www.drlowe.com---Center for Metabolic Health E-mail Newsletter

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The Metabolic Treatment
of Fibromyalgia
by Dr. John C. Lowe
Readers' Comments

The Metabolic Treatment of Fibromyalgia

October 28, 2004
News from the Dr. John C. Lowe
and Dr. John C. LoweNew Items:

NEWS ITEMS

1. Dr. Lowe Appointed to Review Panel of Medical Science Monitor
2. Critique of Dr. Richard Guttler's Beliefs About Hypothyroidism
3. An Appeal: We Need Healthy People for Our Metabolic Study
4. New Book "Tyranny of the TSH" Nearing Completion

Dr. Lowe Appointed to Review Panel
of Medical Science Monitor

Dr. Lowe has accepted an invitation to become an official scientific reviewer on the International Reviewers' Panel of Medical Science Monitor (MSM). MSM is an international medical journal for experimental and clinical science.

Dr. Lowe was invited to join the Panel by Mark R. Graczynski, MD PhD, Executive Publisher of Medical Science Monitor. On August 31, 2004, Dr. Graczynski wrote to Dr. Lowe: "I am writing to you with a sincere congratulation on your recent publication titled, "Mutations in the c-erbA beta1 gene: do they underlie euthyroid fibromyalgia?" (Medical Hypotheses, 1997; 48(2):125-35.) The quality of the article impressed me very much. I found the article very interesting and informative and, indeed, enjoyed reading it. Therefore, as a scientist and editor, I would like to turn your attention to the Medical Science Monitor . . . . "

Dr. Graczynski then asked Dr. Lowe to join MSM's Reviewers' Panel to review select scientific manuscripts submitted for publication. Dr. Lowe will review manuscripts within the overlapping fields of his expertise: thyroidology, metabolism, fibromyalgia, and pain physiology and management.

Critique of Dr. Richard Guttler's
Beliefs About Hypothyroidism
by Dr. John C. Lowe

On March 17, 2004 Dr. Richard Guttler, a thyroid surgeon and self-proclaimed "real thyroid expert," attacked Mary Shomon in his online newsletter. In his attack, he accused her of misleading hypothyroid patients about their disorder and its proper treatment. When Dr. Guttler continued his attack on Mary in subsequent newsletters, I wrote a detailed critique of his beliefs about hypothyroidism. In the critique, I presented scientific evidence that his beliefs are false, and that his beliefs are potentially harmful to hypothyroid patients. The aftermath of the critique is anticlimatic, in that Dr. Guttler backed down from even trying to refute the evidence that his beliefs are wrong. The evidence is simply too solid, and he has no defense. As far as I know, he's gone on his way, continuing to misguide hypothyroid patients with false information about hypothyroidism and its treatment.

If your doctor insists you use T4 (thyroxine) for your hypothyroidism, and he or she adjusts your dosage by your TSH level, then I strongly recommend that you read the critique.

Mary Shomon wrote an article on my critique of Dr. Guttler's false beliefs. As she wrote, "case closed"—Dr. Guttler has no defense: he promotes false beliefs about hypothyroidism (which the endocrinology specialty also promotes) that risk harming patients.

An Appeal: We Need Healthy People
for Our Metabolic Study
by Dr. John C. Lowe

Several months ago, we started a study in which we're measuring the resting metabolic rates of fibromyalgia patients. After measuring the metabolic rates of only 12 patients, we began crunching numbers in our statistics program and made a startling discovery. Compared to the "normal" metabolic rates for these patients (calculated by three equations), we've already reached statistical significance. The result of the measurements is highly significant—so significant that there is less than 1 chance in 1,000 that the result is due to coincidence.

That the measurements on only 12 patients are statistically significant at this extreme level means that hypometabolism (abnormally slow metabolism) is profound among fibromyalgia patients. The result vindicates our hypometabolism hypothesis of fibromyalgia—the scientific proposal that fibromyalgia symptoms are those of abnormally slow metabolism.

We Need Healthy Women to Take Part. We already have an offer by a journal editor to publish this remarkable preliminary result. However, before we can publish the result, we must measure the metabolism of more healthy women.

If you are a female between the ages of 20 and 60, and you don't have an acute or chronic disease, please volunteer to take part. If you do have a disease, and you have a female family member or friend who qualifies to take part, please ask her to consider doing so. You and she will be making an essential contribution to this extraordinarily important study. Please see our webpage with detailed requirements for taking part in the study.

Benefits of Taking Part. The person who takes part will benefit in several ways. First, at no charge, she'll have a full evaluation of the adequacy of her metabolism. The evaluation will include measurement of her resting metabolic rate and body composition (fairly expensive tests if done independently by an individual). The metabolic evaluation can indicate whether her diet, nutritional regimen, and exercise program are providing her with normal metabolism. I'll give her an interpretation of the result of her evaluation in view of her health history and exam results. If we find some abnormality, I'll communicate with any healthcare practitioner on her behalf. We have a webpage with a detailed list of the benefits for participants.

New Book "Tyranny of the TSH"
Nearing Completion

Dr. Lowe and his Editor, Jackie Yellin, are coming close to finishing work on his new book, "Tyranny of the TSH." The book is an indictment of the endocrinology specialty and its corporate sponsors.

In "Tyranny," Dr. Lowe explains how the specialty and its sponsors have imposed on hypothyroid patients and their doctors the least effective and most harmful approach to thyroid therapy, T4-replacement. He explains this imposition as "a worldwide atrocity." He describes how it came about, and details the steps necessary to free patients and doctors from it. He also explains how patients can fully recover their health by forswearing T4-replacement and taking advantage of safer and more effective therapies.

The book will be available in about three months. To be notified when it's available, please send an email to McDowell Publishing Company with the word "Tyranny" in the subject line.

June 7, 2004
News from the Center for Metabolic Health
and Dr. John C. Lowe

New Items:

NEWS ITEMS

1. Critique of Four Studies Comparing T4- and T4/T3-Replacement
2. Our Presentations at the Kansas City Fibromyalgia Conference
3. More Participants Needed for Study of Metabolic Rates

Critique of Four Studies
Comparing T4- and T4/T3-Replacement
by Dr. John C. Lowe

Some six months ago, medical journals published four studies by endocrinologists that piqued attention in the alternative medicine community. In the studies, the endocrinologists compared the effectiveness of T4-replacement with that of combined T4/T3-replacement. "Replacement," of course, refers to doses of thyroid hormone that keep the TSH level within its current lab reference range. Keeping this definition in mind is crucial to understanding what the four studies actually showed, and what they didn’t show.

What the studies showed is this: Neither form of replacement therapy relieved hypothyroid patients’ symptoms or abnormal test results. In fact, the four studies are proof positive that replacement therapies leave many hypothyroid patients suffering. Most of the researchers accurately reported this negative treatment finding. However, the finding is buried deeply within their full-text published reports; to see that it’s there, one must first get a copy of the journal articles—which most doctors and patients won’t do—and then read carefully.

In contrast to what they did find, the endocrinologists clearly broadcast something they did not find: that no approach to T4/T3 therapy is more effective than T4 alone. As I explain in detail in my critique, the difference between what they did find and what they didn’t find is no minor distinction; it can seriously impact the clinical care of hypothyroid patients. The false reports of the endocrinologists are almost certain to implant a false belief in the minds of doctors. As a result, the doctors are likely to restrict millions of hypothyroid patients to T4-replacement despite the studies showing that it’s ineffective for many patients.

The four studies appeared to be a response by the endocrinology specialty and its corporate sponsors to a study published in 1999 in the New England Journal of Medicine.[1] In that study, researchers reported a finding that threatened the market for T4-replacement therapy. The finding was that adding T3 to hypothyroid patients’ daily T4 dose improved their cognitive function. As a result of that study, many hypothyroid patients began asking their doctors to add T3 to the T4 they were already taking. The result of the four 2003 studies—that combined T4/T3-replacement was no more effective than T4-replacement—contradicts the result of the 1999 study.

A few alternative thyroid doctors criticized some of the 2003 studies. The main place their criticisms were published was the website of thyroid patient advocate Mary Shomon, where the democratic spirit is exercised by publication of dissenting views.

However, no criticism of the studies was published in any major medical journal. This was certainly no surprise to us at the Fibromyalgia Research Foundation. Our research team learned long ago that the pages of major medical journals are almost always closed to thyroid researchers except under one condition: when they’re reporting study results that support the prejudice of the endocrinology specialty in favor of T4-replacement. If a research team’s study finding isn’t favorable to T4-replacement, the team might as well forget submitting the report to any major medical journal—it’s extremely unlikely that it would be accepted for publication. A truly rare exception was the 1999 study reporting that T4/T3 replacement was more effective than T4 replacement. I’m still wondering how that report slipped past the endocrinology specialty’s censors.

The main editorials on the four 2003 studies in major medical journals were written by endocrinologists. In each of the editorials, the endocrinologists echoed the false reports of the endocrinologists who conducted the studies.

Today, we’ve published my critique of the four studies at drlowe.com. The critique is a formal logical analysis with ethical implications. The purpose of the critique is three-fold: (1) to explain the fallacy in the endocrinology researchers’ reports; (2) to give evidence that for many patients, T4-replacement is both ineffective and harmful; and (3) to question the endocrinologists’ motive in advising that T4-replacement remain the treatment of choice, despite the studies showing it to be ineffective in relieving many patients’ symptoms.

I am sending notice of the critique to these endocrinology researchers and the endocrinologists who wrote editorials repeating the false conclusion. We’ll let our readers know the content of any replies I receive from them.

I want to thank my Editor, Jackie Yellin, for working long and hard with me to make the critique clear and logically precise. Also, I want to thank Michael Yellin for his fastidious proof-reading.

I also thank Mary Shomon for notifying her readers about the critique. She tells me that she’ll advise patients who are restricted to T4-replacement and still suffering from hypothyroid symptoms to print the critique as a pdf file and take it to their prescribing doctors. Doctors who read it will know why their patients continue to suffer from hypothyroid symptoms despite using T4-replacement. The doctors will also be aware that restricting their patients to T4-replacement may increase their drug use and put them at risk for several diseases that can lead to their premature death.

The critique will be published as an appendix in my forthcoming book, Tyranny of the TSH. The book is scheduled for publication in several months. If you want McDowell Publishing Company to let you know when the book is available, just click on this link TyrannyoftheTSH@aol.com and then click send. The company will then have your email address and will notify you when the book is available.

Reference

[1] Bunevicius, R., Kazanavicius, G., Zalinkevicius, R., and Prange, A.J. Jr.: Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N. Engl. J. Med., 11;340(6):424-429, 1999.

Critique of Replacement Studies

My Presentation at the Fibromyalgia
Coalition International Conference
by Dr. John C. Lowe

On May 15, 2004, I spoke at the Awareness Day Conference of the Fibromyalgia Coalition International (FCI). The Conference was held in Kansas City, Missouri, USA.

FCI is a nonprofit organization whose purpose is to provide fibromyalgia patients and doctors with information on recovering from fibromyalgia. In that it’s focused on recovery, FCI is extraordinary among support organizations. I learned this from talking with Yvonne Keeny, founder and Executive Director of FCI.

I was delighted to learn that the other doctors who spoke at the conference basically advocated the same treatment approach we do: integrated metabolic therapies. This is in line with what Yvonne told us FCI encourages—abandonment of the use of drugs merely to control symptoms, and the use of treatments that correct the underlying causes of fibromyalgia symptoms.

FCI is the type of organization that can help fibromyalgia patients avoid the frustrated hopes that virtually always come from using conventional drug treatments. We enthusiastically encourage patients and their doctors to avail themselves of what FCI has to offer. Below is FCI’s contact information:

Fibromyalgia Coalition Intl.
P.O. Box 9509
Mission, KS 66201-1509
913-384-HOPE (4673)
Fax: 913-384-2464
www.fibrocoalition.org

More Participants Needed
for Study of Metabolic Rates
by Dr. John C. Lowe

Our study of the metabolic rates of women with fibromyalgia compared to those of healthy women is underway. As I wrote in our last newsletter, we need more women for the study. We especially need more healthy women. Any woman between the ages of 20 and 60 who can be in Boulder at least one day for testing is welcome to apply to take part.

For purposes of the study, we consider a woman healthy as long as she doesn't have a major acute or chronic disease. If you think you're healthy but aren't sure, please apply. Members of our research team will determine whether you classify as healthy through screening lab tests and other methods of assessment.

Please note that to take part in the study, you must live in the Denver/Boulder area or another part of the country at a similar altitude. Denver is exactly one mile high; you can stand exactly 5,280 feet above sea level on the west steps of the State Capitol. Boulder’s elevation is 5430 feet. The metabolism of people who live at much lower altitudes will increase for some time when they come to Boulder. Because the higher altitude raises their resting metabolic rates, we can’t include them in the study.

There is no cost to participate in the study, and participants receive a number of services for taking part. Thanks in advance for applying.

© 2004 John C. Lowe. All rights reserved. This Center for Metabolic Health, LLC Email Newsletter may be copied and distributed subject to three conditions: (1) All text within the full document or any section copied must be copied without modification with all pages included. (2) All copies must contain the following copyright notice: "© 2004 John C. Lowe" (3) Neither this full document nor any section of it may be distributed for profit.