries in their office … and cries at home on the couch.

Perhaps the antidepressant industry benefits the most.

BREAK THE JUDICIAL AND MEDICAL SILENCE

Where are the thyroid patients’ lawyers?

Where are our brave champions?

When Riese’s lawyers suffered a setback, they tried to find doctors to speak on their side of the case. They kept telephoning doctors, but had to cross off name after name on their list.

They knew that most doctors were too afraid to speak against other doctors and the pharmaceutical industry.

Similarly, doctors may care about thyroid patients and understand their situation, but they are simply too afraid for their own careers and won’t speak out in a public manner.

Where are the few brave doctors who will speak up against the injustices endured by many thyroid patients today?

Obviously, it sometimes requires lawyers, not doctors, to help patients.

cute puppy sad cuz low t3

REFERENCES

(1) Larisch, R., Midgley, J. E. M., Dietrich, J. W., & Hoermann, R. (2018). Symptomatic Relief is Related to Serum Free Triiodothyronine Concentrations during Follow-up in Levothyroxine-Treated Patients with Differentiated Thyroid Cancer. Experimental and Clinical Endocrinology & Diabetes: Official Journal, German Society of Endocrinology [and] German Diabetes Association, 126(9), 546–552. https://doi.org/10.1055/s-0043-125064

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