Saturday, August 24, 2013

Misogyny And Misinformation Keeps Women With Thyroid Disease Suffering

If you have an underactive thyroid, you may have been told to take a pill, probably Synthroid or its generic form Levothyroxine, and you’ll feel better (a very misleading yet common belief in the medical field), and that’s only if you have been tested and diagnosed. Many women haven’t been tested or diagnosed, so they unknowingly live with the disease and suffer the ramifications. Thyroid disease stands to be one of the most overlooked diseases of our time and some say misogyny is at the root of the misinformation.

A recent article in Good Housekeeping caused contention among physicians and thyroid sufferers alike as it purported that women who suffer with a mild to moderate underactive thyroid (hypothyroidism) may not benefit from being treated, unless the women are trying to get pregnant. Not only does it go against what the American Association of Clinical Endocrinologists (AACE) protocol for treatment, it also implied that only women who were interested in child bearing should be entitled to medical help.

The article, written by Susan Carlton, based the findings on one Harvard doctor, Gilbert Daniels, M.D. Yet another Harvard doctor, Sara Gottfried was infuriated after reading the piece and blogged about why it was so wrong:

This article is published in Good Housekeeping, a purported magazine that speaks to women and women’s issues in an empowering way. We women are more accustomed to patriarchal attitudes from old-school physicians; we hardly even notice any more when we are dismissed for feeling tired and gaining weight. But when we get the dismissive message from a women’s magazine, it feels incendiary.

I’m a board-certified gynecologist who has managed hypothyroidism, or low thyroid, in patients since I graduated from Harvard Medical School in 1994 . I see the benefit of treatment in women who feel the classic symptoms of hypothyroidism, namely sluggishness, weight gain, low sex drive and hair loss, every day in my practice. And treating the mildly-hypothyroid patient has proven benefits, including a lower risk of Alzheimer’s disease.

Here’s what troubles me most: the same doctors who won’t treat Ms. Carlton as a 40-something would treat her if she struggled also with infertility or difficulty staying pregnant. That makes my blood boil. The implicit message is this: if you are not reproductively viable, sit on the sidelines and suffer through your low-thyroid symptoms. Go to spin class and eat less. But if you’re making a baby, we will treat you.

This leaves women cold. That is misogyny, plain and simple. And I won’t have it. Women deserve better. Women are tired of being dismissed and marginalized.

Hypothyroidism is a horribly mistreated and misunderstood disease. Not only does it remain undiagnosed in scores of people (including children), but once diagnosed, the old school treatment of a single daily synthetic hormone replacement pill is a crapshoot at best. For some, while it may very well improve the overall thyroid stimulating hormone (TSH-the hallmark test for diagnosing hypothyroidism), it often does not improve the symptoms in Hashimoto’s disease (an autoimmune disease that causes the thyroid to not function optimally). So a woman may go to the doctor complaining of headaches, weight gain, extreme fatigue, depression, exhaustion, brain fog and a host of other symptoms. Some doctors just chalk it up to the aging process and stress.  If the doctor actually orders a thyroid test that comes back positive, the patient will be given Synthroid and the doses will be adjusted for a few follow-up visits until the correct dosage is identified. A correct dosage will leave the thyroid gland neither too sluggish or too hyperactive (which commonly happens at the beginning of treatment). Eventually, the TSH will reach a value deemed normal by the labs and the woman will be told all is well.

Except in many cases it’s not.

Numerous women still feel terrible and exhibit the same symptoms they had before treatment, simply because they are still harboring thyroid antibodies which were never addressed. Even in this day and age of medical advancements, for whatever reason, the majority of doctors still treat this disease the same way they did fifty years ago, despite the new research showing how nutritional and natural methods (such as avoiding gluten and bad carbs) which are known to help improve symptoms. Yes, Synthroid is effective but it is not the end of treatment and just because your TSH has leveled off does not mean you will be symptom free.

Most distressingly however, is the fact that doctors still offer the same standard treatment despite women returning and presenting with the same symptoms. Now they not only feel physically exhausted, but begin to doubt themselves after being told they should feel fine now. What’s worse is when endocrinologists suggest that the symptoms may be mental, as in the patient may be anxious, stressed out, or have another issue because her ‘numbers are fine’.

Perhaps, misogyny played an initial role the stagnated treatment of the disease because it is more prevalent in women. Perhaps, it still plays a large role. From the Good Housekeeping article, that certainly seems to be the case.

But, there is also a supreme lack of information and extreme compliance to outdated standards that keep it that way, and in turn keep thyroid sufferers… well, suffering.