Thyroid Calculators

Just added a page with screenshots, links and QR codes for the Thyroid UK blood test calculators.

Nothing new - just easy links to them:

https://helvella.blogspot.com/p/helvella-thyroid-calculators.html

Historical Pages

The history of thyroid treatment has two phases - all history up to George Murray. And onwards from that first use of thyroid gland to successfully treat hypothyroidism.

That was such a profound change. We cannot connect what happened before to what happened after. It is complete separation of treatment. Therefore we have to consider that the history of thyroid treatment is in these two separate phases. Of course, nothing is quite as simple as that. Just because treatment by thyroid extract of various sorts started with George Murray, tt doesn't mean everything change around the world at the same time. Inevitably it took a long time for the treatment to become regularised and standardised, and for the products available. It also took a long time for the treatment to move from the UK around the world an be available to everyone.

These documents primarily consider post-George Murray treatment of myxoedema, but some of the thyroid hormone treatments that were used in the UK are discussed in the historical context of the treatment in the UK. Further, some of the documents report the change from desiccated thyroid, which is more or less what we ended up with thanks to George Murray, to the synthetic products that we have today.

Perhaps the most interesting change since Murray was when Dr Richard Asher wrote his paper, Myxedematous Madness, in which he explained and discussed the treatment of multiple patients at the Central Middlesex Hospital for serious, indeed severe myxoedema, and the profound effect that this had on their mental state as well as their physical bodies. It is something that has been mentioned from the early days, including by people like Dr Hertoghe, but it was not something that had been written up clearly and well.

The fact that Dr Richard Ashcroft managed to treat these patients and see such changes is a testament to his dedication. The paper appears to have had a major effect at the time, indeed several papers, shortly after his original paper, which refer to Myxedematous Madness in various ways, had a major effect. Unfortunately, in these days of treating an awful lot of mental illness by tablet, the basis of mental issues in hypothyroidism have been widely ignored. This is partly because it is unusual nowadays to see profound hypothyroidism myxoedema, despite poor treatment. We do actually see people getting some treatment which prevents that happening very often, but few ordinary doctors in the UK or elsewhere seem to understand the immense impact that thyroid has on the mind And it is an impact but cannot be resolved by anything other than adequate treatment of the thyroid issue. People might need other things as well but they certainly have to have adequate thyroid hormone treatment. Going back to Dr Richard Asher's original paper. I hope emphasises that he was dealing with these issues which other doctors in the country understood existed but had not seen fit to treat with thyroid hormone.

• Dr. E. HERTOGHE on Chronic Benign Hypothyroidism
• Dr Richard Asher - Myxoedematous madness
• helvella - Animal Thyroid in The British Pharmaceutical Codex of 1907
• helvella - Historical Context of Thyroid Treatment in the UK
• helvella - History of Thyroid Hormone Medicines in the UK
• helvella - The End of Thyroid BP
• The First Treatment of Myxoedema in County Londonderry
• THE LIFE-HISTORY OF THE FIRST CASE OF MYXOEDEMA TREATED BY THYROID EXTRACT

 

New page on Scheduling Blood Draws

 Have just posted a new page:

helvella - Scheduling Blood Draws

https://helvella.blogspot.com/p/helvella-scheduling-blood-draws.html

The issue of how to time blood draws in relation to taking thyroid hormones is one the one hand largely ignored (by the medical establishment) but clearly an issue (from patients).

Timing most certainly affects results. And can cause inappropriate decisions about treatment including dose adjustments.

The best bit is the link to Tania's article at Thyroid Patients Canada. As so often!

Medicines Document - Divide and Conquer

After much consideration, and vacillation, I have made a momentous decision regarding my medicines documents.

The document started as a simple list of the UK products with few details. Largely because I was sick of posting that list on the forum. But also because when it is posted in a HealthUnlocked post, it doesn't ever get updated. New products can arrive, and old ones disappear, but if a member falls across an old post, they could be seriously misled.

It would never have been brought into existence if the information had been readily available elsewhere. But all the main UK sources have problems:

British National Formulary doesn't say anything about the medicine itself. Not even the product names. The identification is by supplier - not manufacturer or formulation. And it tends to be out of date. (That has improved considerably over the past few years. I think they now have direct links to other sources.)

NHS Drug Tariff doesn't identify products. Just a simple statement of the reimbursement prices. Occasionally you can infer which product as in the case of liothyronine capsules - there is only one product!

The electronic Medicines Compendium (eMC) is incomplete. Teva levothyroxine has never been included. And Accord levothyroxine, which used to be there, is no longer. 

The MHRA's document store is diabolical to access. A really unfriendly search facility. (Though many links in my document make use of it as it is the only up-to-date source of all UK documents).

Even were all these source good, they don't make clear issues like 'own-label suppliers'. Where a company other than the manufacturer/importer supplies a product under their own name. Examples have included Almus and Northstar.

Trouble was, even with that UK information collected in one document, it missed out on the rest of the world's medicines. Which was a serious issue for the ones which are frequently mentioned. Such as Abdi Ibrahim Tiromel, Grossman Cynomel and Thybon Henning.

So my document expanded, EU (and EEA) at first, plus known other products, and USA, Then the realisation that there is no publicly accessible list, in English, for much of the world. So it kept expanding and was limited only by accessibility of information - and my ability to understand. (Which is why China is almost entirely absent.)

It eventually reached over 600 pages. Unwieldy and simply too much.

Thus I have decided to split the document in two - UK, and Rest of the World.

UK will be more complete. It will have the matrixes of products.

RotW will be thinned out. Products available in multiple countries will largely be separated out to reduce duplication. (But, where possible, there will still be basic details and links to documentation like Patient Information Leaflets, in each country.)

If you only care about the UK, it will be much slimmed down. If you care about RotW, it will be simplified and much easier to see the same product supplied to multiple countries. Sometimes these are not clear - quite often being sold under different company and brand names. With the confusion that there are near-identical company names which are entirely unrelated. Same brand names are used for different products - occasionally even within a single country. And apparently identical products - same company, same brand, but different formulations.

Find out more, including links to the actual documents, here:

https://helvella.blogspot.com/p/helvella-thyroid-hormone-medicines.html

If you find anything incorrect, misleading, typos, links that don’t work, etc., please let me know. Go to my profile and use the contact details there:

https://www.blogger.com/profile/17095075774834042563

 

NHS Codes for Tests

 I've just added a page which might help decipher the codes we see alongside test requests and results within the NHS system.

 

https://helvella.blogspot.com/p/helvella-codes-for-tests.html