One day, a patient I was treating handed me a book titled, Hypothyroidism: The Unsuspected Illness, written by a doctor Broda Barnes, MD, copyrighted 1976, published by Harper and Row. She suggested that I read the book saying that it was a very good book on thyroid problems. I thanked her and assured her that I really didn’t need to read the book since I already had a good understanding of the thyroid system. Nevertheless, she left the book with me and it sat on my bookshelf for about three weeks when I decided it probably would not hurt to look it over. As it turned out, I found the book extremely interesting. Doctors had noticed that patients’ body temperatures would often drop quite low in severe hypothyroidism (myxedema). But to my knowledge, Dr. Barnes was the first doctor to emphasize the correlation between low thyroid function and low body temperature as a guide to therapy. He also pointed out the importance of being mindful of the many and varied manifestations of deficient thyroid function and that it can be important in an unsuspectedly large number of health problems.

Hypothyroidism is inadequate thyroid gland function. It is considered permanent and requiring life-long supportive treatment with T4-containing medicine.

Euthyroid Sick Syndrome is the term for abnormal thyroid tests during a non-thyroid sickness. The patients don’t have thyroid symptoms (they are euthyroid), and don’t require thyroid treatment.

In Wilson’s Temperature Syndrome the thyroid blood tests are usually normal. The patients often suffer from debilitating symptoms of low body temperature (as in hypothyroidism) that can last for decades if left untreated. It can often be reversed with proper T3 therapy and/or natural medicines in a matter of months and does not require life-long treatment.

After reading Dr. Barnes’ book, I began asking patients that I was treating more specifically about their symptoms. If a patient would complain of being tired, I would ask him if he also noticed having headaches, depression, dry skin, dry hair, fluid retention, and all the rest of the complaints. When they complained of having headaches, then I would also question them about whether or not they also noticed having trouble sleeping, difficulty swallowing, itchiness, and the like. I was amazed at how frequently the patients’ symptom came on together with a large group of other symptoms; and not just random symptoms, but the symptoms of low thyroid system function. When I requested the patients to take their body temperatures, I was also intrigued to discover that many times, if not always, they were low, on average.

Dr. Barnes also had a few pages on the treatment of hypothyroidism (one cause of DTSF) as diagnosed by symptoms and low body temperature patterns. By following his treatment recommendations, I noticed that many of the patients’ symptoms improved dramatically as their body temperatures began to normalize. I could see evidence that there was an unequivocal relationship between the symptoms and the body temperature pattern. Unfortunately, the treatment results were not very reproducible and predictable, and when symptoms did improve, they frequently did not improve completely. Such patients could remember how they felt prior to the illness, could tell the symptoms had improved, but could also tell that some symptoms remained.

A few months later I came across another source of information which was a review article from a medical journal: Thyroidal and Peripheral Production of Thyroid Hormones; Schimmel; Utiger; Annals of Internal Medicine, 87: 760-768, (December 1977). The significance of this article has been overlooked for a long time, like the proverbial “needle in a haystack.” Its significance lies namely in the pointing out of the importance of the conversion of thyroid hormones that takes place, for the most part, outside the thyroid gland (peripherally) in the tissues of the body. This article makes it clear that the degree to which T4 is converted to T3 or to RT3 could have profound physiological consequences. The article suggests that the function of the system may not depend merely on how much T4 a patient’s thyroid gland produces or how much T4 the patient’s body is given, but may very much depend on what the patient’s body does with the available T4. New data reviewed in the article has forced a reassessment of long-held views on thyroid hormone physiology. There was some speculation in the article that elevated RT3 levels resulting from a transient shunting of T4 towards RT3 and away from T3 could then secondarily inhibit T4 to T3 conversion. Not only can this happen, it does happen. The same article reviewed the well-known facts that T4 to T3 conversion can be impaired or decreased by fasting, illness, glucocorticoid, and in the fetus.

So then, in addition to just asking patients about their symptoms, I began asking them specifically when their symptoms began, to see if they could identify their onset with any obvious stress, illness, or injury. To my amazement, patients suffering from symptoms of DTSF, while having normal thyroid blood tests, could, in almost every instance (greater than 90%), identify specific stresses which marked the onset and/or worsening of their symptoms.

The scientific information printed in the Annals article (after Dr. Barnes’ book was published) made it possible to understand how a person could have symptoms of DTSF even with normal thyroid hormone blood tests. And it led to the finding that symptoms of DTSF can come on after a stress and persist inappropriately even after the stress has passed. It helped also in understanding why patients’ symptoms of DTSF don’t always resolve completely, as some would expect, with the use of T4 preparations or T4/T3 preparations (medicines). It also helped pave the way for the development of new, better directed, more predictable, more reproducible, and more effective treatment for DTSF symptoms (especially symptoms of DTSF caused by Wilson’s Temperature Syndrome).

The clinical information contained in Dr. Barnes’ book helped provide the basis for the all important guides (especially symptoms and body temperature patterns) to therapy. Without this information, the scientific data could not effectively be put to use. Without the scientific understanding provided by the review article, the information presented in Dr. Barnes’ book alone could not explain why some patients responded satisfactorily to his suggested treatment, while a number of them did not.

Since then, I have performed computer searches of all the available medical literature on the subject. Although I have found many articles supporting the information found in the first two sources, I have found very little that adds to the information, and I haven’t found any sources that could substitute for the first two sources. When taken together, they formed the embryo that has been developed into the information contained in this book. I had stumbled on to extremely simple, yet important information. Simple because of the few number of variables involved and important since it involved one of the most fundamental processes of the body, namely body temperature regulation.