How UK Guidelines For GP's Are Restricting the Diagnosis & Treatment of Thyroid Disease

Diagnosis & Treatment of Thyroid Disease In The UK Limited By Restrictive Guidelines.

Thyroid Disease although perhaps more widely known is the US also affects many patients in the United Kingdom and unfortunately it seems the British medical establishment is making things even harder for UK sufferers to access the treatment they deserve, they may well be making it even harder for those same people to get a correct diagnosis in the first place.

Diagnosis is often not as quick as perhaps it should be due to the nature of many of the symptoms and the fact that they replicate many other conditions if considered individually.

My own experience with the diagnosis of my Thyroid condition led to me being misdiagnosed and treated incorrectly for several weeks prior to even being tested for the possibility of my having a thyroid disorder.

The fact that British Thyroid bodies are now making the diagnosis and treatment of Thyroid Disease harder seems to be unfathomable.

Within the profession this is the very same medical body, which already has a reputation for operating a seemingly intolerant and very outdated approach to thyroid disease.

Only ONE course of medication

This latest setback comes about following the release of guidelines from the Royal College of Physicians (RCP), in which they state that "thyroxine is the only treatment that should be given" for hypothyroidism.

These latest guidelines are considered a backward step in the level and effectiveness of Thyroid diagnosis and treatment for patients in the UK.

Unfortunately it appears that they've gained the support of many of the big players currently operating in the field of thyroid care in the UK.

These include the Society for Endocrinology, the British Thyroid Association, the British Thyroid Foundation Patient Support Group, and the British Society of Paediatric Endocrinology and Diabetes.

These new guidelines quite simply state and in-doing so restrict patients to just one kind of treatment when they say...

Hypothyroid Patients Will Be Limited to Synthetic T4 Only

It appears that Doctors on the NHS will be prevented from or at the very least limited in their ability to prescribe Armour Thyroid, Cytomel (T3), or any drug except for thyroxine (synthetic T4). Synthetic T4, Levothyroxine or Synthyroid becoming the only prescribed hormone replacement permitted for use in treating Thyroid disease. According to research and hence these guidelines, the following has been stated: There appears to be mounting evidence to support the use of Thyroxine (T4) alone in the treatment of hypothyroidism. Thyroxine is usually prescribed as levothyroxine.

The prescribing of additional Triiodothyronine (T3) in any presently available formulation, including Armour thyroid is not recommended, as it is inconsistent with normal physiology, has not been scientifically proven to be of any benefit to patients, and may be harmful.

There are potential risks from T3 therapy, using current preparations, on bone (eg osteoporosis) and the heart (eg arrhythmia).

It is noted that the extract marketed as Armour thyroid contains an excessive amount of T3 in relation to T4. Over-treatment with T4, when given alone, has similar risks... The College does not support the use of thyroid extracts or thyroxine and T3 combinations without further validated research published in peer-reviewed journals. Therefore, the inclusion of T3 in the treatment of hypothyroidism should be reserved for use by accredited endocrinologists in individual patients.

Just one test - Diagnosis of Hypothyroidism Relies Only on TSH and Free Thyroxine (Free T4)

"The only validated method of testing thyroid function is on blood, which must include serum TSH and a measure of free thyroxine (T4)... There is no indication for the prescription of T4 or any preparation containing thyroid hormones to patients with thyroid blood tests within the reference ranges. In patients with suspected primary hypothyroidism there is no indication for the prescription of T4 or any preparation containing thyroid hormones to patients with thyroid blood tests initially within the normal range.

Thus patients with normal T4 and TSH do not have primary hypothyroidism and even if they have symptoms which might suggest this should not be given thyroid hormone replacement therapy." In the UK, the reference range for the TSH test is .4 to 4.5, and TSH levels between 4.5 and 10.0 -- with Free T4 levels within the reference range -- are considered subclinical hypothyroidism. In the UK, only at levels above a 10.0 is a patient considered overtly hypothyroid. The decision to treat patients with a TSH under 10.0, therefore, is left to the practitioner.

Why is are these Guidelines wrong - No Proof

It is very difficult to begin here.

But here goes, there isn't any peer-reviewed research proving synthetic T4 therapy is safer or even any more effective than the combination T4/T3 synthetic treatment, or natural desiccated thyroid drugs like Armour often prescribed in the US. Nor is there peer-reviewed research that proves that proper management of hypothyroidism with thyroid medications that include T3 is dangerous to bone or heart health.

Restricted from relying on knowledge and experience

However without the benefit of conclusive research, the RCP and its fellow thyroid organizations have opted to restrict the methods of treatment practitioners are able to offer despite the fact many want to use these medications primarily based on their own previous experiences of treating this condition.

It is not however only a restriction on practitioners they are also drastically reducing the choices options open to patients, may of whom have been safely using these medications for years, or who given the opportunity to try might benefit from their use as their treatment progresses.

These new guidelines have also stated the diagnosis of thyroid disorders should be based purely on TSH and Free T4 tests only. The exclusion of thyroid antibody tests, does nothing but prevent practitioners from diagnosing symptomatic Hashimoto's disease. In some cases, symptoms develop when antibodies are elevated, without TSH reflecting the damage being done to the thyroid gland. Hypothyroidism treatment can relieve symptoms in such patients, and can in some cases stop the development of their condition to that of overt hypothyroidism. The guidelines offered here, as a result exclude treatment for the entire spectrum of Hashimoto's sufferers who have a TSH level under 10.

What is the reference range for testing, diagnosis and treatment

This brings us then to the subject of the "reference range" that the guidelines are based on. As noted, TSH levels under 4.5 are considered normal and within the reference range. Only TSH levels above 10.0 are considered overtly hypothyroid. Levels within 4.5 and 10.0 are, if Free T4 is normal -- considered "subclinical" and for patients that fall into that category, the decision to treat is left to the practitioner's discretion. Research experts in the U.S. are still discussing and exploring the following, however it seems to be widely accepted now that a TSH test indicating levels over 3.0 are in fact proof of hypothyroidism.

Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now. (Source: AACE Thyroid Awareness 2003)

It is also accepted that untreated subclinical hypothyroidism is a contributing factor in the increased risk of heart disease, obesity, infertility, miscarriage, and a host of other health problems.

A Backward Step

It seems then the United Kingdom is taking a backwards step, and seems to be determined to reduce the capabilities of its own physicians to practice medicine in the way they were initially trained.

These guidelines make diagnosing and treating thyroid disease a very precise if incorrect process not allowing for anything other than the results dictated in the guidelines be viewed as warranting treatment even if the practitioner feels differently.

Doctors who have until now used years of experience and practice to make there are now being expected to disregard all that knowledge and blindly follow these insanely restrictive guidelines.

It now seems more and more thyroid patients in the U.K. will be forced to go outside the National Health Service to seek private medical care in order to have their Thyroid conditions treated in a way, which provides a more balanced approach.

Even for Private Practitioners there is mounting pressure to comply with the guidelines specified, those who are not endocrinologists especially will face increased scrutiny and limitations in their ability to prescribe T3 medications to their patients.

It seems that once again medical science is refusing to look beyond what they first identify as the best and only treatment for a particular condition, refusing to accept other alternative and often-complimentary medicines are available.

This seems to be something, which is going to affect the Thyroid sufferers of the UK much more than those it would seem now luckily living elsewhere in the world.

Tips For Coping With Cancer Diagnosis

When a person finds out that he/she suffers a cancerous disease this may be a great shock for the person. This is really a very difficult experience. Many people feel overwhelmed and anxious after asbestos diagnosis. This is a difficult experience for the relatives and members of the family as well. But it is very important to find courage in oneself and bravery and cope with cancer diagnosis. Here are some tips how to cope with cancer diagnosis.

First of all one should try to find as much useful information about the diagnosis as possible. If the person feels overwhelmed, one of the relatives can accompany him on his first visit to the doctor. It is advisable to ask the doctor the following questions:

• What kind of cancer it is? • Where is the cancer? • Has it spread? • Can the cancer be cured? • What treatment should be done?

These questions will help to learn and find out much information about the disease and its treatment.

Another tip to cope with cancer diagnosis is anticipating possible physical changes. The person may ask the doctor what physical changes he can expect so that he can prepare himself to these changes.

Other important tips are leading a healthy life and letting family members and friends help you. Healthy life can improve your energy level which will help to fight against the disease and to overcome it. You should also learn to accept help and understanding from friends and family members who will run some errands for you.

Duck Al' Orange - Alias: Canard a l'Orange; Duck in Orange Sauce

Here I propose an easy way to prepare the famous "Canard a l' Orange". It only takes less than 20 minutes to prepare and about 1 hour to cook, depending on the size of the bird. To serve 4 people you will need the following ingredients:

One whole duck, preferably Mulard duck.

4 spoons olive oil

1 cup dry white wine

3 bitter oranges

Salt

Many think that this recipe is French while its roots are actually Tuscan. Caterina de' Medici (born in Florence in 1519, wife to Enrico di Valois and mother to two kings (Enrico III and Carlo IX) introduced her refined ways and cuisine into the French court from Florence. This recipe was just one of many that she brought over.

Clean the duck, trimming off any excess fat. Salt the inside of the duck and place it in a pan with olive oil. Brown it for a few minutes on each all around and then add the white wine and some water.

Continue cooking with the lid on and a low flame, for 45-60 minutes depending on the duck's size. Add salt once cooking is finished.

In the meantime, clean one orange and with a small, sharp knife, remove the yellow part from the skin and cut it into thin strips. Boil the strips for a few minutes and strain them thoroughly. Juice the other two oranges (make sure to use bitter oranges!) and add the orange juice to the duck along with the orange strips.

Let the juice reduce then serve immediately, decorating with the orange strips. Accompanied preferably by either Champagne or a "Brut" sparkling wine.

Tips on Doing Home Construction

One thing I believe is to let the house talk to you and it will tell you what it needs.

This doesn't mean that if you have a Spanish house and you want Modern that you can't incorporate some of the modern into the look, but remember a Spanish is a Spanish and a Modern is a Modern, simple rule. So if you want a great look keep it simple and stay with one or two styles and don't become crazy just mixing everything or fighting what is there. I have found a little sometimes goes a long way when finishing a house or room.

If your working a full week nine to five your not going to fill like coming home to a house that is all tore up. So my rule of thumb here is stay organized, be able to clean up and put everything away after your day of working on the project. Trust me you will be much more comfortable and be able to find the things you need. Even when I have a large project that I'm working on organization is the first thing, there is nothing worst than seeing your trades fall all over everybody else's tools and trash. It just makes you crazy and adds so much more stress, yes I said stress.

And for the others that don't have the time and want to hire a contractor or sub-contractor to handle everything be carefully and do your research before hand. Nothing worse than someone promising you everything and giving you nothing but a headache is not a good way to go. A good way to avoid this problem is know there work, go see it if you can and inspect everything with a sharp eye. Look at the finished details and how cleanly there are installed along with quality of materials. My saying here is if the finished caulk job is sloppy on the out side the workmanship is sloppy on the inside. A contractor usually takes the same work ethics from begin to end of a project. I have found that a trade person that is good for someone else is not always good, so talk to the person you want to hire in length about the project, use you feeling here if something doesn't feel right don't do it. Don't second guess yourself, that doesn't mean you won't make mistakes but there won't be so many.

What is the Difference Between Chinese Acupuncture and Medical Acupuncture?

Acupuncture is often looked upon as some mystical medical procedure that the majority of people in the US have never experienced. Most of the information that they received has been what they've viewed on television. Most can't fathom the idea of actually paying someone to stick them with needles. But in many cases when the standard medical treatments have failed and they are desperate for a solution or miracle they might turn to this procedure for help. If you are thinking about getting an acupuncture treatment do you know the difference between Chinese acupuncture and medical acupuncture? Before you set up an appointment make sure you know what you are getting.

Medical acupuncture is sometimes referred to as a watered down version of the Chinese method. Sure, tiny needles are inserted or placed in your body but it is usually performed by a physician or licensed health professional. You may not think that this is a bad thing but in many areas physician don't have to be trained at all to include this service in their office. Even If training was completed it may not be on the same level as a licensed acupuncturist trained in Chinese acupuncture who has trained for many years. This may also be known as western medical acupuncture or wma. In either case it is practiced from a more western point of view. They will look at you and make decisions based upon your western illness and may still offer you prescription medication as a way to help solve the problem.

Chinese acupuncture is holistic. It is performed by licensed acupuncturists. They want to treat your entire body not just the ache that you have in your back. Your body is a complex piece of machinery with intricate details and designs. There are sometimes things that you do that cause a reaction or side effect. These side effects are what you are experiencing. Chinese acupuncture works to solve the underlying cause of your problems not just the symptoms. They have trained for many years and much longer than a "medical acupuncturist". They will place the needles in specific points or meridians on your body that are based on Chinese medicine which works on your life force or chi. Many believe that when your life force is out of balance you become ill. They aid your body to help it heal without all the harmful drugs and side effects that are so common in modern western medicine.

If you want to have an acupuncture treatment, make sure that it it with a qualified and licensed acupuncturist that has been trained in the Chinese method. The differences between western medical acupuncture and Chinese acupuncture are very great. Even if your family physician offers the service, you may not get the full effects that you should if it was done by a properly trained Chinese or licensed acupuncturist.

How to Take the Ex Out of Ex-Boyfriend

I received an advance copy Janette Rallison's book, How to Take the Ex Out of Ex-boyfriend, and love it!! Couldn't put it down. Read it all in one sitting.

To tell you the truth I don't normally go for romance type reads so I actually started reading it at 11 p.m. with the idea that I would read a little and then put it down...well, thanks to Rallison's awesome writing it was 3 a.m. before I put the book down and only because I got to the last line, "I laughed and went inside."

Rallison totally won me over with her first paragraph, "I bet you Cinderella didn't get along with Prince Charming's friends. Oh sure, the knights and barons probably put up with her on account that she was pretty and had such dainty feet and all, but you know every duchess and countess in the kingdom hated her guts. That's how women are when someone encroaches on their turf." I found myself reading page after page and not being able to stop. I laughed. I cringed at the messes Giovanna kept getting herself in and out of. The scene with Buddy, I mean Gary, I mean Buddy was to die for!!! Hilarious!!! Just toooooooo much fun.

YA audiences are going to love getting their hands on this book. I loved it that Rallison wove tremendous lessons within the pages of a totally engaging and fun read. "How to Take the Ex Out of Ex-boyfriend" is the type of book I love reviewing and recommending to others.

Janette Rallison is the author of the bestselling All's Fair in Love, War and High School and a number of popular romantic comedies. She lives in Chandler, Arizona. If Rallison's other titles are anything like her How to Take the Ex Out of Ex-boyfriend, they should all provide a fun and engaging read.