Saturday, July 30, 2005

Wilson's Syndrome: A Bogus Thyroid Diagnosis Trips up another Physician

A physician Naturopath, was following E.Denis Wilson's
methods to treat functional hypothyroidism in over 200 patients in a western state.
In 1994, he began treating a patient by online contact, with just a history form , and no physical examination from another western state. He sent instructions to take tempatures, and send them to him. After looking at the hx and temp. charts he diagnosed Wilson's syndrome. He did not do any lab testing. He odered T3, cytomel which was sent via mail from his local pharmacy. By 1995, he was treating 100 long distance patients, via online,telephone, and mail.
T3, cytomel is normally used at doses of 25-75 mcgs. He gave up to 300 mcgs. 25% were on > 200 mcgs. Overmedication with T3, can be very dangerous and cause death. Even his claim that he saw tests from the patient's primary care group was not factual, as the records release came after he started treating the patient. In 1992, Wilson was suspended and fined and has not returned to practice in Florida. He was ordered to receive metal health assistance as part of the order. His website is still up, and caught this naturapath, in it's bogus web.
1998, the naturapath was fined $3,000, and given a 30 month suspension. He was ordered not to treat out of state patients, without a physical examination, and only with the help of tandem physician in the state of the residence of the patient. He had to submit to audits of his patient records for an additional 2 years after suspension.

The American Thyroid Association stated:
1.Wilsons is inconsistent with known facts about the thyroid gland.
2. Diagnosis is imprecise, using non-specific symptoms and body temperature.
3. T3 is no better than placebo in treating non-specific symptoms, of patients with normal thyroid hormone concentrations.
4.T3 results in wide swings in blood levels, and can produce symptoms, and cardiovascular complications in some patients, that can be potentially dangerous.

Wilson's Syndrome as described by Denis Wilson is a bogus diagnosis, but there is a real Wilson's disease , but it is a rare disease of copper metabolism.


Disciplinary actions: E.Denis Wilson MD #0048922
Longwood FL. 2/12/92 Board of Medicine 8(2):10,1992
FL.Depart. of Professional Regulations Tallahassee FL.

TSH, and usually T4, will be abnormal BEFORE you have symptoms of hypothyroidism. Throw away the thermometer, unless you need it for your child's fever, mom!

Even with the new TSH upper normal of 2.5-3.0, you need to have the TSH > 5-10 before symptoms occur.


Thursday, July 28, 2005

Women Smokers have higher incidence of Graves' Disease

115,000 women's lifestyles were studied to see the effect on the incidence of Graves' Disease. 543 women developed Graves' Disease. Heavy smokers > 25/day, were 3 times more likely to develop Graves' Disease. The rate decreased if they quit 10-15 years ago. However, even past smokers were still more likely to develop Graves'. Archives of internal Medicine, July 25 2005 vol.165, pp.1606-1611.

Now, besides worsening thyroid eye disease, we now know we have more Graves' Disease in smoking women!


Monday, July 25, 2005

Overcoming Thyroid Problems: A Great New Book from Harvard Medical School Guide Series. A Book Review.

Dr.Jeffery R.Garber,assistant clinical professor, Harvard Medical School, and a fellow member of the Academy of Clinical Thyroidologists ACT,, American Thyroid Association ATA, and American Association of Clinical Endocrinologists AACE,, has written a thyroid patient book for the Harvard Medical School Guide series.
The introduction compares thyroid disease to the auto part you never heard of until your car breaks down. This is a good start. He has contact to the laymen, by this simple, but apt analogy.He states the thyroid is undervalued, and it is normal for patients, to not know it's basic functions. He tells the reader thyroid works behind the scenes, and can effect every organ if it is malfunctioning. The only thing most people know is that thyroid failure causes obesity, and that is wrong.

The chapters are well written, and have great side bars.
An example is the one on Kelp, Myth or Fact:
The myth is that kelp is good for you if you have thyroid problems, while the fact is just the opposite, it can harm you. He includes excessive kelp or iodine under risk factors for hypothyroidism, nodular goiter, Hashimoto's thyroiditis, and hyperthyroidism.
The use of the myth or fact approach is seen next in the thyroid medication section.No, it does not cause osteoporosis if the the dose of thyroid hormone is normal. No, hypothyroidism does not cause obesity. And, no, it is not a good therapy to cause significant long term weight loss. No, animal thyroid products, or T4/T3 combinations are not better than T4 alone.
The section on ultrasound for nodules is very up to date.
He describes changes seen on ultrasound that point to cancer, and the need for FNA. However, I think he needed to tell the patients, that ultrasound results depend on the person doing the examination. Clinical thyroidologists, doing their own ultrasound can yield better information to help manage patients with a the thyroid nodule.
The section on pregnancy is excellent, and a must read for pregnant thyroid patients.The need for iodine in prenatal vitamins, and the need to take thyroid hormone at a different time than the prenatals with iron. The present day feelings that ATD's for treating hyperthyroidisms, can be given to breast feeding mothers is discussed.
Finally, he brings up the most important issues.
Who do you see about your thyroid problem? He talks about the thyroid surgeon with a high number of thyroid surgeries/ year, and the endocrinologist with extra training, and experience with thyroid problems. He calls them clinical thyroidologists. He talks about finding out if the physician sees a high percentage thyroid patients, and are less active in diabetic care. Because, the new clinical thyroidolgists society ACT, was just formed , he failed to put the thyroidologists website as a source of referrals to endocrinologists that practice 50-100% thyroidology. The site,, I hope will be listed in his revised edition in the future.

In conclusion, I will recommend this book to my patients,
and hope to see it become a classic in thyroid patient
literature.It is an excellent book, to give to all my new thyroid patients at the initial consultation. The book is available at the bookstore section on, or at It is worth the $14.95 retail price in the USA, $19.95 Canadian, or 8.99
English Pounds in the UK.


The Thyroid Home Page is First!

The Thyroid Home Page, the official website for Santa Monica Thyroid Center, was recently re-evaluated by a company that ranks websites by visitor traffic. They only rank the first 900,000 websites. Any lower ranking, is listed as "not ranked". was ranked first for pure thyroid websites at 156,000.
Only was ranked higher at 47,000, but it had wider draw as it included all of endocrinology. American Thyroid Association,, was ranked 195,000, or second. Thyroid Foundation of America was not ranked, nor was Stats were not available for , because it was part of a large corporation website, AACE website was ranked 164,000, but it was a general endocrine website. Canadian Thyroid Website, was ranked 322,000.

Even though may be googled at 2nd through the 5th position, it still is the most visited pure thyroid website.

Thanks for all your support,


Wednesday, July 13, 2005

Visit to Ireland: Birthplace of The Physician who was one of the first to describe Hyperthyroid Graves' Disease

We just returned from Ireland, home of Sir Robert Graves. He was born in Dublin in 1796. He graduated from Trinity College in medicine when he was 22. He was a dynamic fellow. In a severe storm when the ship he was traveling on, was about to sink, due to damaged pump values, he took an axe to the lifeboat, because he knew they would all perish in it.He then took over command of the ship, and using his own boot leather, repaired the pumps.He published "Newly observed afflection of the thyroid gland in females" in the London Medical Journal in 1853. He detailed the clinical features of what is now recognized as Graves' disease, even though it was described earlier by Caleb Perry in 1825. It is remarkable that it is the one contribution that is most remembered today. Few call it Perry's Disease today!

In 9 days traveling throughout Ireland, I did not see a single goiter.

My daughter rode horses in western Galway, and at Castle Leslie in the northern Irish Republic, she rode cross-country on the castle's 1000 acre eventing course.

My Irish wife searched out her clans, the Delaneys, and McMonagles.
We found her family McMonagle homestead in Meenagoland,Donegal and the graveyard with 26 McMonagles in nearby Finn Town. There were 600 Delaney's in the Kilkenny phonebook!

It is good to be back.


Friday, July 01, 2005

Ireland on Horseback: Sir Robert Graves, Here We Come

Well, it is the time of the year to get away from the
usual daily exposure to the many problems associated
with caring for thyroid patuents, and lay back and relax.
However, my 14 Y/O daughter A.J. is an eventer. That means she rides horses over fixed objects, such as stone fences, logs, and water holes. We are going to the land of Sir Robert Graves, one of the first physicians to describe the disease of hyperthyroidism. A.J. will be riding Irish Horses all across western Ireland, and will
then travel to Castle Leslie to jump 150 fixed sites in 5 days. Thyroid clinic is less stressful, than watching her, in a titanium helmut, and flack jacket, jump irsh stonewalls. However, because my wife is second generation 100% Irish, we will search for her roots in Donnigal,in Northwest Ireland, for the McMonigle homestead. We will also look in Killkenny for signs of the Delaney clan. I will research the exact location of the famous man who
has his name on one of my most common disorders, Graves' Disease, I see in my center. It should be fun, if all goes well with my little horse mad daughter. Delaney, my wife, and a private chef,, will get a few cooking tips from Darina Allen. She is the most famous chef in Ireland, and has a cooking school just outside of Cork. We will stay in the Red Room at Castle Leslie on the last night in Ireland.
This is for me. I am half Italian from Umbria Italy.The Red Room is decked out in rare items from Umbria.
Paul McCartney was married there to his second wife.
I will return on July 13, 2005. I will post a blog, if I find anything about Sir Robert Graves.


Treating Hypothyroid Patients By Symptoms Alone. Trouble Brewing in the UK

this is an audio post - click to play

English Physician Diagnoses and Treats Hypothyroid Patients by Symptoms Alone. He Does Not Believe in TSH.

A private clinic in a large city in England treating 4000 patients
referred by GP's for hypothyroidism, by symptoms alone. The physician
felt blood tests failed to diagnose hypothyroidism. He had testimonials
of dramatic cures, including shedding wheelchairs, curing depression, and severe lethargy. He defended his methods saying you could not rely on T4, TSH testing.
The British Thyroid Association and the General Medical council, considered removing his certificate to practice medicine, but due to no fatal outcomes recorded, they allowed him to continue to practice, but with restrictions. He was not to accept
referrals from GP's that were not endocrine in nature. He was to inform the GP of the exact thyroid diagnosis, and thyroid therapy given. He also had to keep detailed records of all patients treated with thyroid hormone, who did not have modern thyroid testing proof, ie T4,TSH of hypothyroidism.

Beware of physicians who claim you are hypothyroid, when you present with symptoms, but
when your prior endocrinologist's testing results were normal. Check to see if his new tests are normal also. Treating by symptoms for hypothyroidism is wrong.
The thyroid tests are always abnormal before symptoms occur.

This physician, although they allowed him to continue practice, with careful supervision, is at risk to do harm in the furtue. This will not be the last we hear about this clinic.

Be Safe,
It is a jungle out there!