One of the greatest and most far-reaching scandals of modern medicine has to do with the appalling ignorance of doctors about the workings of the thyroid gland.
This tiny bow-tie-shaped gland is our body's central metabolic regulator and, when it goes awry (as it can in today's highly toxic environment), it can cause untold mayhem. Hundreds of thousands of people - one-sixth of the over 55s, according to one survey - are walking around with undiagnosed underactive thyroid. Half of all women and a quarter of all men will die with an inflamed thyroid (J Pathol Bacteriol, 1962; 83: 255-64). This becomes all the more serious when you consider that a thyroid gland out of control can sometimes even kill you.
Indefatigable researcher Doris Jones, who has tirelessly searched for an answer to her son's myalgic encephalomyelitis (ME), has discovered copious evidence that undiagnosed thyroid problems may be one of the major elements contributing to those puzzling diseases of the 21st century like ME, fibromyalgia and chronic fatigue syndrome now appearing in epidemic numbers (see Special Report, p 1).
Doctors have trouble diagnosing an underactive thyroid because they use the wrong tests. They still cling to a number of blood tests, which don't tell them about the full state of a person's thyroid, only about the levels of thyroid hormone circulating in the blood. These tests also can't tell them how much thyroid hormone the body is able to use or how much is necessary to ensure an individual's health.
To make matters even more complicated, a host of conditions and drugs can throw off a thyroxine reading. Even taking the Pill can give a false picture of the state of your thyroid.
Doctors like Barry Durrant-Peatfield have successfully diagnosed patients simply by relying on a simple, non-invasive test developed by Dr Broda Barnes, a thyroid expert, 30 years ago. Dr Barnes, who believed that many people have subtle thyroid disorders that don't show up on any blood test, publicised a simple, accurate test for both hypo- and hyperthyroid conditions that can be done at home (Barnes B, Hypothyroidism: The Unsuspected Illness, London: Harper & Row, 1976).
Barnes' test involves recording your basal body temperature (BBT), the body's lowest temperature during its waking day. This is invariably when you wake up, but before you get out of bed in the morning.
The test simply entails placing a thermometer under your armpit for 10 minutes first thing in the morning before you get out of bed for several days and recording the results. (Premenopausal women need to take the test on days two or three of the menstrual cycle.) A normal reading ranges between 36.6 and 36.8 degrees centigrade (97.8 to 98.2 degrees). Anything markedly below this could signal that the individual has an underactive thyroid; anything markedly higher suggests an overactive one. Of course, a good doctor will also consider and exclude other causes of a low basal body temperature, and the BBT test is no substitute for careful and complete history-taking.
According to Dr Peatfield, this test has been ignored or derided by many practitioners and authorities. Doctors used to diagnosing on the basis of a scientific reading, like a laborary result, tend to suspect anything as simple as a thermometer reading. The tragedy is that this reliance on gadgetry is blinding medicine to the simple wisdom of Peatfield's approach and instigating a witch hunt to round up all those doctors who refuse to diagnose thyroid disorders on the basis of blood tests.
As with most areas of medicine, space-age equipment and high-tech lab results are no substitute for having a good look at a patient and listening to his story. In order to figure out how to treat some of the most puzzling new illnesses plaguing us nowadays, doctors may have to recover some of the lost art of traditional medicine: learning again how to read the state of a patient's tongue.