Updated March 08, 2014.
Each year in January, public attention turns to Thyroid Awareness Month, an effort spearheaded by the American Association of Clinical Endocrinologists (AACE).
There's a basic thyroid awareness public service announcement video on Youtube that you can view, share, or embed on your own site or blog.
They have basic thyroid information, from a conventional medical perspective, that provides some useful background, including:
- About Your Thyroid
- How to Do a Thyroid Neck Check
- My PillCheck -- a database of photos of different thyroid medications.
- Resources -- which lead to various online PDF fact sheets that you can read/download
- Thyroid Awareness Lapel Pins
- Thyroid Awareness Necklace or Bracelet Charm
- Thyroid Awareness Pocket Mirror
- AACE Thyroid Awareness Car Magnets
The Drug Company Sponsorship Conundrum
It should be noted that AACE's Thyroid Awareness Month site and activities are sponsored by AbbVie (formerly Abbott Labs), the manufacturer of the top-selling brand-name thyroid drug, Synthroid. (In 2013, AbbVie financed a major public awareness campaign, "Follow the Script," featuring "Modern Family" star and thyroid cancer survivor Sofia Vergara.
That campaign emphasized levothyroxine, and as a result, was controversial among thyroid patients.)
Research has shown that financial support -- even small giveaway items like mugs -- have an undue influence impact on doctors' prescribing decisions, so drug-company sponsored campaigns, often self-serving in nature and marketing-oriented, need to be taken with the proverbial "grain of salt."
Given that the information is developed and provided by the mainstream endocrinology community, and financially supported by a major drugmaker, the information in the 2014 Thyroid Awareness Month campaign tends to be very conventional, and ignores the legitimate integrative approaches of many of the nation's top physicians.
Some examples:
The MyPillCheck feature includes photos of all the brand name and generic versions of levothyroxine on the market in the U.S., and even includes the discontinued and unavailable drug Thyrolar (liotrix), but fails to mention or include photos of any of the prescription brand-name natural desiccated thyroid drugs available in the U.S., such as Nature-throid, Westhroid, or Armour Thyroid.
The online discussion of hypothyroidism mentions testing of Thyroid Stimulating Hormone (TSH), Free Thyroxine (Free T4), and thyroid antibodies, but fails to mention the Free Triiodothyronine (Free T3) test, or Reverse T3, which are often used to make a diagnosis of hypothyroidism by integrative physicians.
The only treatment mentioned for hypothyroidism is levothyroxine. There is no mention of the use of liothyronine (T3) drugs, or natural desiccated thyroid drugs. (This is not surprising, given that the information page is sponsored by the top brand-name levothyroxine manufacturer.)
The information on hyperthyroidism indicates that the "treatment of choice" is Radioactive Iodine (RAI), a permanent treatment that renders most patients permanently hypothyroid. Meanwhile, in Europe, instead of the American propensity to rush to RAI, the "treatment of choice" is more often antithyroid drugs, which can achieve remission in some patients, and do not result in permanent hypothyroidism.
Some Thoughts
In the end, increasing public awareness of thyroid disease is a positive goal. The more people recognize the signs and symptoms of a thyroid condition, the fewer people will remain undiagnosed, and some experts estimate that as many as half of the people with treatable thyroid disorders are not yet diagnosed. So from that standpoint, the AACE's Thyroid Awareness Month efforts each year are positive.At the same time, the more rigid diagnostic processes espoused by the AACE, including the focus on the broad and controversial TSH range, can lead prospective patients -- and their doctors -- to wrongly exclude a thyroid diagnosis, when they could potentially be diagnosed, safely treated, and enjoy better health and quality of life as a result if other factors -- such as clinical signs, Free T3 levels, family history, and Reverse T3 -- were taken into consideration as part of the diagnosis.
Another concern is the over-emphasis on levothyroxine as a hypothyroidism treatment -- to the exclusion of other legitimate options such as T3 or natural desiccated thyroid. This can erroneously lead patients to conclude that the only treatment for hypothyroidism is a levothyroxine drug, when the reality is that treatment options include levothyroxine, liothyronine (T3) drugs, prescription natural desiccated thyroid drugs, and compounded prescription thyroid drugs. And recent studies have shown that the majority of patients with hypothyroidism prefer a combination therapy that includes T4 and T3, versus monotherapy with a T4 (levothyroxine)-only drug.
As with all information about thyroid disease, it's important to know the funding source, the perspective, any agendas or influences, and recognize that the conventional medical establishment does not feel any obligation to provide information and education about the range of options available to patients.
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