Since then I have spent my full time working in this area of medicine. Since I have been dealing with patients suffering from symptoms of MED (again, in the thousands), I have seen surprisingly reproducible and predictable patterns. These patterns become quite obvious when one has the two sources of information just referenced above and when one works with the same problem day in and day out, month after month, year after year. Some of these patterns are only easily seen when one deals with a large number of patients, because some of them are subtle. Since most doctors probably think about the thyroid system only three or four times per month while treating patients in their practice, their observations might be so few and far between that the pattern might not be as evident. So, it really is not too difficult to see how Wilson’s Temperature Syndrome has been overlooked for so long. The best indicator that patients’ symptoms are being caused by Wilson’s Temperature Syndrome are when their symptoms resolve together and completely when proper therapy is given. By treating so many patients and carefully analyzing their responses, an extremely effective treatment has been developed. In addition, when a doctor is treating a large number of patients with a treatment that very effectively resolves their symptoms, patients sometimes make comments or observations that the doctor might not have been particularly listening for. But if one hears the same comments often enough, a particular pattern might gain one’s attention. By exploring these patterns more fully, it is possible to find that they are quite reproducible and predictable. The patterns may contribute to changes which make the treatment even more predictable, reproducible, and effective.
This process has also made it possible to see the effect of the thyroid system on many symptoms and complaints that previously seemed unrelated. All these relationships can be very useful in recognizing the clinical picture of a patient suffering from Wilson’s Temperature Syndrome. In fact, the clinical picture can be so recognizable that it is sometimes obvious just by looking at someone that they are likely to be suffering from Wilson’s Temperature Syndrome. With a little experience, one could probably recognize several likely sufferers while walking through the mall. Many of the varied manifestations of Wilson’s Temperature Syndrome will be discussed in Chapter 9.
Tools of Problem-Solving
Perhaps the greatest value of medical learning is its usefulness in the treatment of patients’ problems. Learning is obtained by reading and studying what is already known or believed to be true. Then it may be applied. By applying medical information one can gain experience. There are some things that aren’t written yet, and some of the things that are written are incorrect, and that’s what experience is for. As we gain experience, we can employ common sense postulates of problem solving that are used by all doctors in approaching medical ailments. Since there are still far more things in medicine that remain unknown than are known, it is better to use words like could, should, probably, maybe, possibly; and less often words like definitely, always, never, etc.. All we can do is the best that we can with the tools that we have available. The usefulness of tools certainly depends on how well they are used. The following are some common sense postulates:
1. When a cluster, group or multitude of characteristic symptoms appear or worsen at the same time, it is more likely that they are related.
2. If such a group of symptoms begin and end together at identifiable times, it is more likely that they are related.
3. If the onset of a group of symptoms was closely related in time to a particular event and the resolution of that cluster of symptoms was closely related in time to a particular treatment, it is more likely (although not definite) that the event was the cause and that the treatment was correct.
4. If the symptoms appear after a particular event, resolve after a particular treatment, remain resolved after that treatment has been discontinued for a time (for example 10 months), return after a particular event extremely similar to the first, and resolve again after the same treatment and remain resolved after the treatment has been discontinued again, it is even more likely that the events were causes and that the treatment was correct.
5. If the symptoms appear after a particular event, then resolve after a particular treatment and remain resolved after that treatment has been discontinued, then it is more likely that a persistent correction has been effected.
6. The fewer the variables involved in a particular problem, the easier the solution.
7. The more predictable a patient’s response to a particular treatment, the fewer unaddressed or unanticipated variables present.
8. The fewer the treatments the better, so there is less chance of drug interaction and also better chances of good compliance (patients following instructions as prescribed).
9. The more instances in which certain clinical observations are found, the more reliable are those observations.
These common-sense postulates have been useful in helping to uncover Wilson’s Temperature Syndrome and to provide the information contained in this book. They have helped in generating certain criteria useful in the recognition and treatment of Wilson’s Temperature Syndrome. It is easy to predict whether a person will or will not respond to proper T3 treatment. Many times patients will receive treatment and they will have their symptoms corrected and they will stay corrected for long periods of time, even years after the treatment has been discontinued. In such cases, the same symptoms may return again after another physical, mental, or emotional stress.
Wilson’s Temperature Syndrome follows very predictable and recurrent patterns, and is based on a particular model, or theory. Considering how predictable and reproducible patients’ responses are to treatment, monitoring, diagnosis, etc., it stands to reason that the model, or theory, upon which the treatment is predicated is very close to being correct, with there being few unaddressed variables. For example, when something happens 95 times out of a 100 just the way one would expect it to happen; the principles, ideas, or premises which caused one’s expectations are likely to be very close to correct.
Adages from Medical School
There were some additional principles of common sense that we were taught in medical school to help us reason through medical problems and the various alternatives that can be used in addressing those problems. Some of these adages follow:
“It is better to treat the problem, not the symptoms.” Patients with Wilson’s Temperature Syndrome, suffering from a multitude of complaints, frequently find themselves being treated for their symptoms to varying degrees in varying ways. It stands to reason that it is always best to treat the underlying problem rather than treating the symptoms. However, with no obvious cause in sight, sometimes we are left to handle the symptoms as well as we can until a cause can be uncovered. For this reason, patients who present to doctors with symptoms consistent with Wilson’s Temperature Syndrome will frequently be treated with a number of symptomatic treatments pointed toward handling the symptoms. The characteristic thing about symptomatic therapy is that when the treatment is discontinued, the symptoms return or persist.
I compare this to the problem of a ship that is taking on water. One can turn on a pump to get water out of the ship, or one can plug the hole through which the water is entering. If the pump is effective enough, it may be able to remove the water. However, if the pump is turned off and the ship continues to take on water, it is unlikely that the hole has been plugged.
One saying that I really like, was told to me by an old professor. “If you listen to your patients long enough, they’ll tell you what’s wrong with them, and if you listen longer still, they’ll tell you how to fix It.” This saying underscores the point that the patients are the ones that live in their bodies 24 hours a day, 7 days a week, 365 days a year. After spending so much time with their own bodies, they frequently become quite well acquainted with their own bodily functions. In many ways, they know their own bodies better than anyone else does. When patients’ symptoms of Wilson’s Temperature Syndrome have resolved after the WT3 protocol they sometimes remark, “It’s great to have all these symptoms gone, it’s great to feel normal again, I knew I wasn’t crazy. I had been told so many times that there wasn’t anything wrong with me and I was even told that it was all in my head. But I knew my own body well enough to know that there was definitely something wrong. I knew that something, somewhere was not quite right. I could tell that something was out of balance.”
It is interesting to watch, however, peoples’ attitudes towards their symptoms and the resolution of those symptoms. I have a distinct vantage point because I see patients who are complaining with a large number of generalized complaints, and I have the opportunity to watch many of those complaints resolve quickly and completely, with the patients often experiencing a dramatic difference from before to after. Some people will say, “I was beginning to wonder if I was a hypochondriac.” Others will say, “I knew I wasn’t a hypochondriac.” And most interestingly, some will say, “I’m sure you see a lot of hypochondriacs, but I knew I wasn’t one of them.”
Before treatment, certain patients sometimes seem to think that only they, of all the patients that I see, are not hypochondriacs. It seems strange, because of all people, it would seem that those who have been through it would be less likely to be prejudiced against others who may be unfortunate enough to be suffering from medical science has not yet been able to easily recognize or correct. Especially, when they have gone through the frustration and know what it is like to have their friends, neighbors, and doctors look at them as if they are complaining because they enjoy feeling bad; as if they are looking for sympathy or excuses; and as if they have ulterior motives. But sometimes even they seem to imply that they feel hypochondria is a prevalent condition.
Another adage states, “When you hear hoof beats, think of horses, not zebras.” This saying emphasizes that it is best to think of common things first, because common things are more likely to happen than rare things. By far, is abnormal body temperature is the most common cause of the symptoms of MED. We have already discussed that abnormal body temperature patterns could, theoretically, be caused by adrenal hormones, female hormones, and thyroid hormones as well as by other factors. I feel that DTSF is by far the most common explanation or cause of abnormally low body temperature. Since the thyroid system normally adjusts up and down in response to stress and other conditions, it seems reasonable that the thyroid system is the most likely to get stuck in a position that causes inappropriate body temperature patterns. This is a little like a man who often travels back and forth between two cities that are separated by a certain forest of trees. Suppose that through the middle of the forest runs a paved highway. Through other sections of the forest can be found two narrow and unpaved paths that wind through the forest from one city to the next. If the man called me asking me to bring him a can of gas because he had run out of gas halfway between the two cities, and hung up before he told me exactly where he was, the first place that I would look is on the paved highway. I would check the highway first because I know that even though the two paths also connect the two cities, they are both barely manageable with ordinary vehicles and they are used mainly for recreational purposes. I would reason that it would be much more likely that the man would run out of gas on the highway because he more commonly uses the highway for traveling.
“Treat the patient, not the tests.” This adage underscores the important of remembering the shortcomings of our medical technology. The physical and emotional manifestations of patients suffering from DTSF resolve far more quickly, predictably, reproducibly, and completely with normalization of body temperature patterns than with normalization of thyroid hormone blood tests
Another saying that I remember hearing in medical school that I find quite useful is, “Everything in medicine is a therapeutic trial.” This saying underscores the importance that we constantly reevaluate the clinical course of a patient. Because nothing in medicine is absolute, one can never be absolutely 100% sure of the diagnosis or 100% sure about how a patient is going to respond to a certain therapy. Subsequent therapy should always be based a patient’s response to initial therapy. In other words, the plan of management should be continually reevaluated based on a patient’s response. This decreases the chance of overlooking any important developments because of tunnel vision. This is another way of saying that there is always a small chance that the initial diagnosis and plan of management might not necessarily be optimal. In medicine, how patients respond to therapy is always the bottom line. In some medical problems, especially in those that affect lower levels of organization of the body, how a patient’s symptoms respond to treatment may be one of the only indicators available.
For example, it is practically impossible to measure the chemical imbalances in a person’s brain that are causing him to be depressed. Yet, with careful questioning and with careful observations, doctors frequently diagnose patients as having clinical depression and will often prescribe antidepressant medication in an effort to alleviate the condition. If the patient responds, this positive response to treatment provides more reassurance that the patient was suffering from depression and that the treatment prescribed was effective.
Some might ask “How can one tell if a patient might benefit from antidepressants when the situation can’t be measured?” Or, others might ask “You mean, it can’t be known how one will respond to treatment until it is given?” Yes, one knows best how a particular therapy will go, and how correct the diagnosis is only after one sees a patient’s response. This is true for every medical problem and every medical treatment (easily measured or not).
History, physical examination, laboratory tests, and other observations may provide important clues to a patient’s diagnosis and likelihood of responding to a particular therapy; but one can never know for sure how a patient will respond to a particular treatment until that treatment is given and the response evaluated. So, even though there are no good tests to pinpoint exactly the chemical imbalance in any given person’s brain that is causing them to be depressed, this does not prevent antidepressant medications from being used in therapeutic trials to bring about a great benefit in many lives.
I like to use, from time to time, an analogy of a circuit breaker to illustrate another principle. “If your lights go off in your house all at once, you don’t check the light bulbs, you check the circuit breaker,” not because it is the only explanation, but because it is the most likely explanation and also the easiest to address first. If you’re fortunate enough to find that the circuit breaker has been thrown, you can simply restore your lighting with the flip of a switch. This saves you from having to check all the light bulbs, or calling the power company, an electrician, or a service man. This analogy points out the importance of trying “simple things first.”