End Fatigue

The Tragic and Invisible Epidemic of Thyroid Disease

For over a decade, research by Jacob Teitelbaum M.D. author of the best-selling book From Fatigued to Fantastic!¹ has shown that hypothyroidism, like most other illnesses that affect predominantly women, has been dramatically under diagnosed.^2,3 The American Academy of Clinical Endocrinologists (AACE), the nation's largest organization of thyroid specialists, has now confirmed this. After a recent meeting, the normal range for thyroid tests was dramatically narrowed. As noted in the AACE press release:

“Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now.

"The prevalence of undiagnosed thyroid disease in the United States is shockingly high - particularly since it is a condition that is easy to diagnose and treat," said Hossein Gharib, MD, FACE, and president of AACE. "The new TSH range from the AACE guidelines gives physicians the information they need to diagnose mild thyroid disease before it can lead to more serious effects on a patient's health - such as elevated cholesterol, heart disease, osteoporosis, infertility, and depression."⁴

Now, 6 months after the new directives have been given, doctors are still largely unaware of these new lab guidelines for diagnosis and treatment. Even the major labs doing thyroid testing have not bothered to change the now incorrect normal ranges for both diagnosis and treatment of thyroid disorders.

The normal range for thyroid hormone levels in the past have been based on statistical norms (called 2 standard deviations). This means that out of every 100 people, those with the 2 highest and lowest scores are considered abnormal and everyone else is defined as normal. That means if a problem affects over 2 of these patients can improve with proper treatment-especially including thyroid hormone.²

Hypothyroidism is a major cause of gaining and being unable to lose weight. It causes fatigue, dry hair, coarse skin, depression, and “brain fog” as well. Americans are currently treating hypothyroidism, which is often confused as being depression, with Prozac! This is an even bigger problem in the elderly who are being misdiagnosed with depression or Alzheimer's/senility when what they have is hypothyroidism.

What makes this situation especially tragic is that, given the proper information, hypothyroidism is incredibly easy and inexpensive to diagnose and treat. Instead, because of lack of awareness on the part of physicians, Americans unnecessarily suffer with a major public health disaster.

1. From Fatigued to Fantastic! (Avery/Penguin Putnam 2001;1st edition 1995). Jacob Teitelbaum M.D.
2. Teitelbaum JE, Bird B, Greenfield RM ,Weiss A., Muenz L, Gould L. Effective Treatment of CFS and Fibromyalgia—A Randomized, Double-blind, Placebo-controlled, Intent to Treat Study. The Journal of Chronic Fatigue Syndrome. Volume 8(2), 2001,pg3-28.
3. Teitelbaum J, Bird B. Effective Treatment of Severe Chronic Fatigue: A Report of a Series of 64 Patients. J Musculoskeletal Pain 1995; 3 (4):91-110.
4. Press release on AACE web site: http://www.aace.com/pub/tam2003 /press.php
5. Canaris GJ ,et al.The Colorado Thyroid Disease Prevalence Study: Archives of Internal Medicine, Feb 28,2000 p526-534.
6. National Assn of Clinical Biochemistry web site. http://www.nacb.org/lmpg/thyroid_LMPG_PDF .stm p31-46
7. HAK AS, Subclinical Hypothyroidism is an independent Risk Factor for Atherosclerosis and MI in Elderly Women. Annals of Internal Medicine 2000;132:p270-278.
8. Allan WC,et al. Maternal Thyroid Deficiency and Pregnancy Complications; Implications for population Screening. J Medical Screening.2000 .Pg127-130
9. Haddow JE,et al. Maternal Thyroid Deficiency During Pregnancy and Subsequent Neuropsychological Development of the Child. New England Journal Of Medicine 1999:P549-555.
10. Travell J, Simons DG, Simons L: Perpetuating Factors. Chapter 4. In: Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams and Wilkins, Baltimore MD