by Marwa Arfaoui
Guest Middle Eastern Patient
The situation of thyroid patients in the Middle East may not seem any different from that of other thyroid patients around the world. At least this is what conventional medicine seems to think.
The challenges thyroid patients from Arab countries are facing are in some ways different than those thyroid patients in other countries are facing, despite the similarities. In fact, even with the attempts of some Arab countries to develop the field of medicine, build hospitals, educate doctors in Europe and the US, and implement a well-developed
Living in the Arab region means that you belong to the Third World where health care and medicine are not on the same level as in the West. Here, countries are either poor or still in the process of development, which results in a great number of their citizens remaining undiagnosed, either because they can’t afford it or because of the lack of awareness about thyroid disease in the region. But most of all because doctors are still reluctant to acknowledge their suffering.
To get a full insight into the treatment of various thyroid conditions by Arab doctors one should know that: in all Arab countries, without exception, hypothyroidism is treated exclusively with Synthroid. Doctors focus only on the suppression of TSH levels, which they believe is the most important part of treating hypothyroidism. They take for granted that all hypothyroidism patients are capable of converting T4 to T3 hormone. They don’t even bother to test Free T3 and Free T4 levels apart for some exceptions, but in general they don’t concern themselves with the issues of conversion and absorption or resistance of the body to Synthroid.
Here in the Middle East, doctors do not believe in the importance of the thyroid hormone T3. This means that they don’t believe in any other alternative to Synthroid. For them, Synthroid (Levothyroxine) is the best replacement that has ever existed. It will solve all patients’ health problems, and if they suffer from symptoms it must be “in their minds”. In addition, there is still not a single lab in the Middle East that tests for Reverse T3. All doctors use what they call the “French protocol” to treat hypothyroidism, which consists of testing TSH and replacing only with the T4 hormone, especially in the Arab countries of North Africa. They don’t use T3 therapy, or the combined therapy of T3 and T4 together, or Natural Desiccated Thyroid.
But what about autoimmune thyroid disease such as Hashimoto’s thyroiditis? First of all, it is rarely diagnosed because doctors don’t test antithyroid antibodies that often. The vast majority of Hashimoto’s patients have not yet been diagnosed. Indeed, Hashimoto’s is only treated with T4, while the immune side of the disease is totally neglected. A few doctors may give Hashimoto’s patients selenium supplements if asked.
Because Middle Eastern countries are branded as Muslim countries, people tend to think that the resistance to the use of porcine thyroid hormone is for religious reasons. In fact, Natural Desiccated Thyroid is not yet well known among all Arabic doctors, and the few who do know about it still don’t want to prescribe it. When asked why, the only answer is that they follow the “protocol” used by all doctors in their countries. Any change needs legal procedures and approval from their health ministry or the head of endocrinology. Among patients, treatment with Natural Desiccated Thyroid is not yet known either, and those who do know about it are willing to use it, whilst there are only a few patients who prefer to opt for T3 therapy due to religious reasons.
Islamic religion bans the use of porcine meat, but when the life of the person is threatened, it is allowed. The Al’Azhar, the number one religious authority in the Middle East, and some religious authorities from the Arabian Gulf like Kuwait issued a number of “fatwas” allowing the use of pork meat and organs for medical reasons. Left undiagnosed and poorly treated, hypothyroidism can be life-threatening. For this reason the controversy of using NDT is more medical than religious.
The Middle East is known for its political instability, wars and poverty. People are facing stress and depression. One of the greatest health challenges facing thyroid patients in the Arab region is depression. Unfortunately, Arab endocrinologists believe that the only way to treat depression and mental illness is to dope their thyroid patients with antidepressants. They do this without testing their thyroid hormones like Free T3 or ensuring that they are optimally treated. This is because they don’t believe in the importance of the thyroid hormone T3 for all cells and organs of the human body.
Being a thyroid patient in the Middle East means you have no choice but T4, and if your body does not convert the T4 to T3, does not absorb thyroid hormones, is resistant to them or you have an allergy to any component of T4 or inflammatory autoimmune conditions, you are forced to use T4 or hope for a miracle that will bring change to the region.
Thyroid patients around the world still face the same challenges and they are thirsty for a change, while the only difference is that outside the Arab region there are some doctors who look deep into the patient’s condition, who attribute importance to symptoms, and who are willing to prescribe T3 or NDT for those who need it.