Letters about Dr. Rowsemitt's and Dr. Najarian's two
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hypothesis paper and
case reports by
Thomas Najarian, MD and Carol N. Rowsemitt, PhD, RN, FNP
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please accept our apologies for still publishing in what my
brilliant mentor Robert S. Mendelsohn, MD described in the late 1980s as
"the dark ages of medicine."
Were Dr. Mendelsohn still
with us, he would clearly see that we have not advanced a jot
from the darkness; in
fact, we have sunken further into the dark vat where expressing
what we have learned to be true is likely to bring upon us
verbal abuse, other
punishments, pain, and banishment from our commitment to do out
best to relieve human suffering.
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Subject: Euthyroid patients: Many are harmed by thyroxine therapy
Date: June 20, 2010
From: Author prefers anonymity
June 20, 2010
Question: I am a general practitioner in the
UK. Many of my patients have told me that they recovered from their
hypothyroid symptoms after they found a private doctor who treated them with
thyroxine despite their normal TSH levels. These patients had been denied
thyroxine treatment by doctors within the National Health Service because of
their normal TSH levels. So many patients have told me this that I have
developed reservations about ruling out hypothyroidism and the need for thyroxine therapy based on a normal TSH test.
Many more of my patients with normal TSH levels ask
me to prescribe thyroxine or Armour Thyroid. I am hesitant to comply
because of the Royal College of Physicians' statement about adverse effects
from unnecessary thyroid hormone therapy. May I have your point of view on
the potential for adverse effects from thyroxine treatment when patients
do not actually need it?
Dr. Lowe: I'm familiar with the
statement you refer to by the Royal College of Physicians. Specifically it
is: ". . . some patients are
inappropriately diagnosed as being hypothyroid (often outside the NHS) and
are started on thyroxine or other thyroid hormones which will not only cause
them possible harm . . ." (Italics and bold mine.)
Like too many other statements or implications by the Royal College of
Physicians, when applied to the general population, this one is patently
Unless you're a geriatric specialist whose patients
are among the most fragile of human
beings, even if they don’t need supplemental thyroid hormone, a trial of thyroid
hormone therapy is harmless. If the hormone doesn’t help them, you can
wean them off it and then have them stop it altogether. No harm done!
Proof of this is in the history of FDA-guided studies of the potency and
stability of T4. To test T4 for potency and stability, researchers—using FDA test guidance!—have
used volunteers who were "euthyroid," meaning, of course, that
they subjects had normal thyroid function test results. Moreover, FDA test guidance has allowed
researchers to use euthyroid volunteers to test higher-than-physiological (supraphysiologic)
doses of T4.[1,p.109]
I ask the Royal College of Physicians: If T4 were likely to harm euthyroid
volunteers, why would FDA-test guidance allow researchers to use them for
the testing? And why would institutional review boards approve the
studies as not potentially harmful to the volunteers?
The answer is simple, of course: A trial of thyroid
hormone therapy—even for people with perfectly normal thyroid function—is
harmless, even when they use supraphysiologic doses.
Only recently have researchers suggested that rather than testing euthyroid
volunteers, they would best use thyroidectomized patients. But the
researchers' reason for this suggestion has nothing whatever to do with any
harm ever done to euthyroid volunteers in the studies. The testing hasn't harmed the euthyroid volunteers, nor will a trial of thyroid hormone therapy harm
practically any of your euthyroid patients except possibly the most severely fragile
of them. But, then, a cup of coffee is just as likely to harm those fragile
I just don't understand something: How does the
Royal College of Physicians (as with this particular issue) and the British
Thyroid Association make scientifically false statements and stand by them
in the face of proof that they are false, yet receive no official reprimands
from regulatory authorities in the UK? To me, their false statements are an
affront to the noble tradition of science, and the organizations sticking by
their false statements in the face of refuting evidence reduces the
statements to examples of pseudoscience.
At any rate, I hope this reply is helpful to you in
providing your patients with harmless trials of thyroid hormone therapy,
whether they truly need it or not.
1. Royal College of Physicians.
The diagnosis and management of primary hypothyroidism. 2008.
Subject: TSH is Not the Answer: Drs. Rowsemitt &
From: Writer prefers to stay anonymous
Date: Tue, July 26, 2011 9:41 am
Dear Dr. Lowe,
I'm glad that there are researchers and doctors that continue to
work on Hypothyroidism. Over the years, I have continued to
follow your website (I have your first book). You might be
interested in my experience with TSH and the thyroid hormone.
I was diagnosed with Hashimoto's Disease in 1984, but did not
take thyroid hormone until 1999 when I went from doctor to
doctor for almost 2 years to find out what "disease" I might
have. I had terrible symptoms of pain in my legs, numbness, not
being able to think clearly, and generally not being able to
walk without a cane. I was 51 and done with menopause, but
doctors said that anti-depressants would help my "menopause
symptoms," I threw them out because I wanted to get rid of the
pain, not cover it up in "la la land."
After I was at least diagnosed with fibromyalgia, I found
another doctor who prescribed Armour Thyroid, initially in tiny
doses. (Synthroid did nothing for me. My TSH was 22.) This went
on for months with the doctor increasing the dosage up to
average. I still had symptoms that prevented me from working for
5 years. I lost a lucrative career and most of my life.
My symptoms would not subside (fibromyalgia, pain, could not get
up from a sitting position, etc.). One day, I was sick of living
with the pain and weakness. I decided to increase my dosage of
Armour Thyroid to see if the excruciating pain in my legs would
lessen. I honestly didn't care if I got a heart attack from it.
I wrote a will before taking the dose. To my amazement and
relief, I did not die, nor did my heart beat faster. The pain in
my legs lessened. I continued increasing the dosage weekly until
I felt o.k., not great, but able to function.
I was able to get a job in 2004 as a teacher, which keeps me
very active during the day. I have been taking the dosage of 450
to 540 mg. of Armour Thyroid for 8 years. I am 62 years old, my
blood pressure after medication is 120/76 and my heart rate
continues to be normal. Even my Endocrinologist is
surprised...he constantly tells me to take less medication, (He
won't even prescribe the dose I'm taking . . . he writes "Take as
Finally, I have my life back. Thank you for your work.
An anonymous author
Subject: TSH is Not the Answer: Drs. Rowsemitt & Najarian
From: Best keep low profile because of you-know-who!
Date: Tue, July 26, 2011 10:08 am
Hello Dr. Lowe,
My GP has decided to
slightly lower my T3
15 mcg-to-10 mcg.
I have noticed that
and diet regime has
slightly affected my
decided to do this
as my T3 reading was
heading for the high range.
thought I was
In spite of this, I
feel I need to be on
15 mcg so I'll print
out this article for
him, although I wish
I had Dr.
Rowsemitte's and Dr.
Najarian's wisdom to
Weight loss is
difficult enough. As
patient (and 5 years
anyway, and If I had
been exercising and
dieting like this in
my 20s and 30s I
would probably be
underweight. As it
is, I am only just on the right side
of the body mass
index (high) for my height.
Regards and thanks
for the articles by
Dr. Rowsemitt and Dr.
silence . . .
this writer instead
introduction to and
defense of Drs.
is Not the Answer:
Drs. Rowsemitt &
From: I choose to abstain from
divulging my name,
for obvious reasons
Date: Fri, September
30, 2011 9:08 pm
Disagree with these
two humane and
Too another look and
Subject: TSH is
the Answer: Praise
Rowsemitt & Dr. Najarian
From: A physician
who lives in fear of
Date: Aug. 18, 2011
To: Dr. John C.
Lowe, LLC <firstname.lastname@example.org>
I sit in my medical
office this morning
deceit I am forced
to express to the
practice in my
medical complex. If
they were aware of
how I rescue the
patients they keep
sick with their
they would arrange
to have my license
to practice medicine
revoked. I have seen
Then I read this
awe inspiring two
papers in Thyroid
Science by your
champion of doctors
and writers, Dr.
Najarian and Dr.
Rowsemitt. I wonder
at how they have
been able to survive
to practice medicine
in a world dominated
wish I knew the
magic they exercise,
while those of us,
such as myself, with
student loans over
mortgages, wives and
hide in the shame
have forced us into.
Bless you, Dr.
Lowe, for giving Dr.
Rowsemitt and Dr.
heroes of scientific
forum to expresses
what God and science
have allowed them to
see and express.
Subject: TSH is Not
the Answer: Drs.
Rowsemitt & Najarian
Date: Monday, July
28, 2011 10:44 PM
To: Dr. John C.
Lowe, LLC <email@example.com>
Dr. Lowe: Having
known and worked
with Robert S. Mendelsohn, MD, I
believe he was right
about so much that
was so dreadfully
in his days. But of
late, having studied
the bravery and
doctors such as Drs.
Carol Rowsemitt and
including you and
others like you, I
believe much has
taken a turn for the
better since the
time of our beloved
Praise you all, and
may the Lord bear
with you all until
completely wins out.
still work in
thank you for
keeping my name