We are all idiots, or as I prefer to say it, “We are dogs doing calculus” (not to insult dogs, of course). The amount we don’t know is vaster than the vastness of the material universe, but we delude ourselves by mastering one teeny tiny part. Art, cell phones, delicious foods and our other creations make us proud of our intellect and life more enjoyable. Yet every one of us is intelligent enough to know, and to suppress the knowledge of our smallness in both space and in time.
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Minds tend to create edifices to which they assign their identity, an illusion of immortality. Whether that edifice be a tower, a mound of cash, a corporation, or even a prodigy, once assigned it is hard for many to let go of, or change the shape of that edifice. When information comes along that requires a paradigm shift, there is huge upheaval, waste of resources and often human lives.
This is the status of thyroid therapy. There is a lot of wasted human lives because of a simple stuckness of a dominant profession. A paradigm shift was suggested decades ago but it has only been accepted by less than 5% of those who are in this convention field. Unfortunately, patients are not (yet) enabled to self-test and self prescribe, though this is loosening up, and in other countries many medications can be purchased without a prescription. On the other had, Canada has recently gone the other way by dramatically limiting the manufacture and provision of nutritional supplements (I guess the Canadian government is run by big pharma?)
Fortunately, information is power and quality information is quality power. Anyone with half a brain can apply a set of rules to the evaluation of thyroid and adjustment of thyroid therapy. In medicine, these rules are called a “protocol”. More specifically, a protocol is a series of steps that have been laid out in advance by experts with the intent of utilization by non-experts. For example, nurses are enabled to adjust diabetic and blood thinning medications without doctors orders using such protocols. In my decades serving various medical institutions, we saw our protocols work great. They standardize an approach and allow for the best response to each defined scenario well in advance. A protocol can also specify and quickly identify dangerous parameters and when to call in a higher level of support. In summary, protocols can be more efficient in resource and provide quicker and better outcomes.
The protocol in this book and on my website, which I call “Thyroid Algorithm A” is based on three simple premises:
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- TSH is a measure of pituitary function, NOT thyroid function. Therefore TSH is NOT utilized to assess the body’s (“peri-pheral”) need for thyroid hormone.
- By measuring just three parameters, Free T4, Free T3 and Reverse T3, each with high, low, or “optimal”, there are 27 possible scenarios.
- If only T4 is adjusted, there are only three possible changes:, up, down or none. If T3 and T4 can be adjusted, there are nine possible changes.
Applying these simple premises allow for a tighter handle on thyroid measurement and adjustment than the standard use of TSH and T4. I developed this algorithm in 2020 when I saw my mother-in-law harmed by improper thyroid adjustment. Though I tried to intervene, the distance from Pennsylvania to Florida plus the resistance of the endocrinologist led to failure. So instead of removing her cancerous thyroid at 88 years old improving her life, it took away her vitality and ultimately independence. I said to myself, “Any idiot can adjust thyroid”, and I set out to prove it by creating this algorithm. It is been in place for over four years and applied to hundreds of thyroid evaluations with over 95% applicability.
As stated in the disclaimer that begins this book, the best way to utilize this algorithm is to use it as a venue to discuss adjustment with your prescriber. If your prescriber is unwilling to work with you, then at the least you will know that you have the potential to feel better. Unfortunately, in some regions, finding a prescribing partner is difficult. But where there’s a will there’s a way and people have overcome larger obstacles than this. Zoom, Uber and the Internet have certainly made it much easier to get this done.
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