A Step by Step Plan Built Over Years of Listening to My Thyroid Patients that will Help End Your Suffering…Forever.
You Can Fuhgeddabout Your TSH! —How Decades of Discovery Into Root Causes Resulted In a Drug-Free Solution to Thyroid
YOU ARE NOT ALONE
Every day in my practice I hear the same stories from new patients about their frustrations of playing by all the rules, putting in years of hard work and planning for life ahead—only to wake up feeling that this is all being compromised by thyroid problems.
I hear the years of suffering and feel the mountains of injustice my patients experience as they try to get their health back in order but instead are ignored by doctor after doctor.
I hear women puzzling about the disparity problem and worrying over the lack of attention to their needs.
I hear the pain in their voices as they recount being told they are crazy by even the family doctor, whose final offer is a prescription for an anti-depressant.
All the while, they feel stuck. Too many are spinning their wheels dissecting not just the disparity problem, but the problem of their thyroids.
Hearing all this and more from my patients, I understand how their sense of self can be undermined by an underlying thyroid issue that no doctor had ever diagnosed before they came to me.
Maria’s story is a good example: She’s a woman in her early 40s who struggles with low energy, weight gain, achy joints and mental sluggishness. “All my friends just seem a lot more active.” She has two young children and a husband who rely on each other to run the household. She also works part time and often babysits for her niece and nephew while remaining active socially. Martha outwardly appeared to be a healthy person, but appearances can be deceiving—her body was actually failing her.
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LEARN THE SYMPTOMS
I began holding free thyroid workshops for women and men in my office back in 2011.
I was surprised to learn how many of the attendees had been told by their doctors that the symptoms they were complaining of were not real.
That they had tried for years to get their doctors to connect the dots for them on whether their weight gain could be connected to their cold hands and feet.
Also, not surprisingly, I heard from many who said they continue to suffer with low thyroid symptoms even after taking replacement hormones for months or years!
Are you one of the many who continue to suffer with any or all these thyroid symptoms?
- Tired, sluggish
- Can’t lose weight even with exercise
- Feel cold in hands, feet, or all over
- Require excessive amounts of sleep to function properly
- Increase in weight gain even with low-calorie diet
- Gain weight easily
- Difficult, infrequent bowel movements
- Depression, lack of motivation
- Morning headaches that wear off as the day progresses
- Outer third of the eyebrow thins
- Thinning of the hair on scalp, face or genitals or excessive falling hair
- Dryness of skin and/or scalp
- Mental sluggishness
- Nervous and emotional
- Insomnia
- Night sweats
- Infertility
- Low libido
- Hypoglycemia or low blood sugar
- Constipation
- Problems with balance and coordination
It’s important to know that you are not alone in feeling this way.
YOUR JOURNEY SO FAR
You’re looking for answers. With only the information that you glean from friends while chatting about your symptoms or scouring the internet, you determine to have someone test for thyroid function.
Your primary care doctor evaluates you based on one test—the TSH marker—and tells you that you are fine.
You get a referral for an endocrinologist, who initially makes the same determination.
On your subsequent visits, once your condition has worsened enough, you are given a medication for a synthetic hormone and it works for a couple of months. You feel greatly relieved and then all of a sudden, this stops.
Your thyroid dosage increases and you probably continue to suffer with some or all the symptoms of low thyroid PLUS now you’re worried about this being a gateway medication to more and more drugs, one prescription after another.
Whatever the process, you begin a slow decline as you try to figure out this one marker, the TSH, and how to make it perfect.
You begin hoping that if you can fix that, then you can take back your thyroid health, feel beautiful, and bring back that energy for life you once had.
I am sure the biggest frustration is getting rushed in and out of your doctor’s visits, and each visit, you walk out with a new prescription and NO ANSWERS.
A number of years ago, I had heard this story enough times that I started really talking to my patients about their TSH and what it does and does not mean.
YOUR SINGLE MOST IMPORTANT DECISION
The ability to recover your health and improve your thyroid function depends more on this decision than on any other: Can you abandon the conventional standard of treatment and commit to a better solution?
Should you continue trying the same method of analysis that is the standard of conventional medical care—only monitoring your TSH—or is it time to embrace a more comprehensive approach and move forward?
Are you satisfied with a perfect test score, an A+ on your laboratory report, or do you want to live your best life?
For years now, I’ve been putting my finger on the pulse of what my patients are saying, and their voices have been echoing in my head.
Throughout the 30 years I’ve been in practice, I’ve listened closely to my patients’ stories, their fears, and what it is they really want in their lives.
I asked them to bring in their lab tests so that I could see for myself what was happening.
As I thought about the many people who come to me for better answers, I made a startling observation about the ones who never get started with treatment: It’s almost as though they are plotting to go head to head against their own recovery.
They are trying to find a way around carving out more time in their already hectic schedules in order to improve their health.
They are just hoping to find a quick-fix remedy that would be more convenient.
They would rather continue to go it alone and be stuck than set aside personal time and make an investment in their health and their futures.
I realized that their mindset was counterintuitive to their own healing.
This is what separates the patients who are truly capable of recovery from those who aren’t:
a. They pay attention to their symptoms and are willing to make fundamental alterations to their lives if need be.
b. They have made the decision to get unstuck and to stop going at the problem alone. They are ready to listen to their bodies and their doctor.
c. They are critically aware that the old standard—that of measuring and monitoring the TSH—is pointless.
WHAT YOU DON’T KNOW, HURTS
According to statistics from the American Thyroid Association, an estimated 20 million Americans have some form of thyroid disease.
Women are five times more likely than men to suffer, and one in eight women will develop a thyroid disorder in her lifetime. However, male thyroid disorders have been commonly overlooked in the past but are being recognized today.
Undiagnosed thyroid disease may put patients at risk for infertility, osteoporosis and heart disease.
Pregnant women with a thyroid disorder have an increased risk of miscarriage, pre-term delivery and severe developmental problems.
Worse still, up to 60 percent of those with thyroid disease are unaware of their condition altogether.
WHAT WORKS BEST
The Big Picture. Unless your recovery is built on THE BIG PICTURE, your health will take a turn for the worse.
Your thyroid is a small snapshot of what’s happening inside you. Until this day you have felt mostly indifferent about it.
Now is the moment when you decide that it is time to act.
This problem, when solved, will be simple.
An Elegant Solution. The woman who dedicates herself to recovering fully will develop important insights into her thoughts, emotions, and lifestyle that may be contributing to her health issues. What has she been missing all along that will help her lead a healthier, happier life?
It pays to have an awareness of your own desires and an eye for detail. Most failures occur through lack of consistency or the inability to recognize any subtle changes that, little by little, amount to a gratifying shift in wellbeing.
Recovery is not complicated; it simply takes a better formula.
Facts Are Friendly. The flaws that are revealed by tests can be corrected—we have doubled our successes simply by treating what we find.
More than just facts, test results provide the doctor with information that he uses to guide his own course of action.
Before coming to us, the women who become our patients remark at having felt trapped inside the data. Indeed, they want to be freed from these constraints.
MY PROMISE TO YOU
Every promise is a benefit to you—the seeker.
Here’s what you will get if you take what I am about to teach you and use it in your life:
a. you will wake up feeling productive
b. you will double your knowledge of how your thyroid functions
c. you will be able to identify which areas of your health need the most improvement
Those areas are known as root causes and are the areas of concern that we will work on.
ONE CRUCIAL INSIGHT
After you read this report, you are going to see that resolving your thyroid problem does not have to be a battle.
What I am about to reveal here has the potential to change your life.
The Replacement Model as the standard of care never had the potential to make you feel better.
By trying to replace real thyroid hormones (which are chemical messengers) with synthetic drugs or with bioidentical hormones as the basis of your recovery, your doctor based her treatment decision on a totally false premise.
This faulty premise is that you can make up for lost thyroid function by replacing the deficiency.
You can’t.
If the internal mechanism is broken, it cannot be fixed with external hormones like Synthroid or Armour in the vast majority of cases. The only exceptions are in the 10 percent of patients who have what is known as primary hypothyroidism. In that small population, taking a synthetic hormone may keep their metabolism where it should be.
But there’s a reason that the other 90 percent fail.
Continue reading this special report and you will learn:
- The one simple reason why 90 percent of hypothyroid patients will never get lasting results from hormone replacement.
- Why your thyroid medication dose continually goes up, yet you continue to suffer with all of the same symptoms.
- Why, for so many women (and men), you can’t even get the testing you need or want.
- Why the common argument about natural vs. synthetic hormone replacement is completely irrelevant.
- Why 9 times out of 10 your thyroid gland is just an innocent bystander in the battle that your immune system is waging.
- Why your goal is not to figure out which drug will work best for you or what the perfect marker on your lab report should be.
- And More..
MY NAME IS DR. PUCCI
My journey into healthcare began because I had a desire to help people and provide care to ease their suffering, but I didn’t want to just prescribe drugs.
I talked about becoming a doctor from the time I was in elementary school. I always had an intuitive desire to help people and I knew becoming a doctor would allow me to do that.
As I progressed through my formal education I was always asking questions.
I wasn’t one to take everything taught to me at face value.
I needed to UNDERSTAND the reasons and mechanisms behind what was presented.
My goal in becoming a doctor was to learn what was really going on with human physiology and work WITH the body to restore health.
I discovered in my early training that there is a world of difference between treating a set of symptoms and healing a whole PERSON.
Symptoms are like warning signs that tell you it’s time to take the car into the shop.
The symptom can be a flat tire or maybe that the car is burning oil.
Fixing the symptom is like fixing the flat or adding more oil without taking the necessary time to understand WHY this symptom has happened.
Fixing the symptom is also known as masking the root cause.
Root causes are the source, or at the root of the symptom.
An example of a root cause for common health concerns like hypothyroidism would be inflammation.
However, the root cause of Hashimoto’s Thyroiditis is more than inflammation.
It’s inflammation plus something else.
Once I came to realize that medicine in general and pharmaceutical drugs are really only good for masking root causes and treating symptoms (you may have come to a similar conclusion already through your own hardship), I decided to become a natural healthcare doctor instead.
Even in my earliest years as a chiropractic physician I could see the desperation on the faces and in the eyes of the patients I met who were not receiving the care they wanted.
They were yearning to have someone listen to them, to spend the time necessary to get to the bottom of their body image and personal health issues, and most importantly, to help them break the chains that illness had put on their lives.
I understood them, and I knew that it was up to me to engineer my practice in a manner that would allow me to function as the doctor I needed to be for them.
Because I could see and feel their pain, and also because I have a gift for helping to make sense of everything and put it in perspective, I couldn’t rush people in and out in 10 minutes, as happens in every other doctor’s office.
I refused to cut into appointment times or be distracted by arguing with insurance companies over tests they claim aren’t medically necessary. Instead, I chose to use that precious time helping to peel back the layers of my patients’ health issues and find a true course to their recovery.
Once I realized we were stepping outside of the box and into a new frontier of medicine, I never looked back.
I not only stepped outside the box, I LEAPED out of it.
Inside that box was a system that could never help people in the way they needed to be helped.
Although early on I got great results with both chiropractic care and my brain-based approach, I still realized something was missing.
I would get amazing results with most patients, yet with others I could not make the changes they needed.
The most confusing part was that the patients who did not have good results seemed to have the same characteristics and test findings as the ones who were successful.
THE MISSING PIECE
This awareness about the missing piece led me on a journey to read and research everything, to question the very basic premise of what I was doing.
Shortly thereafter, I made an important personal discovery.
I realized I was trying to do what most other doctors do.
I was focused on brain and nervous system function without looking at the complete picture.
I had overlooked the hormone system, immune system, and gastrointestinal function.
Today we call it the neuro-endocrine-immune super system.
I knew I would have to understand and look at all these systems at the same time if I wanted greater and more consistent results.
So, for a huge period of time, I hibernated at night and on weekends.
I poured through scientific journals, textbooks, and articles.
I traveled across the country to learn from the best doctors I could find.
I burned the midnight oil to learn all that I could about nutrition, hormone analysis, metabolic care, blood chemistry and functional medicine.
It was this intense study of physiology, neurology, and immunology that led to my greatest discovery…everything in the body affects everything else.
It seems obvious now that to properly recover from any type of chronic ailment or condition you must look at EVERYTHING, all at once.
This is called Functional Diagnostic Medicine.
I began looking at and measuring everything.
I began running the necessary laboratory tests needed to take this big picture approach.
I also developed, with a few of my closest colleagues, a unique forensic examination, which is like being a detective at the highest level.
As I started doing this with more and more with patients, I found most of my patients had undetected and underactive thyroid problems.
I also found at that the number one cause of those thyroid problems was autoimmunity.
That’s the critical mistake that most doctors make: They don’t test for autoimmunity, and even if they do, they don’t alter their course of treatment because all they would have is a referral out and an immune suppressing drug.
Which would be crazy, right?
Immune suppressing drugs increase your risk for infection and are almost only ever used for cancer and the like.
And because I developed a deep-level understanding of the immune system and how it works in concert with hormones and neurology, and since it was the body’s immune system going haywire and attacking the thyroid gland, I knew we had to focus on calming the immune system if we were to stand a chance at helping these patients.
So I took everything I knew about functional neurology, endocrinology, immunology, functional blood chemistry analysis, and science-based nutrition and began making huge changes in my patients’ lives.
ABOUT YOUR THYROID CONDITION
For most thyroid sufferers today, the immune system will NEVER be looked at, let alone discussed, or properly addressed by your doctor.
In fact, chances are that your doctor is one of those that likes to confine himself or herself to that tiny box we spoke of and won’t even acknowledge that anything can be done.
As you continue reading this report, you are going to discover the secrets and clinical pearls we have found that help with Hashimoto’s and the symptoms of hypothyroidism.
You will also learn why a drug-free approach is the only approach for treating autoimmune thyroid.
First, let me explain why thyroid replacement hormones are completely ineffective for 9 out of 10 people:
Globally, the number one cause of low thyroid function, arguably, is said to be iodine deficiency.
That’s an argument that harkens back to the days before environmental toxicity and radioactive exposure, so I don’t put a lot of faith in that.
Regardless, in the United States, the number one cause of low thyroid is Hashimoto’s Thyroiditis, or what they are now referring to as thyrotoxicosis, or autoimmune thyroid.
The shorthand version of this is that Hashimoto’s is an autoimmune disease in which the immune system itself has run amok and is attacking thyroid cells.
It is widely known by endocrinologists, physicians and doctors in general that low thyroid function is always secondary to something else; yet, the issue of the autoimmune attack is not addressed.
Instead—and if you’re reading this, you probably know this already—you are “fine” when your TSH marker normalizes or is within normal range on your blood test.
If you haven’t had this experience yet, you probably will.
You will walk into your doctor’s office because you STILL suffer with the same symptoms. In order to move you out of the office in the allotted 4 to 7 minutes, he is going to first tell you you’re fine while at the same time, as one of my patients said, “shove an anti-depressant prescription” at you.
Do you suffer from depression?
Maybe…because of the thyroid problem that is not being managed properly.
Or maybe you’re depressed because you have a chronic problem that no one is taking seriously, and doctors just want to shove pills at you so you will go away.
Either way, an anti-depressant isn’t the fix.
WHAT ABOUT NATURAL THYROID SUPPORT
Have you already been to an alternative health doctor or nutritionist looking for some relief from your thyroid symptoms?
They gave you supplements that contained iodine, B vitamins, and a glandular to help improve thyroid function.
They ignored the immune system itself. Right?
That’s the ROOT CAUSE of your thyroid problem.
And even if you don’t have Hashimoto’s, you still have inflammation and hormone imbalances brought on by congestion in your liver, a viral infection, or even low blood sugar.
At my office, we recognize this.
So at the same time as we are balancing hormones, and not just your thyroid hormones, we are analyzing your steroid hormones, including cortisol and DHEA and all the reproductive hormones like estrogen, testosterone and progesterone.
We are also balancing your immune system.
Therefore, we have been extremely successful with autoimmune thyroid cases.
If we win the immune battle, you will feel normal again: you’ll have more energy and your digestive issues as well as your brain fog will disappear.
Before I tell you about our unique approach to modulate the immune system, let’s talk about the traditional treatment used in most autoimmune conditions.
Whether you are diagnosed with rheumatoid arthritis, lupus, myasthenia gravis, multiple sclerosis, or Hashimoto’s, the basic medical treatment is steroidal cortisone shots, immune suppressing drugs, or surgical removal of the gland where possible, as with a thyroidectomy.
The current medical approach favors immune suppression, which is an attempt to dampen the attack against the target tissue.
Unfortunately, this model creates many side effects and is not clinically effective. And as you are probably aware, with Hashimoto’s, usually the immune treatment is…NO treatment at all. They just completely ignore the immune issue.
If you want to save yourself a laundry list of side effects from the immune suppressing drugs and you want to avoid completely shutting down your immune system, you need an approach that is centered on specific immune evaluation.
The immune system has two primary components:
When you have a cold or the flu (or an infection) it is the TH-1 that will respond first. It will mount an immediate response against foreign elements such as bacteria or parasites, environmental compounds, and toxins.
The cells involved in the TH-1 system are called macrophages, natural killer cells, and cytotoxic T Cells.
They comprise our front-line defense.
The other side of our immune system is our T-Helper 2 (TH-2). The TH-2 involves the production of antibodies that are supposed to assist by “tagging” these foreign elements so our TH-1 system can more easily recognize and neutralize them.
These tags are called “antibodies.”
Antibodies are like footprints: they are evidence of activity.
If you think of the TH-1 and TH-2 as ants and elephants, it is almost as if there is an overly dominant HUGE elephant (TH-1) that has gone rogue over a particularly tiny, weak ant (TH-2) colony, and the only evidence they were there is the remaining high count of ant footprints.
This madness creates imbalance.
Before we can begin to modulate the immune system, a very specific evaluation must be done.
I call this my forensic workup.
Autoimmune thyroid sufferers start with some sort of genetic susceptibility that predisposes them to the disorder.
At some point the genes for the disease “turn on” and the destructive immune attack against thyroid tissue begins.
Possible triggers that are known to “turn on” autoimmune attacks in general are:
1. Environmental compounds—things like heavy metals, pesticides, etc.
2. Endocrine imbalances and hormone changes
3. Chemical exposures & exposures to molds
4. Stress responses
5. Antigens (food toxins, stealth infections, coronavirus.)
6. Leaky gut
Any number or combination of these factors combined with some genetic susceptibility can “turn on” the autoimmune response and lead to the slow, gradual destruction of your thyroid cells by your own body.
MY THYROID EVALUATION
I start with a comprehensive thyroid panel, including antibodies, to see exactly what the source of the thyroid problem is.
There are over 30 different patterns for thyroid dysfunction.
You can spend months or years learning each one, and the result is that there are really only two treatments.
One treatment is to take a pharmaceutical drug that will (hopefully) change the output of the thyroid hormone.
The other is to balance all the hormones, including the immune system, and then identify what is triggering an autoimmune attack.
Autoimmunity is the most common, affecting 9 out of 10 people.
We rule this out first.
Then we look at conversion pathways, nutrient deficiencies and so on.
We then run laboratory panels to look at blood sugar disorders, hormone regulation, anemia patterns, and adrenal dysfunction.
These things play a crucial role in thyroid function.
From the information we derive through the blood workup, the comprehensive thyroid panel, the specialized hormone panels and neurological assessments, the forensic testing, and so on, we are going to devise an all-natural treatment plan to support you.
We develop specific nutritional strategies and natural remedies based on our workup.
Most importantly, we can do this without all of the side effects of immune suppressing drugs.
Long-term success necessitates that we remove any triggers that are flaring up your immune response.
Triggers that may be involved include:
- Food Sensitivities
We will run additional lab testing to determine if there are foods that create an immune response. This is not the same as testing for food allergies; instead, it involves looking at the proteins in certain foods and how they affect the gut barrier.
- Iodine
Even though iodine is a very important nutrient for thyroid function and iodine deficiencies are very common across the country, iodine-containing supplements can trigger a Hashimoto’s response.
Most natural healthcare practitioners with limited understanding of autoimmune physiology insist on giving iodine supplements for thyroid conditions in much the same way as the medical community uses thyroid replacement hormones as a “blanket” treatment for all hypothyroid conditions.
- Hormone Imbalances
This is especially true when looking at estrogens throughout pregnancy. It is very common to have a woman deliver her baby and then months later get diagnosed with hypothyroidism.
A similar pattern occurs with the use of the birth control pill.
Perimenopause is another time when estrogen surges.
This is a time in a woman’s life cycle where the feedback loop between the pituitary and ovaries loses connection.
It is a consequence of normal aging whereby the pituitary no longer regulates the ovaries. In effect, the ovaries continue to produce estrogen more than progesterone.
Elevated estrogen in an environment that is already resistant to thyroid hormone is like adding gas to a fire that is already ablaze.
Hormones that have gone wild, so to speak, can inadvertently increase the autoimmune destruction. Hormones that become free-floating, with nowhere to land and no job to do, are eventually released into the bloodstream.
In the case of thyroid hormones, this will create a short-term increase in thyroid hormone levels, which will increase the metabolic activity overall, including for estrogen, and a woman will experience hot flashes, insomnia and irritability.
Hot flashes and the like are commonly attributed to estrogen, which is erroneous. It’s not estrogen surges themselves that are causing the hot flashes, insomnia, and irritability, it’s the immune attack that was promoted by the estrogen fluctuations from the menopause process that creates a temporary hyperthyroid response.
- Insulin Surges
Surges in insulin really promote the autoimmune attack on the thyroid.
The insulin surge stimulates the immune cytokines responsible for your autoimmune attack.
Insulin surges occur in patients with low blood sugar, called hypoglycemia, and in patients with diabetes or who are pre-diabetic.
Many people get checked by their medical doctor and are told that everything is okay.
I am going to tell you right now that the sheer numbers of people walking around who are unable to properly manage their blood sugar and insulin response is staggering.
With Hashimoto’s, there is a good chance there is an underlying blood sugar problem.
I could write pages and pages on the harmful effects of altered blood sugar patterns.
Suffice it to say we are going to test for this and look at functional markers that are going to let us know what is really going on.
We MUST deal specifically with these things or else you will continue to promote attacks against your thyroid and continue to suffer and feel lousy.
- Hypercortisolism
Cortisol is your body’s stress hormone.
It is produced when energy demands increase, expectedly first thing in the morning.
When there is an active stress response or a defect in your brain’s ability to modulate stress, then you will have increased cortisol production.
The increased cortisol promotes insulin resistance and therefore causes insulin to surge.
This will cause your immune attack to get worse.
We look at this from a neurological and a metabolic standpoint.
- Infections and Pathogens
There are a number of gastrointestinal infections that promote the autoimmune response.
Your gut has a huge number of healthy living bacteria that actually produce positive benefits for normal functioning.
When the balance between good and bad bacteria is skewed, called dysbiosis, it is known to promote autoimmune inflammatory responses.
We do forensic and lab testing to reveal the health of the GI system, including toxins and pernicious agents that have weakened the organs.
MY PERSONAL APPROACH
There is NO cookie cutter approach to dealing with thyroid.
You are an individual as unique as one snowflake is to a blizzard.
I treat you as a person, first.
A person with a thyroid problem, or any health issue, that needs resolving.
You might have a history of past exposures to toxins, pathogens and infections that all become part of your body burden.
This burden can be hidden.
It can reside deep in the layers of your tissues.
Until we look at this burden and all the triggers that cause and promote the autoimmune attack, there really is no chance at ever normalizing thyroid function and giving you your life back.
Sometimes this journey can be painful.
It can hurt to suffer with illness.
We deal with these problems every day, and we are very good at turning the “dimmer” down so you can begin to feel like you used to.
That probably sounds like a lot, doesn’t it?
Even if you had been lucky enough to get some of this done, the doctor who ordered your prior blood tests didn’t know what to do with you and all this information.
Not everyone needs to suffer.
We do one of the most thorough and extensive case reviews you will experience.
From your history, current presentation, and an initial consultation, we work with each individual to determine what is needed.
It is truly an individualized approach.
“And it’s worth pointing out that, in reality, NO other doctor is going to do what I’m describing to you right now. They just simply won’t do it. Why?”
One reason is they just don’t know that they need to.
Most physicians (and endocrinologists in particular) are seriously behind the times, practicing the same way today as they would in 1940s, ’50s and ’60s.
They are using a model that is outdated and doesn’t work for most people.
They’re not current on the latest scientific research (as opposed to “research” paid for by drug companies) and certainly don’t know how to use natural supplements and nutrition.
The other reason is that they and the insurance companies don’t consider this comprehensive approach and testing medically necessary.
I explain this in my seminars.
How the laboratories develop the “alert” ranges for doctors who provide medications.
Why, unless you fall outside this lab alert range, you fail to get the treatment you need.
This system is not working for most of my patients, which is why we run all the tests and develop a functional range, a pattern analysis for seeing what’s wrong.
I work with patients to make it as easy as possible to get the tests that will help improve their condition.
Some patients want the data.
Other patients just want results.
My job in this area is to facilitate the gathering of the proper information to make the appropriate changes.
I know you may not have experienced this before, but it is truly a partnership when you work with a doctor on your health condition.
That is the way it was always intended, but unfortunately medicine and healthcare in general has moved away from that.
I’ve seen some truly desperate people, patients who came to me suffering with thyroid problems but who finally got better.
They tell me how much better they are; how much happier they are now.
They can go through a day without crying from the fatigue, constant weight gain, hair loss, depression and frustration.
They thank me for being the one doctor who finally did what needed to be done to figure out how to help them.
These patients are living proof as to how “medically necessary” this kind of approach really is.
No matter what anyone else thinks or says.
The goal of the case review, consultation, and any initial testing is to tell us what your thyroid pattern is, what your immune pattern is, what your areas of weakness are (antigens, triggers and lifestyle factors) that are contributing to your health problem.
We can design a powerful, all-natural, step-by-step approach to helping you achieve your desired results.
We will most likely have many things to work on.
We will systematically create a program that is going to change the abnormal physiological shifts we measured with our testing.
We look at everything we need to up front so we know what sequence we must take to help you.
Most times we need to normalize one dysfunction before we can effectively normalize the others.
Fixing these functional immune, hormone, and metabolic imbalances should be done in the proper sequence.
“HOW WILL I KNOW I AM GETTING BETTER? WILL THIS EVEN WORK FOR ME?”
We are going to know we are making the changes we are after because we will be working together weekly or biweekly face to face.
This is necessary.
We can’t just run a bunch of tests to find out what is wrong and then do nothing about it.
We can’t see each other once every six months and hope for change.
That’s the current medical model, and it’s failing.
And no, we can’t take a few shortcuts like so many so-called health coaches are doing these days.
If you’re serious about getting to the bottom of this and ready to make the commitment to healing, then I’m your doctor.
It takes work and there are no easy solutions, but you can do it, and I’m willing to go the distance with you.
We start with hormone balancing, the nutritional component, the neurology and immune healing, and make alterations in your treatment protocol…then measure again.
Not that you won’t be feeling better as we make these changes. You will. You’ll have more energy and stamina.
We monitor progress, retest, and continue in our journey until we reach our goal.
We will make a series of changes before you start feeling better, and at every point we have labs and forensic testing and clinical experience to guide us.
You will SEE AND FEEL that things are changing in the right direction.
Based on your specific case, we are going to have a schedule of re-tests so we can make corrections and know when we need to move on to the next thing.
Sometimes we can’t normalize or fix a problem until we normalize another thing first.
No other doctor is going to do this for you.
Like I said, most natural medicine is based off NO testing, minimal testing, or the wrong testing. It is also typically outdated and old fashioned “caught in time” type advice.
Holistic practitioners and the like can make the mistake of NEVER reading the literature or updating their beliefs, methods, and practices.
They will also succumb to their own versions of Replacement Model medicine, prescribing an all-natural pill that is supposed to somehow CURE the thyroid.
Remember, my job is not to give you a pill and hope a symptom goes away.
My job is to take a step back, look at the big picture, and systematically support your physiology.
The reason no one has helped you yet is because no one dug deeper, was willing to listen, understand your problem, and take the time necessary to make changes.
“CAN I REALLY BE HELPED?”
If you are sitting here reading this, you know that your present approach to helping your thyroid problem is not helping adequately.
Honestly, I could teach a six year old to give you the current treatment you are getting.
I’d tell him to look at the thyroid labs, and if the TSH is greater than “X”, give Synthroid.
When the TSH drops down to “Y” and the patient still has symptoms, give the patient anti-depressants, because the remaining symptoms are “in their head.”
Of course, I am being sarcastic but that is exactly what I hear and see from patients every day.
You deserve better than this.
You deserve to have a doctor who listens, who understands you, who is willing to do what it takes to help you, regardless of what some out-of-touch doctor or HMO thinks.
Because it doesn’t matter what anybody else thinks, what matters is that you’re still suffering and you need someone who is going to treat you right and help you.
You are reading this because you are one of the smart few who want to take control of their health and do what it takes to help their body.
Nothing else matters when your health goes south.
I love working with patients like you because you are willing to learn about your problem, listen, and make the changes necessary to get your health back on track.
To get back to the business of living well again.
“I’M READY TO GET ON TRACK AND START FEELING WHOLE AGAIN. WHAT DO I DO?”
To become a patient takes about 3 hours and will provide you with a complete overview, a thorough exam, a functional interpretation of your existing labs, and next steps.
As we discussed, our unique approach steps out of the “medical box” so we can do what is necessary, and take the time necessary, to help YOU.
Until we know the specifics of your case, what labs we need to run, and how long we anticipate it will take to make the changes you need, there is no way to say exactly what the cost is right now, but you’ll have all the information ahead of time so that there are no surprises down the road.
Just rest assured that I am on your side.
My job is to work with you.
To help you improve your condition.
My role in your life is to deal with all the specifics of your case, listen to you, and work with you to make the proper changes.
Everything can be done in steps.
The first step is to watch my Thyroid Tutorial and download the Clinical Guides.
This information is available at www.ThyroidRecoveryFormula.com
I also recommend you attend one of my free seminars. Recordings of a few of these are located on my website www.GetWell-Now.com
Afterward, once you decide to proceed, we will send you the paperwork and set up your initial consult + in-office functional exam.
Your main concern should be getting well and feeling good again.
You have the rest of your life in this body, and you can be energetic, healthy, and enjoy it or suffer with fatigue, depression, weight gain, and hair loss.
The smartest choice is to get to the root of the problem, not get passed through the medical system, getting treated like you don’t know what you are talking about or feeling.
Ask yourself if you can afford not to get treated.
If you are honest with yourself, the answer is you CAN’T.
The hormone replacement is not addressing your immune problem.
Immune suppressing drugs are going to create long-term side effects and greater problems in the long run.
Natural support for the thyroid gland itself is futile for Autoimmune Hashimoto’s Thyroid.
There is nothing else that is going to help this problem unless we do the things I just outlined for you.
You can be one of the fortunate few who get the proper treatment and live well OR you can become another medical disaster.
The choice is yours…but the correct option is staring right at you.
It’s here.
I believe you know in your “gut” or in your “heart of hearts” that this is what you need to do.
At this point you should realize that your thyroid condition has not been managed properly or completely, and your current thyroid protocol is not going to get you where you want to go.
You really should be asking, “How can I get this taken care of?”
“How can I get the kind of treatment you describe?”
If you live near our practice in Oradell, NJ, we recommend you come to the office and meet us in person.
‘HOW DO I START?”
Every new patient we work with begins with a two visit face to face sit down like I spoke of previously.
When you are ready to schedule your first appointment, we will send you our information packet.
The forms you complete, along with past medical records, will allow us to learn about your case and your history.
We will also review all your previous lab tests.
We prefer to have you fax or mail the completed forms prior to your scheduled office visit.
This allows us to have adequate time to review your case prior to your scheduled appointment and makes our time together extremely efficient and productive.
Your consultation and case review will take approximately two hours.
During that time we are going to thoroughly discuss your case and talk about the work we do here and how to proceed.
Our main goal at this point is to obtain the information needed to make a functional diagnosis and get to the root cause of your problem.
We want you to improve your condition and we will do all we can to facilitate that for you.
How we continue our relationship after that initial appointment is up to you.
After we have completed our initial consultation and made our initial set of treatment recommendations, we will decide on our next step.
When we are working in the functional model (looking at the mechanisms for dysfunction), there are usually a logical progression of changes that we have to make in order to improve your condition.
We may identify three imbalances, call them A, B, and C.
Your case may require optimizing imbalance B before we can be effective with A and C.
What usually happens is a practitioner will ONLY ever look at imbalance C, because that is their specialty, and after two or three attempts to normalize that imbalance they will give up…with no results achieved.
Had the specialist looked at the big picture and had specific lab findings like we do, they would have known that imbalance B was the area that must be optimized before they ever had a chance to fix imbalance A or C.
We can work together to truly improve your condition.
Keep in mind that we are going to work at your pace and take the necessary steps to help you reach your goals.
TO BECOME A PATIENT
Whether you’ve tried everything and still feel lousy or your thyroid medication is failing and you don’t know why…you deserve answers.
One phone call could be the first step toward life-changing care.
If you are ready to make the change that your loved ones and you have been waiting for, then you’re on your way to getting well.
Warmest Regards,
Dr. Doug Pucci, D.C., FAAIM
Schedule your FREE Health Assessment by calling (201) 379-6502.
Or, or selecting your preferred time using my online scheduler:
Click here to Book A Time to Chat
P.S. A QUICK NOTE TO MY FUTURE PATIENT: If you’re like a lot of my patients, you’ve gone from doctor to doctor looking for answers. Or worse, you’re searching for answers on your own.
I’ve had so many patients over the years say to me things like:
“I had told my husband before I started coming here that I would was going to die. Like, if I stayed with my regular doctor I’d be dead because he kept running the same tests and telling me I was fine. That it was all in my head. Look, I’m not crazy. They just keep ignoring me.” ~Natacha W
“The doctor I went to told me that sometimes when I feel all these aches and pains and I feel tired or brain fog, and basically any symptom that is linked to thyroid, that it’s probably mostly mental. Can you believe that?!” ~Johnny M
Don’t worry, you’re not alone. All my patients hear the same things and they want the same results:
- They’re tired of being told they’re crazy, and they want to be heard
- They want all the proper testing so that at least they know what’s going on
- They want a doctor who listens and who can actually do something with the tests they receive
- And yes, they would love to have a drug-free solution to resolving their thyroid symptoms
- They all really want their health back
MY PERSONAL PROMISE TO PATIENTS
“Whereas many doctors just treat symptoms, I personally promise to focus on the reasons why you have these symptoms in the first place. Together we’ll take a journey to restore you back to health—effectively, efficiently, and naturally. With over 30 years in practice, I believe that I’ve been able to develop a groundbreaking functional diagnostic approach to chronic illness and autoimmunity that no other doctor has created. When you are accepted into one of my programs, we treat you like family. We will run all the tests, and I will personally use this information to treat you according to your unique biochemistry and individual needs.”
~Dr. Douglas J. Pucci, D.C., FAAIM
(click here for a printer friendly pdf of this article)
SO, WHY DOESN’T YOUR ENDOCRINOLOGIST KNOW THIS?
A question often raised by patients is: “Why doesn’t my physician know about the inaccuracies and limitations of standard thyroid tests?” The reason is that the overwhelming majority of physicians (endocrinologists, internists, family practitioners, rheumatologists, etc.) do not read medical journals. When asked, most doctors will claim that they routinely read medical journals, but this has been shown not to be the case. Many reasons exist, but it comes down to the fact that doctors do not have the time — they are too busy running their practices. The overwhelming majority of physicians rely on what they have learned in medical school and on consensus statements by medical societies, such as the Endocrine Society, the American Association of Clinical Endocrinologists or the American Thyroid Association, to direct treatment decisions.
Historically, relying on a consensus statement to treat or not to treat a particular patient has been shown to result in poor care and, as such, society consensus statements and practice guidelines are considered to be worst level of evidence in support of a particular therapy or treatment. A number of organizations, including the World Health Organization and others, have ranked the strength and accuracy of various types of evidence used in the medical decision process. In all scoring systems, the highest strength of evidence is randomized control trials and meta-analyses, with lower scores for other types of evidence. All grading systems place consensus statements and expert opinion by respected authorities (societies) as the poorest level of evidence, because historically they have failed to adopt new concepts and treatments based on new knowledge or new-found understanding demonstrated in the medical literature (1-6).
For instance, a recent study published in the 2009 Journal of American Medical Association studied the evidence supporting the practice guidelines and consensus statements published by the American College of Cardiology and the American Heart Association. It was found that only 11% of the recommendations, practice guidelines and consensus statements were based on quality evidence and over half were based on poor quality evidence that was little more than the panel’s opinion. The review also found that even the strongest (Class 1) recommendations, which are considered medical dogma, cited as a legal standards and often go unquestioned as medical fact, were only supported by high quality evidence 19% of the time and not revised based on new evidence (6).
Similarly, the Endocrine Society, the American Association of Clinical Endocrinologists and the American Thyroid Association also have a long history of guidelines and recommendations that are not supported by the medical literature and fail to adjust or abandon recommendations when new understanding and knowledge contradicts their recommendations. A case in point is the recommendation by these societies that a normal TSH adequately rules out thyroid dysfunction, despite massive amounts of literature that demonstrate this not to be the case (see Diagnosis of Hypothyroidism [1]) or that T4 only replacement is adequate for most patients. A doctor who simply follows outdated society treatment guidelines that relies on a simple laboratory test and ignores the clinical aspects of a patient is not practicing evidence-based medicine. (1-7). Such doctors may be adequate as lab technicians, but as doctors and clinicians they fall short (1-7). This method of practice is consistently rebuked as improper and poor medicine, but has become the standard used by a large percentage of endocrinologists and physicians who feel medicine can be related to simply reading “normal” or “abnormal” in a laboratory column.
Discussing the lack of scientific basis of most medical society’s consensus statements and treatment guidelines in Internal Medicine News, Dr. Diana Petritti, states, “Expert opinion and consensus statements can be quite misleading when used as the basis for a practice. Expert opinions imply that there is something that the experts know that clinician doesn’t know. I don’t think it’s always appreciated that it’s only opinion. There is a tendency to make guidelines and recommendations seem authoritative. I believe that physicians think that there is a great deal more behind authoritative recommendations than there might be when you lift the lid of the box and see what’s underneath(8).”
Is Your Doctor Ignoring the Science?
There has been significant concern by health care organizations and medical experts that physicians are placing too much reliance on consensus statements and failing to learn of new information presented in medical journals. Thus, they lack the ability to translate this new information into treatments for their patients. The concern is that doctors fail to practice evidence-based medicine, erroneously relying on what they have previously been taught and on “expert” societies instead of changing treatment philosophies based on new information as it becomes available. This is especially true for endocrinological conditions, where physicians are very resistant to changing old concepts of diagnosis and treatment — despite overwhelming evidence to the contrary — because it is not what they were taught in medical school and endocrinology residency.
This concern is particularly clear in an article published in the New England Journal of Medicine entitled “Clinical Research to Clinical Practice: Lost in Translation” (9). The article was written by Claude Lenfant, M.D., Director of National Heart, Lung and Blood Institute, and it is well supported. He states that there is great concern that doctors continue to rely on what they learned 20 years before and are uninformed about scientific findings. According to Dr. Lenfant, medical researchers, along with public officials and political leaders, are increasingly concerned about physicians’ inability to translate research findings in their medical practice to benefit their patients. He says that very few physicians learn about new discoveries from reading medical journals or by attending scientific conferences; thus, they lack the ability to translate new knowledge in the field into enhanced treatments for their patients. He states that a review of past medical discoveries reveals how excruciatingly slow the medical establishment is to adopt novel concepts, noting that even simple methods to improve medical quality are often met with fierce resistance. “Given the ever-growing sophistication of our scientific knowledge and the additional new discoveries that are likely in the future, many of us harbor an uneasy, but quite realistic suspicion that this gap between what we know about disease and what we do to prevent and treat them will become even wider. And it is not just recent research results that are not finding their way into clinical practice; there is plenty of evidence that ‘old’ research outcome have been lost in translation as well (1).”
Dr. Lenfant discusses the fact that the proper practice of medicine involves the combination of medical knowledge, intuition and judgment and that physicians’ knowledge is lacking because they don’t keep up with the medical literature. He states that there is often a difference of opinion among physicians and reviewing entities, but that judgment and knowledge of the research pertaining to the patient’s condition is central to the responsible practice of medicine. “Enormous amounts of new knowledge are barreling down the information highway, but they are not arriving at the doorsteps of our patients. (9).”
These thoughts are echoed by physicians who have researched this issue as well, such as William Shankle, M.D., Professor, University of California, Irvine. He states, “Most doctors are practicing 10 to 20 years behind the available medical literature and continue to practice what they learned in medical school….There is a breakdown in the transfer of information from the research to the overwhelming majority of practicing physicians. Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not (10).”
This view is echoed by the Dean of Stanford University School of Medicine who states that in the absence of translational medicine the delivery of medical care would remain stagnant and uninformed by the tremendous progress taking place in science and medicine (11). This concern has also received significant publicity in the mainstream media. An example is an article by Sidney Smith, M.D., former president of the American Heart Association, published in 2003 in the Wall Street Journal entitled Too Many Patients Never Reap the Benefits of Great Research. Dr. Smith is very critical of physicians for not seeking out available information and applying that information to their patients, arguing that doctors feel the best medicine is what they’ve been doing and thinking for years. They discount new research, Dr. Smith says, because it is not what they have been taught or practiced, and they refuse to admit that what they have been doing or thinking for many years is not the best medicine. He states, “A large part of the problem is the real resistance of physicians…; many of these independent-minded souls don’t like being told that science knows best, and the way they’ve always done things is second-rate (12).”
The National Center for Policy Analysis also expresses concern for the lack of ability of physicians to translate medical therapies into practice (13).
A review published in The Annals of Internal Medicine found that there is clearly a problem of physicians not seeking to advance their knowledge by reviewing the current literature, believing proper care is what they learned in medical school or residency and not basing their treatments on the most current research. The review found that the longer a physician is in practice, the more inappropriate and substandard the care (14). Thus, it is not a surprise that the scientific evidence as expressed in the literature is often opposite to what is continually repeated as dogma by most physicians and those considered to be “experts.”
Another example is a study published in the Journal of the American Medical Informatics Association (15). In reviewing the study, the National Institute of Medicine reports that there is an unacceptable lag between the discovery of new treatment modalities and their acceptance into routine care: “The lag between the discovery of more effective forms of treatment and their incorporation into routine patient care averages 17 years.” (16) In response to this unacceptable lag, the Business and Professions Code passed an amendment relating to the healing arts. This amendment — CA Assembly Bill 592; An Act to Amend Section 2234.1 of the Business and Professions Code — states: Since the National Institute of Medicine has reported that it can take up to 17 years for a new best practice to reach the average physician and surgeon, it is prudent to give attention to new developments not only in general medical care but in the actual treatment of specific diseases, particularly those that are not yet broadly recognized [such as the concept of tissue hypothyroidism, chronic fatigue syndrome and fibromyalgia] (17).
The Principals of Medical Ethics adopted by the American Medical Association in 1980 states that a physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public (18). This has, unfortunately, been replaced with a goal of providing merely “adequate” care. The current insurance reimbursement system in the United States fosters this thinking, as the worst physicians are financially rewarded by insurance companies. While it is true that the best physicians are continually fighting to provide cutting edge treatments and superior care that the insurance companies deem not medically necessary, even these physicians eventually get worn down and are forced to capitulate to the current system that promotes substandard care. This was clearly demonstrated in a study published in the March 2006 edition of The New England Journal of Medicine entitled “Who is at Greater Risk for Receiving Poor-Quality Health Care.” The study found that the majority of individuals received substandard, poor-quality care, and that there was no significant difference among different income levels or whether or not the individual was covered by insurance. It used to be the case that only those in low socioeconomic classes without insurance received poor-quality care. But insurance company restrictions on treatments and diagnostic procedures have made the same poor care afforded to those of low socioeconomic status the new standard-of-care for society at large (19). An example of this is a physician’s failing to spend the time to adequately assess a potential hypothyroid patient and instead simply does a TSH test.
Most physicians will satisfy their required amount of continuing medical education (CME) by going to a conference a year, usually at a highly desirable location that has skiing, golf, boating, etc. Physicians are rarely monitored as to whether or not they actually showed up for the lectures or went skiing instead. One must also understand that the majority of conferences organized by medical societies are in fact sponsored by pharmaceutical companies. These payments by pharmaceutical companies are called unrestricted grants, so that the society has free reign to do what they want with the money and thus can claim there is no influence of lecture content by the companies. The problem, however, is that if the society wants to continue getting these “unrestricted” grants, they must think twice about providing content that the sponsoring pharmaceutical company might disapprove of. Consequently, ground breaking research that goes against the status quo and does not support the drug industry receives little attention.
Evidence-based medicine involves the synthesis of all available data when comparing therapeutic options for patients. Evidence-based medicine does not mean that data should be ignored until a randomized control trial of a particular size and duration is completed. A physician who tries to avoid the need of being a physician and is fine with just being a technician or health care provider will adamantly defend the “one-size fits all” method of diagnosis and treatment. But the best doctors who truly practice evidence-based medicine and not merely the perception of such will not rely on consensus statements to best provide their patients. Instead of relying on old dogma, the best physicians will seek out and translate both basic science results and clinical outcomes to decide on the safest, most efficacious treatment for their patients. Further, the best physicians will continually assess the current available data to decide which therapies are likely to carry the greatest benefits for patients and involve the lowest risks.
References
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2. Guirguis-Blake J, Calonge N, Miller T, Siu A, Teutsch S, Whitlock E., “Current processes of the
U.S. Preventive Services Task Force: refining evidence-based recommendation development”.
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3. Barton MB, Miller T, Wolff T, et al. “How to read the new recommendation statement: methods
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4. CEBM > EBM Tools > Finding the Evidence > Levels of Evidence http://www.cebm.net
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5. Atkins D, Best D, Briss PA, et al. (2004). “Grading quality of evidence and strength of
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Internal Medicine News 2009;42(7):1,8.
9. Lenfant C, New England Journal of Medicine, “Clinical Research to Clinical Practice: Lost in
Translation” 2003;349:868-874.
10. William Shankle, M.D., Key Note Presentation. International Conference on the Integrative
Medical approach to the Prevention of Alzheimer’s Disease. Oct 11, 2003.
11. Phillip Pizzo , M.D., Stanford Medical Magazine. Stanford University Scholl of Medicine.
12. Begley S., “Too Many Patients Never Reap the Benefits of Great Research” Wall Street
Journal, September 26, 2003.
13. “Science Know Best,” Daily Policy Digest. National Center for Policy Analysis, Sept 26, 2003.
14. Niteesh. C et al., “Systematic Review: The relationship between Clinical experience and
quality of health care,” Annals of Internal Medicine.
15. Balas, E.A. 2001,” Information Systems Can Prevent Errors and Improve Quality,” Journal of
the American Medical Informatics Association 8 (4):398-9.
16. National Institute of Medicine Report, 2003b
17. BILL NUMBER: AB 592 AMENDED BILL TEXT; AMENDED IN ASSEMBLY APRIL 4, 2005,
INTRODUCED BY Assembly Member Yee FEBRUARY 17, 2005 . An act to amend Section 2234.1 of
the Business and Professions Code, relating to healing arts.
18. The Principals of Medical Ethics adopted by the American Medical Association in 1980.
19. Asch SM et al., “Who is at Greater Risk for Receiving Poor-Quality Health Care,” New England
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Article printed from National Academy of Hypothyroidism: http://nahypothyroidism.org
URL to article: http://nahypothyroidism.org/why-doesn%e2%80%99t-my-doctorknow-
all-of-this/