A question may be raised: "Do doctors know all of this?". The answer is yes if they don't rely on what they learnt 20 years ago. The answer is yes if their heavy daily activity leaves them time to get informed about recent studies and scientific findings. In other words: "Are the enormous amounts of new knowledge arriving at the doorsteps of their patients?". The answer is yes if they are open to change treatment philosophies as new information become available. The answer is yes if they give attention to new developments of treatment modalities, 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 with TSH in "normal" range, estrogen dominance, adrenal fatigue, chronic fatigue syndrome and fibromyalgia.
TSH in the standard should not disqualify a thyroid condition, and treatment of hypothyroidism is not uniform, contrary to common usage. Medicine is an art and art is not always covered by conventions. Like fibromyalgia which treatment is not just antidepressants, analgesics and hydrotherapy, all useful but leaving most patients dissatisfied, taking the standard treatment of hypothyroidism is often ineffective. To be successful, treatment of hypothyroidism should appeal to a global strategy tailored to everyone who will take into account the autoimmune component.