Herbalist "prescribing" T3 15mg to patient with no blood test

[pathologyDO]

Got a question for you all regarding my mother and her herbalist. She recently decided to go see a "world renowned" herbalist that has an M.D. (pediatrician, PM&R, full prescribing rights still) that decided he hated mainstream medicine and is now an herbalist doctor (although he apparently has no N.D.)

So the story is, my mother goes to this guy because she is having joint problems. She describes all the things she had done to her while there in the office which took FOUR hours, things like holding aluminum rods and measuring electrical signals and changes in her "pulse" to diagnose where her "pre-arthritic" bones are (or something). Apparently he has prescribed her herbal meds from germany that act as muscle relaxants for her to take, and he is starting her on a regimen to REVERSE her arthritis, which will happen after 2 years of taking these herbs and meeting with him regularly. He also prescribed her LMW heparin??!? She also told me that WITHOUT a blood test, he diagnosed her as having hypothyroidism and prescribed her 15mg T3 to take twice daily, and will soon be starting her on some antibacterial herbs for the bacteria in her joints from what he believes to have originated from milk she drank in Mexico nearly 20 years ago (again, no blood test, culture, antigens, nothing for the bacteria he believes she has).

OK so besides the fact that listening to her tell me all that pissed me of to no end, I'm also concerned about the implications of her taking T3 supplements (basically dessicated thyroid) for a diagnosis based on history and physical alone, and not having done a blood test to actually confirm it. If she has a normal functioning thyroid (which I believe she does, she just gets tired and has cold extremities) and then she takes this dessicated thyroid for long enough, will this not eventually in fact lead to her developing an atrophic thyroid that will literally then CAUSE hypothyroidism?

So pissed off and in shock that she believed everything this guy told her. Are there not any laws or regulations on this type of herbal medicine? If she gets hypothyroidism based off his treatments, isn't that a serious crime?

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[Psai]

lmao "hasn't even gotten an nd" as if that matters
people have a choice about who they see and who they believe. if you think this guy is practicing unethically, report them to the state board

 

[mik30102]

Hmm, I don't think it would cause any long term damage. And perhaps make a complaint to the board. Maybe they will take away her medical license though I doubt they will. How much does this guy cost for 4 hours lol?

 

[omn]

What's up with "herbalists" and rotting milk.. no joke.. that annoys me to no end also... I was once told that drinking milk and orange juice together makes it curdle in your stomach. IDK, worst case scenario.. it's bull doo doo and they know it is..! Some PPL... what can you do ! Take me HO ME ! And just for the record, a real "herbalist" should be someone who is not only good at organic chemistry, but also who really loves it, and you don't have to study in China for that, or work in a tree top... and now just waiting for the wise crack.. "(Hey buddy) it's called a pharmaceutical researcher..." ... as if I didn't know already...

 

[ACSurgeon]

Got a question for you all regarding my mother and her herbalist. She recently decided to go see a "world renowned" herbalist that has an M.D. (pediatrician, PM&R, full prescribing rights still) that decided he hated mainstream medicine and is now an herbalist doctor (and hasn't even gotten an N.D., if that even matters).

So the story is, my mother goes to this guy because she is having joint problems. She describes all the things she had done to her while there in the office which took FOUR hours, things like holding aluminum rods and measuring electrical signals and changes in her "pulse" to diagnose where her "pre-arthritic" bones are (or something). Apparently he has prescribed her herbal meds from germany that act as muscle relaxants for her to take, and he is starting her on a regimen to REVERSE her arthritis, which will happen after 2 years of taking these herbs and meeting with him regularly. He also prescribed her LMW heparin??!? She also told me that WITHOUT a blood test, he diagnosed her as having hypothyroidism and prescribed her 15mg T3 to take twice daily, and will soon be starting her on some antibacterial herbs for the bacteria in her joints from what he believes to have originated from milk she drank in Mexico nearly 20 years ago (again, no blood test, culture, antigens, nothing for the bacteria he believes she has).

OK so besides the fact that listening to her tell me all that pissed me of to no end, I'm also concerned about the implications of her taking T3 supplements (basically dessicated thyroid) for a diagnosis based on history and physical alone, and not having done a blood test to actually confirm it. If she has a normal functioning thyroid (which I believe she does, she just gets tired and has cold extremities) and then she takes this dessicated thyroid for long enough, will this not eventually in fact lead to her developing an atrophic thyroid that will literally then CAUSE hypothyroidism?

So pissed off and in shock that she believed everything this guy told her. Are there not any laws or regulations on these people? If she gets hypothyroidism based off his treatments, isn't that a serious crime?

People have the right to make bad decisions. This includes parents of doctors. Not getting regular cancer screening, smoking, being obese and yet eating crap food and not exercising, etc etc. Your mom' s offense is probably mostly harmless. I hope the money she paid for this 4 hour visit, and that which she'll pay over the next two years is truly in excess of her needs. Her economic mistake in this case is worse than her mistreatment of her health.

 

[ACSurgeon]

Got a question for you all regarding my mother and her herbalist. She recently decided to go see a "world renowned" herbalist that has an M.D. (pediatrician, PM&R, full prescribing rights still) that decided he hated mainstream medicine and is now an herbalist doctor (and hasn't even gotten an N.D., if that even matters).

So the story is, my mother goes to this guy because she is having joint problems. She describes all the things she had done to her while there in the office which took FOUR hours, things like holding aluminum rods and measuring electrical signals and changes in her "pulse" to diagnose where her "pre-arthritic" bones are (or something). Apparently he has prescribed her herbal meds from germany that act as muscle relaxants for her to take, and he is starting her on a regimen to REVERSE her arthritis, which will happen after 2 years of taking these herbs and meeting with him regularly. He also prescribed her LMW heparin??!? She also told me that WITHOUT a blood test, he diagnosed her as having hypothyroidism and prescribed her 15mg T3 to take twice daily, and will soon be starting her on some antibacterial herbs for the bacteria in her joints from what he believes to have originated from milk she drank in Mexico nearly 20 years ago (again, no blood test, culture, antigens, nothing for the bacteria he believes she has).

OK so besides the fact that listening to her tell me all that pissed me of to no end, I'm also concerned about the implications of her taking T3 supplements (basically dessicated thyroid) for a diagnosis based on history and physical alone, and not having done a blood test to actually confirm it. If she has a normal functioning thyroid (which I believe she does, she just gets tired and has cold extremities) and then she takes this dessicated thyroid for long enough, will this not eventually in fact lead to her developing an atrophic thyroid that will literally then CAUSE hypothyroidism?

So pissed off and in shock that she believed everything this guy told her. Are there not any laws or regulations on these people? If she gets hypothyroidism based off his treatments, isn't that a serious crime?

Plus at least she saw an MD, not a DO.

 

[pathologyDO]

Plus at least she saw an MD, not a DO.

Whoa there, I know you're joking but I find that comment insulting. Care to explain your point?

People have the right to make bad decisions. This includes parents of doctors. Not getting regular cancer screening, smoking, being obese and yet eating crap food and not exercising, etc etc. Your mom' s offense is probably mostly harmless. I hope the money she paid for this 4 hour visit, and that which she'll pay over the next two years is truly in excess of her needs. Her economic mistake in this case is worse than her mistreatment of her health.

Listen, this has nothing to do with my mother, this has more to do with the M.D. that is prescribing her medications for a medical condition (e.g. hypothyroidism) that he obviously did not follow standard procedure in diagnosing (e.g. blood tests to confirm). Relating this to my board studying, is this not going against the ethics of a practicing physician, specifically, that of non-maleficence? My whole questioning of his action to prescribe her T4 is that, if she has a normal thyroid, is it not possible for the thyroid to be suppressed after long-term therapy, resulting in atrophy of her thyroid? Basically iatrogenic hypothyroidism? If there is no risk of her developing hypothyroidism from taking this then whatever, case closed. If she is indeed at risk then I am worried about it.

 

[pathologyDO]

lmao "hasn't even gotten an nd" as if that matters
people have a choice about who they see and who they believe. if you think this guy is practicing unethically, report them to the state board

What I meant was that I'm not sure of the governing bodies or regulations in regards to becoming a practicing herbalist.. meaning, he doesn't have an N.D., if that even matters.

I'm asking you guys if this is a reportable offense, that's why I posted this here.

I dunno guys, maybe board studying has got my panties in a bundle... but still, I am concerned about the stuff he is giving her.

 

[xffan624]

What I meant was that I'm not sure of the governing bodies or regulations in regards to becoming a practicing herbalist.. meaning, he doesn't have an N.D., if that even matters.

I'm asking you guys if this is a reportable offense, that's why I posted this here.

I dunno guys, maybe board studying has got my panties in a bundle... but still, I am concerned about the stuff he is giving her.

He's still an MD with MD prescribing rights, correct? Report him to the state medical board. Another important questions, did you tell your mother this?

 

[pathologyDO]

He's still an MD with MD prescribing rights, correct? Report him to the state medical board. Another important questions, did you tell your mother this?

Yeah he pretty much has to be, she sent me a pic of her T3 medication and it is a legit prescribed medication from a pharmacy, so unless they're handing out prescription meds without a doctors prescription, he must be still licensed. I also looked him up online and it says he has an M.D. but doesn't mention whether currently board certified or licensed (but again, if he is prescribing he must be).

I told her my concerns about the thyroid meds but she is convinced this guy knows what he is talking about (he probably does, and yet he obviously is deviating from the normal workups), she thinks he is better than our family physician (also M.D.) because the guy actually performed tests on her and acknowledged that something was wrong, rather than our family doc who has told her she is fine. To understand the situation you would have to know her though... she always thinks something is wrong with her and is honestly a borderline hypochondriac. I don't blame our family doc for not doing tests every time she comes in.

 

[ACSurgeon]

Whoa there, I know you're joking but I find that comment insulting. Care to explain your point?

There is no point. I noticed your user name included DO, so I wanted to poke fun.

 

[Merely]

Whoa there, I know you're joking but I find that comment insulting. Care to explain your point?

You wouldn't get it, DO.

 

[ACSurgeon]

Listen, this has nothing to do with my mother, this has more to do with the M.D. that is prescribing her medications for a medical condition (e.g. hypothyroidism) that he obviously did not follow standard procedure in diagnosing (e.g. blood tests to confirm). Relating this to my board studying, is this not going against the ethics of a practicing physician, specifically, that of non-maleficence? My whole questioning of his action to prescribe her T4 is that, if she has a normal thyroid, is it not possible for the thyroid to be suppressed after long-term therapy, resulting in atrophy of her thyroid? Basically iatrogenic hypothyroidism? If there is no risk of her developing hypothyroidism from taking this then whatever, case closed. If she is indeed at risk then I am worried about it.

Is this "supplement T3" a prescription medicine? If not, do you have any evidence that it causes iatrogenic hypothyroidism? Unfortunately, many/most herbs and supplements have little efficacy and safety data. If the consumer is willing to take it at their own risk, you can't blame anyone for recommending it based on "theoretical" risk explained by physiology. I would strongly discourage anyone I care about from seeing such provider, much like I would any ND or chiropractor, but I'm not sure he violated any ethical rules. Non-maleficence wasn't violated because you can't demonstrate intent to harm or any resulting harm as a direct consequence of this supplement.

You have every right to be pissed. It's like when my parents refused to get a colonoscopy for years and years. Being a general surgery resident, colorectal cancer was something I wanted to save them from. They eventually got their scopes, but I kinda gave up and they did it on their own.

 

[JP2740]

I just don't give a **** anymore. Patient wants to see herbalist and get prescribed rat poison? Great! Go for it. Go natural baby. I support it 100%. I'm done stressing myself out about the majority. They're dumb. If I get concerned about these things it'll make me rage beyond belief.

 

[pathologyDO]

I just don't give a **** anymore. Patient wants to see herbalist and get prescribed rat poison? Great! Go for it. Go natural baby. I support it 100%. I'm done stressing myself out about the majority. They're dumb. If I get concerned about these things it'll make me rage beyond belief.

Hahaha. No, but really. Its enraging.

Is this "supplement T3" a prescription medicine? If not, do you have any evidence that it causes iatrogenic hypothyroidism? Unfortunately, many/most herbs and supplements have little efficacy and safety data. If the consumer is willing to take it at their own risk, you can't blame anyone for recommending it based on "theoretical" risk explained by physiology. I would strongly discourage anyone I care about from seeing such provider, much like I would any ND or chiropractor, but I'm not sure he violated any ethical rules. Non-maleficence wasn't violated because you can't demonstrate intent to harm or any resulting harm as a direct consequence of this supplement.

You have every right to be pissed. It's like when my parents refused to get a colonoscopy for years and years. Being a general surgery resident, colorectal cancer was something I wanted to save them from. They eventually got their scopes, but I kinda gave up and they did it on their own.

At first I figured it would be some sort of dessicated thyroid herbal medicine or something, and I asked that she send me a picture so I know what this is. She sent me this picture (edited to remove identifiers)

 

[loris]

Hahaha. No, but really. Its enraging.



At first I figured it would be some sort of dessicated thyroid herbal medicine or something, and I asked that she send me a picture so I know what this is. She sent me this picture (edited to remove identifiers)

Well this may not be that helpful, but it’s a bottle of 60 capsules of 15 micrograms of liothyronine compounded with an unlisted percentage of Methocel E4M Premium to make slow-release capsules. The original manufacturer of the T3 that was compounded can’t be looked up because the listed National Drug Code was probably invented by the pharmacy for internal use; the labeler code of 99999 is sometimes used unofficially for compound drugs since that number is still to my knowledge unassigned to a company/manufacturer.

 

[notbobtrustme]

To get TSH in the normal range, you need like 100 - 300mcg. 15mcg is like placebo, truth be told.

 

[baxt1412]

To get TSH in the normal range, you need like 100 - 300mcg. 15mcg is like placebo, truth be told.

bodybuilders, powerlifters, etc regularly take 12.5-50mcg and have good fat loss properties (usually coupled with other drugs as well of course though).

it may not get OP's mom to regular levels, but she'll be shredded.

 

[pathologyDO]

To get TSH in the normal range, you need like 100 - 300mcg. 15mcg is like placebo, truth be told.

bodybuilders, powerlifters, etc regularly take 12.5-50mcg and have good fat loss properties (usually coupled with other drugs as well of course though).

it may not get OP's mom to regular levels, but she'll be shredded.

Honestly my mom isn't fat, she has had two kids and is in great shape for her age. It makes absolutely no sense that she is hypothyroid!!! Not depressed, has lots of energy. She just has joints that bother her and her skin is dry/cold... doesn't really fit the bill just from history IMO, maybe the cold/dry skin buts that's about it. But hey, if she gets shredded then I guess it isn't hurting her. OK cool thanks guys

 

[TheShaker]

bodybuilders, powerlifters, etc regularly take 12.5-50mcg and have good fat loss properties (usually coupled with other drugs as well of course though).

it may not get OP's mom to regular levels, but she'll be shredded.

What the hell? Now we have bodybuilders abusing these medications to lose weight? Give me the contact info of these distributors so I can make a complaint.

 

[baxt1412]

What the hell? Now we have bodybuilders abusing these medications to lose weight? Give me the contact info of these distributors so I can make a complaint.

the majority of them aren't getting this from their doctors lol.

 

[Apoplexy__]

I just figured out that T3 refers to Synthroid, and not to Tylenol #3. Just wanted to share.

I came in here wondering the same thing. Lol.

You know you're a surgeon when...

 

[mspeedwagon]

I have a surprisingly simple solution. Why doesn't she go get a blood test and confirm if she has hypothyroidism? If she does, then she needs more treatment... 15 mcg won't do anything (it's basically a placebo dose as stated above).

Honestly my mom isn't fat, she has had two kids and is in great shape for her age. It makes absolutely no sense that she is hypothyroid!!! Not depressed, has lots of energy. She just has joints that bother her and her skin is dry/cold... doesn't really fit the bill just from history IMO, maybe the cold/dry skin buts that's about it. But hey, if she gets shredded then I guess it isn't hurting her. OK cool thanks guys

 

[mspeedwagon]

But, 25 is just the starting dose for Cytomel. My understanding is that is normally increased from there and the maintenance dose is often higher. And, monitoring is usually done from lab results.

15 mcg as a constant unchanged dose may or may not have desired effect.

(Disclaimer: all my knowledge comes exclusively from a family member with the condition)

I wish people would stop repeating this.

T3 =/= T4

Do none of you ever use cytomel?

15 is a little low, but 25 is a common starting dose for T3.

 

[jdh71]

I wish people would stop repeating this.

T3 =/= T4

Do none of you ever use cytomel?

15 is a little low, but 25 is a common starting dose for T3.

Exactly. This is bio-identical T3.

 

[jdh71]

Did you read the prescription that he took a picture of?

1 capsule QAM for a week then 1 capsule BID sounds like an increasing dose over time to me.

Nowhere have I said that prescribing without lab monitoring is appropriate.

I'm saying people should stop dismissing 15 mcg of T3 (actually 30, after a week) as a "placebo dose" and saying it won't do anything when they are obviously thinking in terms of synthroid dosing.

Don't let reasonable speak stand in the way of outrage.

 

[mspeedwagon]

Nope, clearly missed that part of the bottle. Good catch !

Did you read the prescription that he took a picture of?

1 capsule QAM for a week then 1 capsule BID sounds like an increasing dose over time to me.

 

[Instatewaiter]

To get TSH in the normal range, you need like 100 - 300mcg. 15mcg is like placebo, truth be told.

That would be a massive dose of liothyrinine. The conversion is 1:4 for synthroid. So 300mcg of liothyrinine would be 1200mcg of synthroid... or you know, probably deadly.


edit: I see people already beat me to it.

 

[notbobtrustme]

That would be a massive dose of liothyrinine. The conversion is 1:4 for synthroid. So 300mcg of liothyrinine would be 1200mcg of synthroid... or you know, probably deadly.


edit: I see people already beat me to it.

ya misread that, it was like 3am broseph

 

[omn]

"Theories about the Earth's crust" black box warning.... Stayin' above...

... and also in the "The Great Mysteries" series, we cover other matters of weight, such as:

"Why did that Smoothies go right through me"....
https://answers.yahoo.com/question/index?qid=20120611132521AAHOZJh

 

[genericpremedstudent]

I've taken 75mcg daily of triiodothyronine for extended periods of time for uhhh... Research purposes. 15mcg dose will do nothing.

 

[VA Hopeful Dr]

I've taken 75mcg daily of triiodothyronine for extended periods of time for uhhh... Research purposes. 15mcg dose will do nothing.

This sounds suspiciously similar to the narcotics abusing patient who swears that 5 mg percocet doesn't work, only the 10mg does.

 

[CliffDO]

Reminds me of this story: http://www.thisamericanlife.org/radio-archives/episode/437/old-boys-network

 

[genericpremedstudent]

Your choices are to listen to the drug abusing douchebag, or the two board certified internists (+ me)

I'm a douche bag because I've taken a medication that wasn't prescribed to me? And comparing t3 use to opiate abuse? LOL ok... there is no evidence that long term t3 use will damage your thyroid.

 

[genericpremedstudent]

When exactly did I compare it to opiate abuse?

You're a douchebag for giving bad medical advice based off of your own illicit drug use.

No one has said anything about long term damage to the thyroid.

Go back to the gym, loser, and quit giving medical advice when you don't have a clue what you are talking about.

lol the post above yours referred to opiate abuse. and yes, the OP was concerned about their mom experiencing hypothyroidism induced by unnecessary exogenous triiodothyronine use. and i wasn't giving medical advice, i was relaying my anecdotal experience. take the stick out of your ass lol, last I checked you haven't served an endo fellowship either...

 

[genericpremedstudent]

also, why such the hard on for guys who lift weights? did you get beat up by jocks in high school? its a shame that you have to resort to name-calling to defend your point.

 

[VA Hopeful Dr]

lol the post above yours referred to opiate abuse. and yes, the OP was concerned about their mom experiencing hypothyroidism induced by unnecessary exogenous triiodothyronine use. and i wasn't giving medical advice, i was relaying my anecdotal experience. take the stick out of your ass lol, last I checked you haven't served an endo fellowship either...

You don't need an endocrine fellowship to know basic thyroid physiology and pharmacology.

What you do need, at minimum, is med school.

 

[Wordead]

I'm a douche bag because I've taken a medication that wasn't prescribed to me? And comparing t3 use to opiate abuse? LOL ok... there is no evidence that long term t3 use will damage your thyroid.

Is that what you read on bodybuilding.com?

You think using a hormone with as widespread effects as thyroid hormone has no long term effects, are you a ****ing idiot?

 

[genericpremedstudent]

Is that what you read on bodybuilding.com?

You think using a hormone with as widespread effects as thyroid hormone has no long term effects, are you a ****ing idiot?

lol no. enlighten me though. I searched high and low for a peer reviewed article about the long term effects of exogenous t3 use in euthyroid patients but nothing turned up.

 

[genericpremedstudent]

You don't need an endocrine fellowship to know basic thyroid physiology and pharmacology.

What you do need, at minimum, is med school.

apparently that is subjective since the doctor who unnecessarily prescribed the t3 in the first place is an MD.

 

[genericpremedstudent]

I have no need to defend my point. I'm a fully licensed physician who has prescribed these medications to hundreds of patients.

I know what I'm talking about. If I didnt, I wouldn't have posted.

You, on the other hand, don't know what you are talking about and make your idiocy clear more and more with each passing post.


Maybe if you actually make it into and through medical school, you'll learn some humility. Most of us who've done so know enough not to speak off our ass.

I only brought up the weight lifting since that is the obvious context in which you've abused this drug, and because I knew it would get your goat (which obviously worked).

LOL someone with your hubris trying to teach me a lesson in humility. good one...
my goat has yet to be gotten. i'm not the one calling people "loser douchebags" on the internet like i'm mad or something...

 

[VA Hopeful Dr]

apparently that is subjective since the doctor who unnecessarily prescribed the t3 in the first place is an MD.

Its one thing to learn something and then ignore it, its something else entirely to never know it in the first place. The doc in the OP is the former, you are the latter.

 

[Winged Scapula]

Please refrain from using personal insults and name-calling when disagreeing with each other.

 

[omn]

the field is vast...

Sent from my SM-N900V using Tapatalk

 

[baxt1412]

I wish people would stop repeating this.

T3 =/= T4

Do none of you ever use cytomel?

15 is a little low, but 25 is a common starting dose for T3.

this is why i said many athletes use this same dose.. idk why people keep saying it