I’ve on occasion been critical of Doctors who appear not to listen to what symptoms female patients are relating – particularly hair loss concerns – and refuse to consider anything other than ‘generic’ blood testing in place of symptom-specific testing – if they order any testing at all.
All too frequently women relate a negative consultation experience where they feel they’ve been dismissed as ‘stressed’, pre-menopausal, post-menopausal, or simply neurotic.
Whilst this remains a valid censure in some cases, I now understand just how much pressure Medicare exerts on Medical Practitioners NOT to test for potential health issues in patients.
Apparently every pathology test a Doctor orders for her/his patients is recorded against the Practitioner’s name and profile. Restrictions – understandably – are placed on how often a test may be ordered for an individual patient or what tests may be ordered for that patient. But should the Doctor move outside their ‘profile’ of pathology requests, they may be ‘red flagged’ and investigated for over-servicing.
Essentially we now follow the US system where medical practice is determined by bureaucrats and ‘bean counters’ in place of the treating Doctor’s clinical judgment and investigation through pathology testing. Practitioners aren’t questioned if they continue ordering the generic ‘overview’ pathology – cheap for Medicare to fund – but of limited diagnostic value.
(In the opinion of many) Doctors are also not compensated for the time it truly takes to obtain a thorough clinical history from the patient. As a Trichologist I ask an hour of a new client’s time for history taking and scalp assessment – and this is for a non life threatening hair loss or scalp problem. I defy the best clinician to glean all the information required in a fifteen minute consultation.
As I suggest in my Blog ‘Medicare or care only about the $$’, skewed Government funding for health care encourages the practice of “band-aid” medicine in place of a more far-sighted, healthier – and ultimately more economical – preventative medicine.
Dr. John Lee – my hormone mentor and arguably Australia’s most progressive thyroid researcher – has found 40-60% of all patients who consult him are – at 1st encounter – Iodine and Vitamin D deficient. My own client statistics concur with this although I find greater than 80% of all clients I see over autumn-winter have Vitamin D levels ranging from insufficient to severely deficient. I believe other forward thinking (ACNEM) Doctors around the country see similar high statistics.
Iodine deficiency profoundly influences thyroid gland hormone production and function. It’s known to be a factor in breast disease in women (Wright: 2000, Zava: 2007); slow brain development and lowered IQ levels in children (Eastman et al: 2006).
Professor Creswell Eastman from the Council of Control (Iodine Deficiency Disorders) – has been publicly urging food manufacturers to again add Iodine to their products. His concerns arise from a recent national study which found almost half of all children of primary school age show Iodine deficiency.
Vitamin D deficiency is known to be associated in osteoporosis, diabetes, high blood pressure, ‘stroke’, and heart disease; autism in children, depression, and body muscle mass wasting, gum disease, & certain forms of cancer. The neuro-degeneration of Alzheimer’s disease is believed associated with Vitamin D deficiency (Sutherland et al: 1992).
The potential to develop autoimmune conditions such as alopecia areata, vitiligo, psoriasis, & inflammatory bowel disease is thought to increase with Vitamin D deficiency.
Lee (2007) has found ‘sufficient’ Vitamin D (>100nmol/L) is required for optimal Triiodothyronine (active thyroid hormone – T3) ‘receptor expression’. I regularly see clients with Vitamin D levels less than 20nmol/L.
Any example one could cite: smoking, alcoholism, the benefits of an active lifestyle and healthy eating to resist heart disease, have all shown ‘prevention’ is infinitely more desirable than allowing the disease to develop.
Past public health awareness campaigns aimed at ‘prevention’ or early detection for Melanoma, Tuberculosis (TB) and Polio – even compulsory seat belts - greatly diminished deaths and illness from these causes in our society.
Allowing potentially preventable illness to fester into chronic, debilitating disease increasingly burdens our nation’s ability to fund the expensive surgery and hi-tech medical interventions which are then usually necessary.
The personal cost to individuals and their families – and therefore our nation – is incalculable. The individual’s private pain, suffering, and stolen future; as well as their families’ misery, grief and loss is an intangible cost that no $$$ figure may be calculated for.
The ‘Catch-22’ for Iodine and Vitamin D testing is they are not bulk-billed by Medicare so Doctors (generally) don’t test for them. Worryingly, I’ve spoken with two or three health practitioners who had little idea how Iodine influences body functioning (or how to interpret Iodine results).
My clinical experiences……
This past year I’ve been consulted by three elderly women with advanced Parkinson’s disease who’d experienced telogen effluvium hair fall from changes to their medication. Having read the many published articles linking Parkinson’s disease and Vitamin D deficiency – www.vitamindcouncil.org - I requested these women’s Vitamin D levels be tested. All three women were found to be severely deficient; between 10-14nmol/L respectively.
The obvious question is: Were these women Vitamin D deficient before they developed Parkinson’s disease or are they now deficient because of impaired mobility and are essentially housebound? In all three cases there was no record of their Vitamin D levels ever being tested.
Two of my clients have undergone breast removal (mastectomy) and are currently taking the drug Tamoxifen. Another client’s sister and mother both died from breast cancer. (A Doctor whom I greatly respect told this woman my testing to establish her hidden Iodine deficiency had probably saved her from her sister and mother’s fate - heady praise indeed!!).
In consulting these women for their respective hair loss issues, it was found ALL THREE were severely Iodine deficient Again there was no record of their Iodine levels – a simple urine sample - ever being tested.
These are not elderly women; their ages range from 35-45 respectively. They are – or should be – in the prime of their lives.
In his text, ‘Iodine: ‘Why You Need It, Why You Can’t Live without It’ (3rd Edition) - leading expert and author Dr. David Brownstein firmly believes Iodine deficiency to be a factor in breast disease in women.
This leaves me to wonder about the highly publicised illness and recent early deaths of two prominent Australian women from breast cancer – did any treating practitioner ever think to test their Iodine levels.
Obviously Iodine deficiency is one risk factor in female breast cancer. Heredity, oestrogen-progesterone balance, Vitamin D levels, or taking synthetic hormone therapy for extended periods of time is just some of the many other considerations. But with 100,000 Australian women being sought to participate in a national breast cancer study that’s just been announced – we ask them to reflect on ‘easy to test’ nutritional issues such as Iodine.
(My next Blog will attempt to explain why women are more ‘at risk’ of Iodine deficiency and how this increases the threat of breast disease)……