49 Y/O male ex- chirpractor, first sought medical care 8 years ago. He had every major symptom of Graves' Hyperthyroidism. He refused medical therapy for most of the next 8 years.6 years ago after 2 years of holistic medicine, he had Hyperthyroid induced rapid irregular heart beats called atrial fibrillation. He did nothing for 6 years! He was sent to a heart specialist this year. He was told the thyroid needed therapy and the heart problem would go away. The heart was enlarged, and he was at risk for blood clots to his brain and a stroke if the thyroid was not treated. He never took the blood thinner medicine to prevent stroke. He continued holistic therapy, even though he was told the thyroid could be easily cured by radioiodine, surgery, or antithyroid pills.
When I saw him in consultation, he had a large goiter with blood flow sounds, Atrial fib out of control, and thyroid eye disease and skin disease.
The bone density was low.
The left atrium was enlarged and at risk for an embolus to the brain.
There was decreased function of the heart.
Ultrasound showed a firestorm pattern of increased blood flow in the thyroid.
There was a very high iodine uptake, and diffuse scan consistent with Graves'
hyperthyroid 8 years after first diagnosed!
He swore to me he was finally ready to be treated by standard thyroid therapy methods.
Well, he failed to return, and was trying another holistic regimen in hopes of cure.
He is a fool, and puts himself at grave risk for no reason. Modern well known therapy
could have fixed him 8 years ago. There is no holistic therapy for Graves' Hyperthyroidism. I hope he learns this in time, before his stroke.
I sadly sent him a withdrawal letter as I did not want to be the physician of record when he became paralized from a blood clot from his heart, or when he went into heart failure.
Before 1940, there was a high mortality for untreated Graves' Disease, but that was because there was no therapy! With 3 proven therapies today, no one should stroke out or die, unless you try unproven methods in cure yourself.
Dr.G.
The Thyroid Doctor's log after seeing his patients. I am a rare bird. I am one of the few physicians to practice clinical thyroidology only for 35 years. I am the sole physician at the Santa Monica Thyroid Center, and have the best thyroid blood lab with Dr.Carole Spencer, expert in thyroid hormone analysis, and thyroid cancer markers, as my lab director.The lab is also CLIA certified in thyroid cytology. Dr.Guttler is a thyroid ultrasonographer certified by AACE, and AIUM.
Wednesday, November 22, 2006
Wednesday, November 08, 2006
Distant Metastatic Disease 30 years after Partial Thyroidectomy for Thyroid Cancer
I was not expecting this when a nurse called me to see her 85 Y/O father. He had a mass under the skin of his abdomen which was removed, and was found to be metastatic papillary thyroid cancer.The story gets worse. Since his surgery in his home country 30 years ago, he never knew that he had had thyroid cancer. The family did not tell him. They thought he had been cured by the partial thyroid surgery. There was no cancer follow up. With the distant cancer spread 30 years later, the family asked me to see him. He was wearing a pacemaker, had heart disease, and was not a good surgical risk. He was taking a heart drug, amioaderone, which was very high in iodine content. He had nodular masses in the lung by CT, and had significant thyroid tissue
still in the neck by ultrasound. 24 Hr uptake was 18%, the scan showed bilateral thyroid gland with cold masses in the left lobe. The thyroid tests confirmed severe hypothyroidism with TSH of 70. He had never been treated with thyroid hormone for the cancer or hypothyroidism. The TSH stimulated cancer marker TG was > 2000.
He was ready for ablation therapy, but was incontinent! No hospital would take him.
What do you do with this case?
After much thought, because he was most effected by the hypothyroidism, I elected to treat his hypothyroidism first. He had wide spread cancer with very high cancer marker, and had no local symptoms due to the cancer. I will wait for local symptoms and then treat for symptom relief with external radiation. This is a very sad case, because if he knew he had cancer, the patient might have sought medical care when there was a chance it would have help.
still in the neck by ultrasound. 24 Hr uptake was 18%, the scan showed bilateral thyroid gland with cold masses in the left lobe. The thyroid tests confirmed severe hypothyroidism with TSH of 70. He had never been treated with thyroid hormone for the cancer or hypothyroidism. The TSH stimulated cancer marker TG was > 2000.
He was ready for ablation therapy, but was incontinent! No hospital would take him.
What do you do with this case?
After much thought, because he was most effected by the hypothyroidism, I elected to treat his hypothyroidism first. He had wide spread cancer with very high cancer marker, and had no local symptoms due to the cancer. I will wait for local symptoms and then treat for symptom relief with external radiation. This is a very sad case, because if he knew he had cancer, the patient might have sought medical care when there was a chance it would have help.
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