Multiple well-respected and reliable medical journals such as The Annals of Internal Medicine and The Journal of American Medical Association, have investigated the current knowledge and practice of doctors. Another similar study titled “Clinical Research to Clinical Practice-Lost in Translation,” conducted by The New England Journal of Medicine found that most medical practitioners are working, on average, 17 years behind current medical literature and proven medical data. Why is this happening and what does it mean for patients? Understanding the reasons why doctors are unable to keep up, the impact of this loss of information, and how individual health is suffering because of it, can help empower patients to find knowledgeable doctors who can give them the help they need.
What’s Causing the Delay?
There are various reasons why doctors aren’t practicing with the most recent information. One of the leading contributors of delayed change is that doctors simply do not have time to consume all the available medical literature. As a compromise, and less than effective method of staying current, most doctors get their information from studies that drug and medical representatives provide. Other common sources of information include yearly conferences and information that trickles down from their prescribed medical society, which generally takes 10-15 years to adopt current research. The common link between these sources is that they are funded by forces dedicated to maintaining the status quo or raising profits rather than improving healthcare.
Another frustrating roadblock for positive medical change is doctoral stubbornness. A 2003 article presented in the Wall Street Journal titled, “Too Many Patients Never Reap the Benefits of Great Research,” showed that doctors who were shown large amounts of verified and accurate data that contradicted their current beliefs and practices, completely rejected and attempted to discredit the new information. It seems that medical education tends to promote an environment of exclusivity and elitist knowledge, which has caused many physicians to be unreceptive to new data. This is unfortunate because alternative medicine, even if it is not accepted by most physicians, can be more accurate and scientifically sound than a large percentage of “mainstream” practices. In many cases this helpful and verifiable information is disregarded primarily because of its unfortunate title.
Perhaps the most misunderstood and discounted information is that regarding the thyroid. Doctors tend to practice with a herd mentality, meaning that whatever the majority is doing, they do as well. This attitude has led to numerous problems and misconceptions in the mainstream medical community regarding thyroid function and treatment.
Basics of the Thyroid
Some physicians have an unsatisfactory understanding of basic thyroid function. The primary hormones involved in the thyroid are TSH, T4, T3, and Reverse T3. Additionally, other hormones such as SHBG are important for gauging thyroid health. Each play an important role in thyroid function and influence numerous bodily functions, including the metabolism.
- Thyroid Stimulating Hormone (TSH) is the substance responsible for promoting the production of T4. TSH responds to fluctuations in levels of T3 to regulate hormones.
- Thyroxine (T4) is the storage form of thyroid hormone, which is converted into T3 or Reverse T3. Without being converted, T4 does not have any impact on bodily function.
- Triiodothyronine (T3) is the active form of thyroid hormone, which has the greatest influence on one’s health and metabolism. Too much or too little T3 in one’s system can cause one to experience hypothyroidism or hyperthyroidism.
- Reverse Triiodothyronine (RT3) is the mirror image of T3, meaning that it blocks T3 function. This is beneficial in regulating thyroid hormone levels but too much can cause health issues if produced in excess.
- Sex Hormone Binding Globulin (SHBG), although not a thyroid hormone, is an important indicator of thyroid health. This substance increases in response to estrogen and thyroid in the liver. Poor SHBG levels correlates to reduced levels of estrogen, thyroid, or both.
Optimizing the production and efficacy of these various pieces is crucial for improving health and well-being. Unfortunately, many doctors do not understand the complex interactions of these hormones, nor appreciate their importance.
The Problems with Testing
Standard thyroid tests rely solely on TSH levels. This is built on the understanding that as thyroid levels decrease, TSH levels increase, meaning that the patient has an underactive thyroid. However, TSH testing doesn’t work 80% of the time in identifying thyroid dysfunction. The only condition that TSH testing effectively diagnoses is primary hypothyroidism, wherein the thyroid is not creating adequate T4. Part of the reason this testing method falls short is that there are multiple conditions such as improper conversion of T4 into T3, or Reverse T3, poor production of T4, poor hormone transport, and many others.
Accurate diagnosis and treatment of thyroid function requires a comprehensive understanding of one’s thyroid health. Instead of relying solely on TSH to get a small glimpse of the thyroid, it is far more reliable to analyze tissue levels of Free T4, Free T3, Reverse T3, and SHBG. Furthermore, settling for “normal” thyroid ranges is less effective than many imagine. Instead, one should strive to achieve optimal thyroid levels.
Conditions Associated with Thyroid
Poor thyroid function can influence or promote the development of numerous physiological conditions. The following symptoms and conditions are associated with inhibited thyroid function:
- Bipolar disorder
- Weight gain
- Heart disease
- And many others
All chronic illnesses share the symptom of reduced thyroid function. Optimizing the thyroid can help prevent the development of debilitating conditions and reduce the occurrence of age-related disease. Preventive measures such as actively improving thyroid function are far more effective than treating health issues as they develop.
More Effective Treatments
Even though the world of health, medicine, and thyroid function are complex topics, there is new helpful data and proven information that can improve treatment. Unfortunately, according to William Shankle, M.D., Professor, University of California, Irvine, “Most doctors are practicing 10 to 20 years behind the available medical literature…” and “Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not.” Recognizing and resolving this incredible delay of pertinent medical information is one of the most effective ways we can move forward and improve our health and well-being.
For more information, make sure to watch Dr. Holtorf’s “17 Years Ahead” presentation here.