Intervju med Lars Omdal

[Gambetti]

Heisann
Ser ut som Hansen har gitt deg god info på hva som er "naturlig" vs naturlig..
(ref: "De siste årene har bruken av Armour fått en renessanse som et "naturlig"
kombinasjons-preparat." )

Og Sonjas beskrivelse fanget opp hovedpoenget av de signalene jeg mener ligger i Omdals ordvalg
"Før en lyktes i å fremstille syntetisk T4 lønnsomt ..." -
Jaha, ja! Så det er lønnsomheten som spiller den viktigste rollen?
Og ikke pasientenes ve og vel?

Det er riktig som du sier, Kevlin. Men så er jeg glad for at jeg kom med en innvending mot hva du sa, og så fikk jeg nye informasjoner. Det var til og med en matematisk resonnement med halveringstider i det Hansen sa, så jeg synes at det gir god mening.

Forresten, kom jeg nylig over en side som viste at Lars Omdal til og med behandler binyretrøtthet med Cortef, så kanskje må han få høy score på preparatvalg av stoffskiftehormom, full score på binyretrøtthet og full score på alternativ vinkling på vitaminer og annet som byggeklosser i T3-konvertering mv. Men så mangler det bare dette med at han er så opphengt i TSH da. (Og så skal det legges til at for pasienten kan det være forskjellen på å være i full vigør og i full jobb, og å leve et skyggeliv på uføretrygd).

Der er han ikke alene riktignok, siden Ridha Arem mener noe av det samme og han er en lysende fortellerbegavelse i forhold til å beskrive sykdom. Jeg fikk flere a-ha opplevelser, og endatil dukket det opp spørsmål i meg for bestemte symptomer som "hvordan vet du eksakt dette om meg, jeg har da ikke fortalt det til noen". Men det kan enda være håp. Jeg leste et intervju med John Dommisse, en lege som forkaster TSH tenkningen, og han kommenterte om Arem:

"MS: What do you think of Prof. Ridha Arem's new book, 'The Thyroid Solution', published in June by Ballantine Books?

JD: I read it in a few days, fascinated, because here, virtually for the first time, was a conventional endocrinologist who (1) actually listened to his patients, including the female ones, and responded to their needs rather than, in the usual cold academic way, brushing them off with "The problem is not in your thyroid gland, it is normal. Next case, please."; (2) admitted that the standard approach is not the answer in many cases, that some patients 'with normal blood values' do seem to be hypothyroid and to respond to treatment with thyroid hormone (T4); (3) added small doses of T3 2-3 times per day in some cases who did not respond favorably to T4-only. and (4) beautifully and seamlessly integrates physical and psychiatric symptomatology and response to treatment.

So I called him up, to congratulate him and to ask if he would be interested to see my approach of the last 11 years, which has been to include all 3 the accurate tests in all screening and most monitoring, and to re-define the normal range in the TSH, and possibly also in the free-T3 level. Rather than accepting that 'the tests are normal but the patient needs treatment'. As I expected, judging from his open-mindedness in his book, he was very interested and we are exploring ways in which we can collaborate in some writing in the future."

Og da blir det kanskje dumt om jeg ikke også kopierer over et lite utdrag av hva John Dommisse sier om TSH. (Og beklager at jeg tar tråden for et lite øyeblikk 'off topic'):

"The so-called 'normal range' is way too high. Even in conventional circles it has become acceptable to make a diagnosis of grade-3 hypothyroidism (the mildest grade) when the TSH level is "in the upper half of its 'normal range'" (above 2.0, rather than 4.0 or 5.0 mIU), although very few conventional physicians will do this, or treat this 'mild, sub-subclinical' degree of hypothyroidism. But isn't that strange? Doesn't that immediately render the TSH normal range cut in half, to a new normal range of 0.4-2.0? For several years I adhered to the grade-3 primary hypothyroidism range, with 2.0 as my cut-off point. But, eventually, I ran into too many patients who had classic hypothyroid symptoms, which cleared completely on appropriate thyroid treatment, and whose TSH was below 2.0 (but above 1.5) and with FT4 and FT3 levels in the low ends of their 'normal ranges'. So I lowered my range to 0.2-1.5. For several months I was happy to be helping more people (those whose TSH fell between 1.5 and 2.0). Finally, I found some patients with several symptoms and signs of hypothyroidism whose TSH was between 1.0-1.5; so I lowered my range, for the last time, to 0.1-1.0; I now treat primary hypothyroidism with a TSH of >1.0 (if the FT4 and FT3 are low-normal, not above the middle of their 'normal ranges'). Some physicians are still waiting for the TSH to go above 6.0 or even 10.0 mIU before they'll agree that the patient's hypothyroidism needs treatment!"

Du har sikkert lest dette allerede, Hansen.