her symptoms, I did identify suboptimal thyroid functioning. Once we corrected the deficiency, she lost the fifty pounds, her energy improved, her hair loss stopped, she wasn't cold all of the time, and her skin was softer and smoother. She also returned to work as a teacher and felt like she could again be the mom she wanted to be.
Why am I always told that my thyroid tests are “normal"? Every day, thousands of patients who
do have thyroid problems go undiagnosed and untreated because of the TSH test. The TSH test is causing doctors to throw away the clinical diagnosis skills they've worked hard to acquire and are putting patients in boxes. If their TSH is "x", then they are normal. This is not how hypothyroid pa- tients were diagnosed in the past, and I don’t believe that they will be treated like this in the future. Let me give you some background on
how hypothyroidism used to be evaluated and treated before the advent of the TSH test. Doctors used to LISTEN to and LOOK at their patients. They started by listening to the patient's concerns and their list of symptoms such as: fatigue, cold intoler- ance, weight gain, depressed mood, dry skin, hair loss, brittle nails. All of which would suggest low functioning thyroid. Then, they would do a comprehensive physical exam to look for other clues of thyroid dysfunction. If they had multiple symptoms of thyroid dysfunction and mul- tiple physical exam findings then the pa- tient was started on thyroid medication. In the majority of cases, this was good enough to diagnose hypothyroidism and most patients felt remarkably better. Being able to do this was part of the skill or art of medicine but because that is a very subjective approach to diagnosing hypothyroidism, we have been searching for a reliable test to identify thyroid func- tion since the early 1900’s. Some of the first tests used were the Basal Metabolic Rate, Cholesterol levels, and the Creatine Phosphokinase (CK) and they were used until the 1960’s. These were not bad tests but again they did not replace a clinician’s ability to evaluate a patient based on their experience. The next test was the radioac- tive iodine uptake test. This test claimed to be able to diagnose all thyroid problems during its time, but of course, this did not turn out to be true. Then the TSH test was developed in the late 1960’s and was touted as the final answer we had been
Natural Triad Magazine JANUARY 2014 29
"Wiggy" Saunders, MD
looking for. This was quickly adopted as the stan-
dard by medical schools and physicians to determine hypothyroidism. If the TSH is “within normal range” then this person does not have hypothyroidism. This is drilled into our heads from Day 1 as a proven certainty, so it is not surprising that so many doctors will take offense that it might not be what is best for the patient. And that is what is most important, helping the most patients. Reviewing the history of thyroid testing is not to discredit any of these tests, but it is to show you that we
always think we are doing the right thing at the time until some- thing better comes along. I think that at this time, there is something better. Better tests are available but we also have to go back to using clinical acumen.
The Problem: Over the years, I have come to realize
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