John Vlok Dommisse MBChB (S.Africa/CapeTown), MD (USA/Canada),
FRCP(Canada/Toronto, recognized in AZ and other states)
US citizen; medically licensed in AZ (active),
CT, VA, Ontario/Canada, and SouthAfrica (inactive)
Nutritional, Metabolic & Psychiatric Medicine, PLLC
1840 E River Rd Ste 210, Tucson, AZ 85718-5892
Ph.: 520-577-1940 Fax: -1743
Fed. Tax ID No. 86-0809741 (PLLC)
Abstract of The Natural Medicine Newsletter, #8
Volume 4, Number 2, March 2000: Announcement of Article about my
Ground-Breaking New Approach to Hypothyroidism; and the Abstract of that Paper
This is my 8th semi-annual Natural Medicine Letter, now with e-mail being the primary means of distribution. This issue is comprised almost entirely of the copyrighted scientific paper that I have written, explaining the highly successful approach to hypothyroidism that I have taken since early 1989, and covering my experience with some 1,200 patients with this condition, in its various forms and guises.
Announcement about this paper
The diagnosis and treatment of hypothyroidism (all types and grades) are both in a very sorry state at this time in medical history. Most patients are dissatisfied with the way they feel but are told by physicians that their blood tests (often only the thyroid stimulating hormone, TSH, level is measured) are normal and any symptoms they have are due to depression, over-eating, or some other patient-blaming condition. Anyone unfamiliar with this state of affairs need only go to an Internet site like http://Thyroid.About.Com ~ or the paperback book compiled by the editor of that website, Mary Shomon ~ to see the hundreds of dissatisfied patients trying to find the answer to their difficulties. There are also signs of dissatisfaction by certain physicians, as reflected in the papers by Chopra (1997), DeGroot (1999), Ferretti et al (1999), Ridgway, Canaris, et al (2000) and O'Reilly (2000); and in the popular book by Ridha Arem, 'The Thyroid Solution' (1999).
By placing more emphasis on the accurate measures of the actual thyroid hormones, the serum free-T4 and free-T3 levels, than on the 3rd-generation TSH, I have, since early 1989, been optimizing the thyroid function of all my hypothyroid patients, many of them former patients of endocrinologists who use the TSH as the 'holy grail' of thyroid diagnosis. This is how I have come to know that, in most instances, the patient is right and the endocrinologists are wrong: The patient is usually being undertreated (because of an unfounded fear of osteoporosis) and incorrectly treated, with T4 only.
In 1998, after I had posted many messages on the Physicians' Online message-boards about my approach, a nutritionally-oriented osteopathic physician in Schaumburg, IL, became very enthused about it, especially after trying it in several of his hypothyroid patients, with individual e-mail coaching by me. He encouraged me to publish a paper about it, with himself as co-author as he suggested that he was a much better medical writer than I and that he could contribute a lot to the acceptance of the paper by improving the language and style elements in it. I didn't actually agree about his superior writing ability but was willing to offer him the co-authorship, as a reward for getting me off my butt and getting this much-needed paper into publication. However, since every journal in which we considered publication required all authors to have contributed medically to the paper ~ and since he dealt so arrogantly with me about my inferior computer, software and computer skills ~ I told him that he no longer qualified as a co-author. Despite the compelling imperative of my first reason for removing him (lack of medical input), he was unable to see this and preferred to regard my decision as a "lack of integrity", which he prominently stated on his website and in his weekly electronic health letters ~ along with numerous plagiarized portions of my paper, for which he failed to acknowledge me by name but only as a 'psychiatrist' in Arizona. In other words, he regarded his minimal changes in the paper ~ entirely non-medical in nature ~ qualified him as a co-owner of the medical ideas in the paper, not merely someone whose language and style contributions could be mentioned in the paper, under 'Acknowledgements', which I told him I would do.
Not only has Dr Mercola plagiarized my paper for his own personal aggrandizement but, as I told him would occur with his earlier leaks of the paper on Physicians' Online, such leaks would jeopardize publication of the paper. No medical journal editor wants to be embarrassed by material that is claimed to be a medical breakthrough but has been, even partially, published elsewhere already, previously. And editors also certainly don't want to be plagued by ~ and embroiled in ~ legal disputes between the author and others who claim legitimate unrecognized input. Hence my choice of the copyrighted, Internet route for this paper. I hope that all physicians who should read this paper will get the opportunity to do so, with proper acknowledgement of its source. And I hope that the $10 price-tag will not be an impediment, despite the fact that most full versions of medical papers cost considerably more than this.
Here then, is the abstract and the paper. I hope it will spark widespread serious debate, especially among the physicians who treat this multi-facetted condition on a daily basis. I welcome personal e-messages about it but please realize that, if I am flooded with these, you will not necessarily receive an individual response but I will try to include everyone in bulk e-mailings that respond to all the questions, disagreements, praise and other comments that I may receive about it. Through all this I am encouraged by the fact that, despite a very small handful of patients who have been uncomfortable with high-normal serum free-T4 and free-T3 levels, the vast majority have turned out to be completely restored to their pre-hypothyroidism levels of physical and mental functioning, productivity, quality of life, and happiness.
John Vlok Dommisse
Tucson, Arizona, USA
Copyright 2000 http://www.JohnDommisseMD.com Copying permitted, but only with full acknowledgement of its source.
Hypothyroidism: Sensitive diagnosis and optimal treatment (of all types and grades) ~ A review and comprehensive, unifying hypothesis, based on the endocrinological, nutritional and psychiatric medicine literature, and extensive clinical experience.
by John V Dommisse, MBChB, FRCP(C)
Nutritional & Metabolic TeleMedicine, Tucson, AZ, USA
The hypothesis of this paper is that hypothyroidism, in its various forms and degrees, is often undiagnosed in its grade-3-primary, secondary (pituitary), tertiary (hypothalamic), and non-thyroidal illness (NTI) hypothyroidism versions; and under-treated in all versions, including its grades 1 and 2 primary-hypothyroidism versions. The current standard and alternative approaches to the diagnosis and management of hypothyroidism, and their logical inconsistencies and inadequacies, are discussed.
An extensive review is presented, which is then coupled with logical argument and clinical experience to clarify the hypothesis. Methods employing the free thyroid hormone levels (FT4 and FT3), by the accurate direct- (or equilibrium) and tracer-dialysis methods, respectively, and a lower normal range for the thyroid stimulating hormone level, are described, which help optimize the newly-developed diagnostic strategies. Their superiority over the standard conventional and alternative approaches are suggested by inferential and logical argument and by the author’s personal experience of his own case of post-surgical (thyroglossal cystectomy) hypothyroidism - missed by the medical profession for 36 years - and his clinical experience with 4,000 patients over a 17-year time-period.
Diagnostic strategies and treatment methods are described which refute traditional objections to measuring the FT3 serum level - at least in the case of the serum test done by the dialysis method - and to treating with varying combinations of both T4 and either T3 or T4/ T3 combination hormone preparations.
The objections about 'aggressive' thyroid treatment causing or aggravating osteoporosis and cardiac arrhythmias are found, in this practice, to not only be overblown but to be entirely non-existent when certain mineral, vitamin, amino-acid and adrenal, sex- and growth-hormonal deficiencies are optimally corrected as well. [The author's experience in reversing osteoporosis has been outstanding, even while thyroid function was being optimized.]
If you would like the full version of this paper ~ and are willing to pay $10 for the downloaded version, or $15 for the Priority-Mailed paper version (in the US), or at least $9 extra for the version mailed to a foreign country ~ please go to the 'Order' page at the end of the main website and arrange for its delivery to you.