The Epidemic of False Diagnoses | Wellness Force #Podcast

There is this rampant and egregious over and incorrect diagnosis of hypothyroidism. It doesn't mean that hypothyroidism does not exist. Of course it does. But there have been major outcries, even published in the journal Thyroid or in Medscape, that there is this drift to incorrectly diagnosing people, albeit probably because we're trying to help them, but it ends up doing way more harm than it does good. And you're just an example of that.

Yeah. And I wanted to bring you on because this has been your world for so long. How many years have you been involved? If people haven't heard our other three podcasts, which we'll link right here below this video. But how many years have you been specializing in autoimmune and gut health and the enteric nervous system and thyroid function like this has been a long journey for you?

Yeah, I mean, it's been about eight years from. From the start, although it's. It's been about, I'd say, three or four years that I've really been honing in on. Holy smokes. There is this division within alternative medicine that's again, trying to help people, but incorrectly labeling people with a disease when they're actually in an acceptable normative range. Why this is so problematic is because literally once per week at the clinic, which is now a five doctor clinic, who are all working together to publish research and try to rectify some of this, and we're about to publish, or at least submit for publication, a case series exemplifying exactly what you've been dealing with, this incorrect diagnosis that ends up harming people. So it's only been about three years, four years that I've really been queuing in on this happening so frequently that I will see a case of this per week. It's that rampant. And coming back to that paper that was published in the journal Thyroid from 2018 by a researcher named Levanus, he wanted to assess this also in a controlled research setting. So he took a group of people who had kind of an ambiguous hypothyroid diagnosis, had them stop their medication, and then retested six to eight weeks later to see, does your thyroid maintain normal function, meaning you weren't actually ever hypothyroid, and 60% of individuals were able to come off the medication and maintain normal levels. So there is some data to show you how common this. This actually is.

All right, so what I've been dealing with over the past, I would say, 12 months plus because of the COVID and lots of stressors. You know, I'm gonna have a baby boy soon. And, like, that comes with its own unique stressors. So I think it was a. I thought it was a beautiful way to just be transparent and just be open and honest so that my journey could be shared with other people, other men, specifically, that are dealing with some of the symptomology and also, really the erroneous diagnosis of me having hypothyroid. Because, as you've mentioned, this is something that's kind of being abused right now on a large scale. So can we set the foundation of how we came together? I was working with a concierge clinic. I'm not gonna name their name, but the woman was very serious with me on our consult call, and she said, we need to put you on all kinds of medications and all kinds of supplements, and, you know, we need to really get you in the space of understanding that your body is broken. I remember she actually said that. She said, your body is broken, and you need to understand that by you taking the specific drug. I believe it was. What's the specific drug? Thyroxin. I think there was a couple other ones, too, that were, like, clinical drugs. And I thought, you know, I'm gonna get a second and even third opinion. So I talked to my friend Ari Whitten. He echoed a lot of your sentiments, and that led me to you, because I trust you, man. So let's unpack this step by step for people when men or women. But we'll just speak from a man's perspective, because I'm a man. When we get diagnosed with hypothyroid, what does that actually mean? What is the truth about that? Maybe. Let's just start there.

I mean, I just. Firstly, let me just say I really find it disheartening the way this clinician handled the conversation. When people aren't feeling well, there's already a predilection to be a little bit anxious about. I'm not feeling well. And your mind tends to go to the worst case possible scenario, right? I've been there, right. I've bumped my shin. Didn't realize I bumped it. Felt a lump, thought I had bone cancer, right? So it's like, you know, these things happen, and if you prey upon that, it's really the wrong way to handle these conversations because you end up making the person feel worse than they actually are. As clinicians, we should be trying to leverage the placebo in a positive way. Like, hey, you can heal and you can recover, and it's not that bad. And these things can be repaired. So anyway, that aside, the problem comes down to this. There's this thinking that the conventional ranges for TSH and Free T4 are wrong. And if we got you, or if we use these narrower criteria, we would be able to diagnose more people as hypothyroid and then get more people the care that they need, like levothyroxine or whatever type of thyroid medication. That's well intentioned. But when you look at the evidence, that argument has no good support for it. And I'm on the alternative side of the fence here. Right. I'm not constitutionally one who, you know, takes the other argument, but this is really where conventional medicine has it right now. What's the evidence for that statement? Well, the best evidence we have, and I'm sorry, let me take a step back and frame this. Using TSH would be the simplest way to frame this. So the cutoff point for TSH to distinguish hypothyroid versus normal thyroid is 4.5 at most labs. And the mistake that's being made in functional medicine is they want to see people at 2 or 2.5. And that's actually not how one diagnoses the diagnostic criteria. Cutoff is 4.5. However, when someone is on medication, the goal is to give enough medication to suppress their TSH to 2.5. So the myth, the mistaken inference is functional medicine says, oh, if that's the ideal level based upon medication, everyone should be at that level. It's a fair posit. Right. But there's some really compelling evidence that shows us that this is incorrect. And that evidence is looking at what's known as subclinical hypothyroidism. These are people who have elevations of that TSH above 4.5. It's anywhere from 4.5 to 10. Right. And these people will have that elevated TSH, they'll have normal free T4, but they'll have this kind of subclinical hypothyroidism. And the data there are clear that there's no additional symptoms in people who have subclinical hypothyroidism compared to normal healthy controls. And there's no improvements in symptoms when giving them thyroid medication as compared to healthy controls, with one exception, two exceptions if you're infertile or if you're in your teens.

Right.

So if you're very young and infertile, then that subclinical hypothetical may benefit. But outside of those exceptions, there's a fairly robust amount of data showing that as TSH drifts Even above that 4.5, there's no additional symptoms and there's no benefit from medication. So there's really ample evidence that, that using a 2 or 2.5 cutoff for TSH is a really bad idea because it doesn't correlate with symptoms, and those people don't benefit from medication.