A drug-company sponsored campaign is being promoted by several medical groups for January 2005's thyroid awareness month. Their primary message is, per a press release,"the brand of thyroid hormone medication should always stay the same."

In contrast to this message, Shomon's own 2005 Thyroid Patient Advocacy Campaign proposes awareness of the "4 D's of Thyroid Disease": Disseminate, Diagnose, Doctor and Demand. Details are outlined at http://www.thyroid-info.com/campaign2005 online.

1. Disseminate TSH Standards

Most physicians consider the thyroid stimulating hormone (TSH) test essential for thyroid disease diagnosis and monitoring. In 2002, key groups, including the National Academy of Clinical Biochemistry/Academy of the American Association for Clinical Chemistry, and American Association of Clinical Endocrinologists indicated that doctors should follow a far narrower normal range of .3 to 3.0, versus the former margin of 0.5 to 5.0 to. Yet here it is, 2 years later, and almost all U.S. labs still follow the old TSH range, many doctors don't know about the new range, and even when aware, many doctors refuse to diagnose thyroid problems when the lab doesn't "flag" test results as abnormal. Even a patient who tests positive for hypothyroidism with a TSH of 4.0, therefore, won't be diagnosed and treated.

Says Shomon: "Millions of people in the hypothyroid range of 3.0 to 5.0 are still being told they have normal TSH results and aren't treated. There's no justifiable reason for such slow dissemination of information critical to the health of so many."

2. Diagnose The Overlooked Millions

Thyroid symptoms can include fatigue, weight changes and depression. Because the condition is more common in the elderly and women, and symptoms are common to other conditions, many people are misdiagnosed, given antidepressants, or told that the symptoms are a "fact of life," instead of tested for thyroid problems.

People with undiagnosed thyroid disease suffer greatly. Undiagnosed, untreated thyroid conditions increase the risk for heart disease, obesity, depression, stroke, hypertension, miscarriage, stillbirth, birth defects and retardation, infertility, and many other serious health problems.

Says Shomon: "If we're going to effectively reduce this 50% undiagnosed rate, doctors need a refresher course on the prevalence of thyroid disease, the potential symptoms, risk factors, and how not to overlook or misdiagnose thyroid problems. Only then will the millions of undiagnosed get the proper testing, evaluation, and treatment they desperately need."

3. Doctor the Patients, Don't Just Read Lab Test Values

Even when treated, many thyroid patients still do not feel well. Some surveys have found that up to 75% of patients on thyroid hormone replacement have unresolved symptoms despite "normal" TSH levels. Among patients being treated, an estimated 40% of patients still have TSH levels outside the "old" TSH normal range. These findings mean there is a long way to go in properly treating hypothyroidism.

When it comes to thyroid disease, says Shomon, "the experts need to get back to some old-fashioned doctoring of patients. This is not a cookie-cutter disease with a one-size-fits-all treatment. To help each patient feel his or her best, a doctor first needs to find the right dose, the right brand, or the right prescription thyroid drug."

4. Demand Truthful, Unbiased Information

Finally, Shomon urges patients to demand unbiased answers from doctors, insurers, HMOs, professional and patient groups, despite the growing economic pressures these groups face due to cost controls, and drug company funding and influence.

Says Shomon: "We are their clients, their members, and dues-payers -- we deserve truthful information that help us live and feel well. Their job is to help us get well, not to prevent us from getting needed tests, or promote and protect market share for favored brands of thyroid drugs."