Why Thyroid Patients Need to Get Better Faster

I have described hypothyroidism to a lot of people as being the illness that is the ‘death of a thousand cuts’.

Hypothyroidism is often a slow process that gradually wears the sufferer down. Sometimes the symptoms just creep up on the person very slowly. They may not even notice the symptoms to begin with. Issues, like gaining weight, feeling tired, getting depressed, difficulty in thinking straight and feeling cold, can be so general that the individual may think that they are just working too hard, or have too much stress etc. Months or years can go by as the symptoms worsen and new ones appear before they even get a diagnosis of hypothyroidism.

Even when a proper diagnosis has been made, it is common for poor treatment to leave the thyroid patient with many or all of the original symptoms. The life that the patient used to have before hypothyroidism can be lost. Precious time simply vanishes. Eventually, many patients look back with sadness at multiple years or even decades during which they have suffered debilitating symptoms.

During this time, the thyroid patient often goes back and forth to their doctor or endocrinologist and has more thyroid blood tests done (frequently not including FT3 and reverse T3). Sometimes, increases in Levothyroxine (T4) are made and sometimes, the dose is lowered. Usually, any improvement is short-lived. The T4 dosage often ends up being cycled up and down many times over years, with little or no benefit to the thyroid patient. Over time, it is common for the thyroid patient to get more ill. This frequently stops the thyroid patient from enjoying their life and living it to the full. It can leave the patient severely debilitated (it did this to me and I know it does to many others). In this way, more of the person’s precious life is lost.

Worse still can be the collateral damage that hypothyroidism frequently causes. This damage can be to the thyroid patient’s career or job or to their relationships with friends or family members (partner, children etc.). This type of collateral damage only occurs if the hypothyroidism has not been successfully and quickly treated. Sadly, this happens all too often.

Recovering from hypothyroidism as fast as possible is the only effective way to avoid the ‘death of a thousand cuts’. This requires a correct and early diagnosis. It also needs to be followed by really effective treatment that focuses on the clinical presentation of the thyroid patient (symptoms and signs), as well as comprehensive thyroid laboratory tests (not just TSH and FT4, but also FT3 and reverse T3). Other factors also need to be examined and corrected, like vitamin and mineral levels. 

It ought to be straightforward, but all too often it is not.

The current approach that most doctors and endocrinologists use during thyroid treatment is a broken paradigm. Most of them believe that TSH alone can be used to assess the right dosage – WRONG! Low or suppressed TSH when on thyroid treatment is also believed to represent hyperthyroidism in all thyroid patients – also WRONG! This latter prevents many thyroid patients from ever being given a large enough dosage of thyroid medication to effectively treat them and eradicate symptoms. Many doctors think that TSH and FT4 are definitely enough to assess treatment – WRONG! A lot of them do not believe that laboratory testing of FT3 (the active hormone) is essential – VERY WRONG! Most of them believe that T4 medication always converts well and works – WRONG AGAIN!

The current broken paradigm assumes we are all robots that work identically and always convert T4 medication perfectly. The current treatment approach is keeping many thyroid patients sick! Some thyroid patients are aware of these issues and even know what they require – they simply cannot persuade their doctor or endocrinologist to test them properly or treat them with the correct medication. However, the vast majority of patients do not even realise that they are being treated poorly.

The thyroid patients that suffer most are those that do not do well on Levothyroxine (T4). This is extremely common. One common reason for this is that doctors often never raise the Levothyroxine to a high enough level because they fear a low TSH means that the patient is hyperthyroid. Research has shown that this is an unfounded concern if the patient’s FT3 is not high, and the patient has no hyperthyroid signs or symptoms. Another major problem with Levothyroxine treatment is that many thyroid patients do not convert T4 to the active T3 hormone well enough. Only T3 does any real work in the body and the thyroid patient needs enough T3 for them as an individual. Simply having FT3 in the reference range is not sufficient. FT3 needs to be in the right part of the reference range for the person. Sometimes, even an okay looking FT3 may not be sufficient because the individual patient needs a higher FT3 level in order to feel completely well.

Sometimes the thyroid patient needs a T4/T3 combination that is tuned with the right amount of T4 and T3 for them as an individual. Occasionally, the thyroid patient needs mostly T3 and only a little T4 medication. It is also possible that someone can only get well if they are given T3-Only medication and no T4 at all – this was my own situation and I know that many other thyroid patients have found this to be the case for them too.

I wrote The Thyroid Patient’s Manual because I wanted to provide a very practical, easy to use manual to help patients understand whether they have hypothyroidism and to provide a very practical guide on how to recover as fast as possible. In the book, I try to encourage the thyroid patient to ‘get in the driver’s seat of their own health’ and not completely hand their health over to their doctor. This does not exclude having a good working relationship with their doctor. However, it definitely does mean gaining enough understanding of hypothyroidism and how to treat it effectively, so that the thyroid patient can be an active partner in any discussions about changes in treatment. The book will give the reader enough information to understand their situation and to assess what their next steps ought to be.

In my own case, I lost at least ten years of my life from age 30 to 40 through hypothyroidism. I lost my career and my marriage. Worse still was the damage to the relationship with my children. My own ‘death of a thousand cuts’ probably spanned from the start of the disease when I was about 30 and continued for years afterwards due to the collateral fallout. I still see and feel the damage in my own life due to being incorrectly treated for so long by so many doctors and endocrinologists. Many years ago, I blazed with anger about this bad treatment. This anger helped me to write the Recovering with T3 book. These days, I just feel sadness at what happened to me. I am also very disappointed that the knowledge that I gained and expressed within my books has not been taken up and used by doctors or endocrinologists. However, I find consolation in the way that so many patients manage to reclaim their health using my work.

The above is why I am so passionate about the need for a new paradigm of thyroid treatment that provides the fastest possible route for patients to get diagnosed and get correctly treated as unique individuals. Only by getting well fast can the ‘death of a thousand cuts’ be avoided.

The Thyroid Patient’s Manual is effectively Book 1 in the Recovering from Hypothyroidism series. The Manual was written specifically to help thyroid patients recover quickly. The other two books in the series (Recovering with T3 and The CT3M Handbook) are mainly aimed at those patients who need to use mostly T3 thyroid hormone or who need to deal with low cortisol issues.

I wrote the Recovering from Hypothyroidism series in order to help thyroid patients get ‘better, faster’, and avoid ‘the death of a thousand cuts’. It is not that difficult to resolve thyroid hormone issues!

I wish you what I wish readers at the end of The Thyroid Patient’s Manual:
“Get well and enjoy your life!”

Best wishes,


Paul Robinson

Paul Robinson is a British author and thyroid patient advocate. The focus of his books and work is on helping patients recover from hypothyroidism. Paul has accumulated a wealth of knowledge on thyroid and adrenal dysfunction and their treatment. His three books cover all of this.

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