To compound matters, cases of DTSF that do show up on blood tests are not very common. So doctors aren’t always alert to obvious cases (out of sight, out of mind). Recently, one of my patients had a classic presentation of thyroid hormone deficiency with many, if not all, of the symptoms of decreased thyroid system function. She had been seen by five different specialists before anyone thought to check her thyroid hormone levels. When they finally were checked they were found to be abnormal. She was treated with thyroid hormone replacement and her symptoms improved dramatically. Thus, if obvious cases with abnormal blood tests are easily overlooked, how much more easily overlooked are cases with normal blood tests?
As was pointed out previously, doctors were first alerted to the existence of DTSF through cases involving deficient glandular function. Patients presented to their offices extremely sick, sometimes comatose, and they sometimes died. Physicians at that time were able to work backwards to learn more about the underlying cause. Doctors found that if they normalized the patient’s blood tests, they could often prevent the patient from dying. Nevertheless, doctors have still been unable to use blood tests to predictably and reproducibly correct the symptoms of DTSF since many times patients can suffer from the symptoms of DTSF, even when thyroid blood tests are normal. I imagine that if patients continued to die frequently, even when the thyroid blood tests were normal, then more investigation and research would have been done and the importance of body temperature patterns probably would have gained much more attention than it has up until now.
It’s ironic that although the glandular causes of DTSF are more life-threatening than Wilson’s Temperature Syndrome, Wilson’s Temperature Syndrome is by far the most common cause of DTSF and the resulting symptoms of MED.
Needed A Treatment
WS has gone overlooked because no one knew how to treat it. There has previously been no good rationale for treatment of the symptoms of Multiple Enzyme Dysfunction, especially when caused by DTSF. For this reason doctors have been unable to get reliable, reproducible, and predictable responses to treatment. Generally speaking, a good rationale for treatment should include an effective therapy and the means to guide that therapy.
When it was discovered that patients suffering from a characteristic pattern of illness would often respond very favorably to thyroid extract given by mouth, many lives were saved. In fact, there are few problems in medicine wherein a patient can be so sick and have his symptoms resolve and health restored so dramatically, quickly, and easily.
It was also found that some patients, when given too much thyroid supplementation, developed signs and symptoms similar to those of thyroid gland problems that cause excessive thyroid hormone stimulation of the body. So in the beginning, the rationale for treatment of DTSF was limited to giving thyroid medicine to severely ill patients to decrease their symptoms and prevent death. However, there was a need for a better guide than just trial and error to help determine how much thyroid hormone medication was needed.
Later, the thyroid hormones, themselves, were discovered and identified. This led to the development of thyroid hormone blood tests. With this development, it became possible to measure the level of thyroid hormones in patients who were sick and also in normal people. It was found that thyroid system symptoms correlated fairly well with the patient’s thyroid hormone blood tests. The symptoms of excessive thyroid hormone treatment corresponded fairly well to elevated thyroid hormone blood levels. And, inadequate resolution of deficient thyroid system symptoms could often be correlated with thyroid hormone blood tests that were below normal. Many times, however, the symptoms of DTSF remained or appeared even when thyroid hormone blood tests were normalized. Many of these symptoms, however, are rather subjective. For example: fatigue, headaches, depression, decreased memory, decreased concentration, and others. Although it was easy for doctors to document whether or not patients died and how their survival or death related to their thyroid hormone blood levels, it was much more difficult to document how well patients’ symptoms of depression, fatigue, headaches, and decreased memory and concentration related to their thyroid hormone blood levels. Since how a person feels is hard to measure, some physicians may have assumed that the patients were fine when they and their tests looked fine, even though they weren’t necessarily fine.
With the advent of thyroid blood tests, it became possible to guide therapy to the extent that death could almost always be prevented, and the symptoms of DTSF could frequently be greatly improved with few side effects. However, patients often still complained of severe symptoms of DTSF, even though they were not life-threatening, and their thyroid blood tests levels were within the normal ranges. Faced with the quandary and without any good approach to address such a problem, doctors were left with a couple of alternatives, both of which are used even to this day. They could acknowledge the patient’s illness and admit to him that they are unable to find further sickness for which they can address treatment that might alleviate the symptoms of DTSF. Or, the doctor could ignore the patient’s illness and deny that he may possibly have a physical problem based only on the available blood tests and the available literature (and even do so in a tone of voice that might imply that he believed the medical literature and his knowledge of it to be exhaustive- which, of course, is never correct). I emphasize the tone of voice only because of its potentially damaging effects from an authority figure on the unprepared.
Even in the case where a doctor feels that further pursuit of a medical cause of a person’s complaint would be fruitless (because of the limitations of medical science and technology) and that the patient would be better off obtaining psychological help in learning to live with his complaints, I feel that it would always be preferable for doctors to arrive at the same bottom line with a different choice of words. For example: “I can’t find any abnormality that I am aware of that could explain your condition, and I am not very sure that currently anyone else can either. So your alternatives include: continuing to search for a possible explanation and solution; and taking measures to help you cope as well as possible until a solution can be found, when and if it can be found.” It is disappointing enough for one not to be able to find anyone who can correct the problem, without the matter being made much worse by it being said or implied that one also is a sissy, a faker, a complainer, a failure trying not to look like a failure, someone trying to find a socially acceptable excuse for their inadequacy as a human being, someone looking for pity, or someone who’s crazy. If patients suffering from such a problem go to the doctor and the doctor cannot adequately recognize or treat it, that doesn’t necessarily make that doctor a bad physician, and, it does not necessarily mean that the patient’s complaints are all in his head.
To illustrate how the lack of a good rationale for treatment has helped Wilson’s Temperature Syndrome to be overlooked, we can consider the following: Other sources of DTSF have responded well in the past to T4 or thyroxine therapy. However, if one gave a patient with Wilson’s Temperature Syndrome T4 as treatment, the symptoms might improve temporarily, but it would be unlikely that they would remain persistently corrected after T4 therapy was discontinued. Giving a Wilson’s Temperature Syndrome patient T3 as therapy in a non-specific way, wouldn’t be expected to correct the patient’s problem either. Even when the WT3 protocol is given to a patient with Wilson’s Temperature Syndrome according to useful and specific guidelines, it is not always easy to correct the symptoms, because medicines aren’t answers, they are tools. We all know what it is like to experience the surprise that comes from finding the unexpected value in something we are trying to use. For example, if we were looking into the wrong end of a pair of binoculars, we might conclude that binoculars are not useful in seeing far distances. However, if for some reason we turned the binoculars around so that we were looking through the correct lenses, then the surprising and impressive usefulness of the binoculars would be clear and we might be heard saying, “Oh-h-h-h, I see!” So in this way an inadequate rationale and guide for treatment has helped Wilson’s Temperature Syndrome to be overlooked for a long time. The tools (thyroid hormone) that are important in the treatment of Wilson’s Temperature Syndrome have been available for a long time (over forty years). The difference is not in what is used in treatment but the important thing is how the tools are used. Only when a condition responds predictably and reproducibly to a treatment is it most recognizable as a distinct condition. And only when the tools are used properly does Wilson’s Temperature Syndrome respond predictably and reproducibly to treatment.
Another factor that has caused Wilson’s Temperature Syndrome to be overlooked is that it is only natural for more obvious and definable problems to be addressed first. This has led to a great deal of resentment on the part of those people who are unfortunate enough to suffer from problems that affect the more fundamental levels of organization of the body. They sometimes view the limitations of the medical field and the medical professional as a lack of interest, concern, or respect. This sometimes causes them to perceive the medical profession has having a bad attitude. They may feel, “If I die tomorrow, that’s their problem, but if I stay miserable for the rest of my life and nobody can show what’s wrong with me, that’s my problem.”
Not All Medicine Is Scientific
Another set of conditions that has helped Wilson’s Temperature Syndrome to be overlooked for so long, is the specialization and fragmentation of the medical field as well as the economic and legal aspects of the industry. In the beginning, there were no specialties in medicine. There was merely the field of medicine studied and practiced by doctors. However, as the scope of medical information expanded it became easier and easier for doctors to be jacks-of-all-trades and masters of none.
There arrived a time that the amount of information available in a fragment of the medical information, for example diseases of the lungs, was enough to occupy all of a physician’s career. Not only did the medical information proliferate, but so did the number of doctors. And since doctors earn their living by practicing medicine there were also some economic considerations that helped encourage the specialization of medicine. Specialization also helped, in some ways, to better meet the needs of patients. By definition, specialization involves establishing some means to distinguish one specialty or group from another. So doctors having special interests formed clubs or organizations to identify themselves as having special interests. In other industries these are known as special interest groups.
Not everything in the human body can yet be measured, analyzed, or proven. Because of the unmanageable amount of available medical information, it is impossible for even one man to hold all of it in his mind at one time. Therefore, it is impossible for anyone to be able to adequately analyze the information to decide what is most important. For these reasons and others, medicine, in large part, is a matter of opinion. Hence the terms “second opinion,” and “practice of medicine,” and “art” of medicine. So, even though medicine is a scientific industry based on scientific facts, the interpretation and use of those facts is often a matter of opinion.
There are strong sociological, economic and political forces at work shaping the field of medicine. There are groups having special interests that organize themselves in an effort to promote their opinions on a national, state, and local level. To some extent, these arbitrarily and self-established groups have been able to obtain some support from associated industries (for example, health insurance and malpractice insurance companies and the legal system). Many people are aware of the increasing roles that malpractice and health insurance play in the way medicine is practiced (affecting how a doctor makes a living). These factors and influences work together to consciously or subconsciously encourage physicians to adopt similar practices espoused by various special interest groups and to do things because “that is the way they are done,” and not necessarily because it is the best or most correct way. This has also influenced physicians to stay more strictly within the confines of their own special interest groups without addressing problems outside their “specialty.”
Some people now have four, five, or six different specialists instead of one family practice doctor. They may go to a gastroenterologist for their stomach to find that he won’t treat their skin problem; so they enlist the services of a dermatologist who is unfamiliar with breathing problems; which leads them to seek out a pulmonary physician, and so on. One can see that if more and more doctors specialize in more and more specific and narrow fields of practice dealing with more narrow ranges of symptoms, then there will be fewer and fewer physicians to address problems causing extremely wide ranges of symptoms. This would especially apply to a problem that can cause more than 60 symptoms which fall in all the different specialties.
The advances made in the problems affecting higher levels of organization of the body are responsible, to some extent, for the formulation of the different specialty fields of medicine. The problems that affect the lower levels of organization of the body, are harder to evaluate and measure. They generate a greater number of more generalized symptoms than do the problems that affect the higher levels of organization. With increased specialization, doctors are tending to consider much more specific and narrow areas of complaints, leaving the rest to others. So one can see how some quite difficult problems (those affecting the lowest levels of organization of the body) have tended to be left to be addressed by fewer and fewer doctors. But we know that the lower the level of organization, and the more fundamental the level, the more important and far reaching it is. What would have the greater effect, yanking out the bottom floor or the top floor of a 20-story building? If one removes the top floor, then one has affected one story, but if one removes the bottom floor then one can lose all 20.
There are different ways to approach problems.
1. We can consider the way it has always been done in the past.
2. We can consider the opinions of special interest groups.
3. Or, we can consider the possible causes and solutions; we can consider what resources may be brought to bear on the problem; we can consider the pros and cons of the various options; and we can do the best we can with what we have to correct the problems.