Rethinking Hypothyroidism

In this primer for patients, their families, and their doctors, a leading physician and scientist explains why the standard treatment for hypothyroidism fails many—and offers an empowering call for change.   Hypothyroidism, also commonly referred to as Hashimoto’s disease, affects millions in the United States alone. It occurs when the thyroid—the butterfly-shaped gland that sits in your neck right above the front of your shirt collar—malfunctions or after thyroid surgery, causing thyroid hormone levels in circulation to drop below normal. Thus, treatment is aimed at bringing these hormone levels back to normal. This is done with daily tablets of thyroxine or T4. Because hypothyroidism is so common, we likely know someone who is on this type of medication. While most patients respond well to this standard treatment, about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing these symptoms to be unrelated to the thyroid disease. In Rethinking Hypothyroidism, Dr. Antonio C. Bianco, a physician and a scientist who has studied hypothyroidism and thyroid hormones for decades, offers an accessible overview of the disease’s treatment and the role of big pharma in shaping it, making the case that the current approach is failing many patients. But more than this, Bianco calls for alternatives to improve lives, and he equips patients and their families with the tools to advocate for other treatments.

"Rethinking Hypothyroidism . . . offers an accessible overview of the treatment of hypothyroidism, and makes the case that the current approach is failing many patients. . . . Bianco's book goes to exhaustive lengths to help readers understand why some recommendations in the clinical guidelines are flawed; it details the history of the clinical characterization and treatment of hypothyroidism, starting with Napoleon Bonaparte and leading all the way up to the present; and provides scientific evidence supporting the claims and complaints of millions of patients over the past fifty years.", "A landmark book [that] offers comprehensive hypothyroidism information for all. . . . Importantly, this book is not a textbook, rather it is a source meant for patients, patient advocates, and physicians. . . . I will encourage my patients to read this book, and I wouldn’t be surprised if patients start asking their clinicians about its text.", “Bianco explains why treating hypothyroidism isn’t always as simple as it seems. . . . About 15 to 20 percent [of patients] continue to suffer despite treatment. Some feel infuriated when the doctor tells them that their normal TSH levels mean they are fine. They don’t feel fine. They still feel exhausted, confused, and miserable. Researchers, including Bianco, have begun to recognize that people who do not convert T4 to T3 efficiently may suffer from residual symptoms of hypothyroidism. . . . For too long, patients have heard that their residual symptoms are psychological in nature.", "The book is important because it is based on solid documentation and emphasizes that it is necessary to actively listen to the patient and recognize their symptoms. Take the book to your doctor and let him read it (or keep it!). It is a good starting point for a renewed review of your medical history.", "Written by one of the leading experts on the topic, this book is a must-read for both healthcare providers and patients who struggle with hypothyroidism. Dr. Antonio C. Bianco is a clinician-translational scientist who has established his career exploring the pros and cons of different thyroid hormone replacement options. In this work, he provides his unique perspective on the diagnosis and management of hypothyroidism, toward the goal of improving the health of those with one of the most common chronic medical conditions globally."

Antonio C. Bianco, MD, is professor of medicine and a member of the Committee on Molecular Metabolism and Nutrition at the University of Chicago, where he runs a laboratory funded by the National Institutes of Health to study thyroid hormones. Bianco is also a former president of the American Thyroid Association.