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The scandal of thyroid mismanagement is becoming increasingly known to alternative practitioners and patients alike. There are a number of doctors who have become aware of the unsatisfactory situation with thyroid medicine, and offer treatment based on clinical appraisal and a natural therapeutic approach. I am one such; but have suffered in establishment hands as a result.

It is clear that there remains a frightening number of people, here and abroad, whose thyroid and adrenal problems remain undiagnosed or unsatisfactorily treated. It may be recalled that I have said elsewhere that perhaps one third of all of us have, or will have at some time in their lives, thyroid dysfunction, although I don't propose at this time to refer to the less common over-active thyroid. Sadly it seems that this situation has little chance of improving; but the pressure must be kept up, and there is a great deal patients can do for themselves. Hence the title of this article.

The under-active thyroid has been a recognised and potentially mortal illness for over a century now; but the incidence of the condition seems not to be lessening but increasing, and its treatment less effective rather than more effective. If I run through the causes of hypothyroidism we may perhaps find a few clues as to why this is.

Environmental factors play a major role, and this means nutritional deficiencies on the one hand and toxins and poisons in our environment on the other. The deficiencies in our average diet seem to get worse, unless we take an active role in arranging our nutritional supplementation to correct them. The importance of vitamins (especially Vitamin C), minerals like calcium, selenium, magnesium, iron, boron, must engage our attention. And then we are targeted by a vast range of chemicals in our food stuffs, packaging, and medicines; to say nothing of fluorine (once used to shut down the over-active thyroid) in our water and dental products. This is of such importance, that there is a very effective and very active organisation in this country to promote awareness of the severe problems that fluorine can bring - National Pure Water Association. Some of the other causes we may not be able to do much about. Genetic predisposition, major surgery (especially gynaecological), multiple pregnancy, thyroid surgery and glandular fever are examples. Most of you are already aware of the symptoms of the under-active thyroid: weight gain, tiredness, fluid retention, depression, arthralgia, sensitivity to cold, headaches, constipation, skin disorders, repeated infections to name a few. The clinical signs are clearly based on these symptoms, with the enormous value of the Barnes Basal Temperature test which was mentioned in the last issue. I remain wholeheartedly and unrepentantly committed to a clinical appraisal with blood tests occupying a secondary role.

The fact remains that the incidence of thyroid deficiency is increasing; it is poorly diagnosed and the treatment simplistic. Undue and unquestioning reliance on blood tests instead of in depth clinical evaluation, means that the diagnosis is missed, or worse, denied, in hundreds and hundreds of people. You may know that I have continually drawn attention to the high incidence of low adrenal reserve complicating and worsening thyroid dysfunction. Such patients become really quite disabled by their thyroid deficiency, with a poor resistance to infection, episodes of fainting and collapse, bowel disturbances and an inability to tolerate thyroid medication or failure to respond to it. They are to be found very cold and miserable, often with weight loss, lack of appetite, complaining of episodes of prolonged prostration, often unable to leave their beds.

The fact is incontrovertible that the treatment, as standard practice today, is rarely satisfactory in a number of respects. Synthetic thyroxine for all the shrill protestations to the contrary by many practitioners - and endocrinologists - is not enough, and the failure to treat low adrenal reserve an almost inevitable consequence of untreated or, mismanaged thyroid illness, a disastrous omission. The problem here is that the thyroid blood tests don't line up properly, and an adrenal problem may not show up in the test, though it may be clear on clinical examination. The other constant anxiety, expressed by so many patients, is that their own knowledge and observations may not be taken into account, or may indeed provoke hostility.

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