Critique of Thyroid Hormone Replacement Therapy Studies

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Selected Letters in Response to

Thyroid Hormone Replacement Therapies:
Ineffective and Harmful for Many
Hypothyroid Patients


Introduction | Page1 | Page 2 | Addenda | pdf format
Clarifications
| Selected Response Letters

[Responses are posted in reverse chronological order. The latest
responses come first. Earlier ones are further down the page.]

On June 19, 2004, Dr. John Dommisse sent an email to Dr. Lowe in response to his critique of the replacement studies. Dr. Dommisse is a physician who practices nutritional, metabolic, and psychiatric medicine, and who hosts a popular telemedicine website. He is a member of the Endocrine Society, which publishes the Journal of Clinical Endocrinology and Metabolism (JCEM). JCEM published two of the replacement studies in 2003, and an editorial in which the authors reiterated the invalid conclusion of the endocrinologists who conducted the studies.

Dr. Dommisse's email included a copy of a letter he'd written to the Editor of JCEM. He wrote the letter in response to the reports of the replacement studies. JCEM declined to publish his letter, so he gave Dr. Lowe permission to publish it here as support for Dr. Lowe's critique.

In his email to Dr. Lowe, Dr. Dommisse wrote, "JCEM would not even publish a (longish, admittedly) LETTER that I wrote to the editor in response to that spate of bogus articles!"[1]

Dr. Lowe replied: 

I am not surprised that JCEM didn't publish your letter. I'm not surprised despite your letter's precise relevancy to the articles about the replacement studies, despite the excellent points you raised about treatment and avoiding adverse effects, and despite your clear prose. We became convinced long ago that, regarding the diagnosis and treatment of hypothyroidism, most major medical journals are not published in the pursuit of truth. If they were, they would provide for debate of dissenting views—as is traditional in real sciences. Instead, in our view, the purpose of the journals, in regard to the diagnosis and treatment of hypothyroidism, is to perpetuate medical acceptance of financially profitable beliefs and to censor dissenting views that might threaten financial markets nourished by those beliefs. What bothers me most is that, in my opinion, to serve those two purposes, those who decide what will and won't be published in those journals must carry on with cavalier disregard for the pernicious impact of those beliefs on humanity.[2]

Dr. Dommisse's full letter to the Editor of the 
Journal of Clinical Endocrinology and Metabolism


Dr. John Dommisse's Website

References
1. Dommisse, J.: Personal written communication with Dr. John C. Lowe. June 19, 2004.
2. Lowe, J.C.: Personal written communication with Dr. John Dommisse. June 19, 2004.


Subj: Brief Comment on Critique of Thyroid Hormone Replacement Studies
Date: 6/8/2004 4:47 PM Mountain Daylight Time
From: piek@waitrose.com
To: DrJohnLowe@aol.com
Sent from the Internet

The original Bunevicius research found benefits for T3/T4 over T4 and was followed up by a further analysis (Int. J. Neuropsycopharmacology, 2000, 3:167-174) which demonstrated that these benefits applied only to those on TSH-suppressive doses of thyroid hormones, particularly for thyroid cancer. Each of the four replacement studies tested patients on lower doses.

However,

"Combined Thyroxine/Liothyronine [T4/T3] Treatment Does Not Improve Well-Being, Quality of Life, or Cognitive Function Compared to Thyroxine Alone: A Randomized Controlled Trial in Patients with Primary Hypothyroidism" (Walsh et al. JCEM 88(10):4543-4550)

is a classic. ". . . subjects attended after an overnight fast and before taking T4 or study medication (i.e. 24 h after the previous dose)." Their data shows that the T3/T4 group had lower T3 levels than the T4 group and in the Discussion section they acknowledge the 24-hour half life of T3! Duh!!!

Jim Harwood. piek@waitrose.com


In response to Dr. Lowe's critique of replacement studies, a patient wrote to Dr. Gina Honeyman-Lowe on June 8, 2004. The patient described her remarkable improvement after switching from T4-replacement to T3. She expressed understandable outrage at the closed minds within the medical community. She had remained ill for years on Synthroid.

 

Full Paper | Introduction | Page1 | Page 2 | Addenda | pdf format
Clarifications
| Selected Response Letters