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A year ago I was diagnosed with hypothyroidism, a condition where my body makes insufficient thyroid hormones. The standard treatment is synthetic T4, which the body is supposed to convert to the other four thyroid hormones (T0, T1, T2, and T3).

But I've found a website claiming natural desiccated thyroid (NDT) is better than taking just T4 alone. NDT gives you everything - T0, T1, T2, T3 and T4. That's more T than Mr T wearing a tee while drinking tea.

But according to my new doctor, Dr Rafid Khashan, this website's wrong. Today he said:

There's a lot of rubbish on the internet. Don't believe it. It's all rubbish.

Perhaps he would have had an apoplectic fit if he'd known I've been reading a book called Stop the Thyroid Madness. Basically. the book claims there's a global conspiracy to keep patients like me hypothyroid. Doctors give us a second-rate medication - levothyroxine - because Big Pharma has them convinced it's simply the best when actually, NDT is better. Meanwhile, Big Pharma pockets all the money. It all sounds a bit crazy until you read hundreds of patients' testimonies for NDT. From reading them you'd conclude NDT is crushed-up angel wings whereas levothyroxine is buffalo diarrhoea.

That's why I just paid €35 for a month's supply of NDT (on top of the doctor's fee of €120 for blood tests and his 'consultation'). My doctor doesn't like NDT, unsurprisingly. He said,

I don’t recommend switching from levothyroxine to NDT. [...] They're the same.

Anyway, he's prescribing me with it, so for now, I'm sticking with him.

Dr Khashan also believes that blood test results are more important than symptoms. Here are his thoughts on the matter:

You cannot have thyroid symptoms if the blood tests are normal. Because when the blood tests are normal, it means you have enough thyroid going in your blood. So patients can imagine all sort of symptoms, and think, "Oh I feel terrible, I must increase my dosage". Lots of rubbish.

The quote is entirely verbatim, by the way. I recorded the meeting with my phone's voice memo app.

Dr Khashan's logic may sound reasonable. After all, blood tests are more reliable than subjective symptoms, right? But when you experience hypothyroidism first-hand as I have, you'll find the disease doesn't work this way. You can have hypothyroidism despite having normal blood test results.

This happened to me in 2010. I'd researched my symptoms (brain fog, fatigue, depression, etc.) and suspected I had hypothyroidism. I trotted off to my nearest GP, Dr Thomas H Knight in Bournemouth. He did a TSH test (typically the only test doctors will do) and it came back as 3.0, which was in the normal range. So he said, oh-so-reassuringly, that I didn't have hypothyroidism after all. I was relieved but disappointed.

It took me another five years to realise Dr Knight had been wrong. By this point my TSH had risen to 6.4, enough to finally warrant a hypothyroidism diagnosis. By then my symptoms had worsened, and I was tired and miserable. How tired and miserable? Here's a description of myself that I was inspired to write after glimpsing my reflection in a window:

Look at him closely and his expression will surprise you. He has no humour. His face is entirely serious. Subtly it changes from fear, like a dog afraid of being kicked, to a deep tiredness, more tired than an old man. There is a deadness in his eyes. It is like he accepted defeat a long time ago. He tries to keep his face neutral, but the subtle signs still show.

I'm a great writer, huh? I'm probably related to Hemmingway. Anyway, that's at least five years I spent with treatable symptoms, thanks to Dr Knight’s blindness to everything but the TSH test. Here's an appropriate quote from Stop the Thyroid Madness:

It's too common to see the majority of thyroid patients, who have obvious and classic hypothyroid symptoms, report that a doctor pronounced them "normal" for years because of a normal TSH result.

That's what happened to me! It's like the book is describing my life! The book also says:

the TSH is thoroughly unrelated to how we feel!

You can’t fully appreciate the problem until you have hypothyroidism yourself. Present a doctor with a thyroid problem and they'll glitch out and say the same narrow-minded things. They ignore obvious symptoms as long as blood tests are fine. But blood test results don't reflect symptoms in many patients, including me.

Probably they're worried about being struck off for not following official guidelines, or sued by their patients because of adverse side-effects. As Dr Khashan said today:

I cannot give you anything unless I can justify it. Medically and legally speaking.

Unfortunately for me, doctors are the gatekeepers of all thyroid medications. I need a doctor's permission before I can try a new medication or a different dose. This sounds reasonable at first - after all, doctor are just looking out for my best health, right? But the problem is doctors are too cautious and stingy with medication. Plus, they only care about blood test results, and not symptoms. If your blood test results betray you, then no, you can't have a higher dose, because you must be imagining your symptoms.

Here's an idea I have. How about if patients can take any medication they want, as long as they waver the right to sue doctors upon any adverse side-effects? Seems reasonable to me.

But until governments come to their senses and act on my expert advice, I'm stuck under the tyrannical rule of my doctor. He's prescribed me with a brand called Armour Thyroid. Could Armour be the end of my mind fog? Could I finally get myself back after all these years? Judging from this quote from Stop the Thyroid Madness, perhaps not:

Armour was reformulated in 2009 with a flip-flop in the amount of dextrose and cellulose - dextrose going low and cellulose going high. Patients were not happy with the results, noticing a return of symptoms.

It’s like I’m walking in the author's footsteps but I’m too many steps behind.