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protein-bound iodine test

Broda Otto Barnes

Broda Otto Barnes (April 14, 1906November 1, 1988) was an American physician who became an authority in the diagnosis and treatment of hypothyroidism. He spent more than 50 years of his life researching and treating endocrine dysfunctions, specializing in the thyroid gland.

Barnes is credited for several important discoveries in the field of endocrinology pertaining to the thyroid gland. These include:

  • developing a simple diagnostic test for hypothyroidism: "Barnes Basal Temperature Test".
  • realizing the inadequacy of thyroid diagnostic tests
  • discovering that the prevalence of undiagnosed hypothyroidism has risen to over 50% of the American population.
  • realizing the superiority of desiccated thyroid extract over synthetic drugs, in treating hypothyroidism.
  • showing hypothyroidism is a cause of other chronic diseases including heart disease.

Barnes' views were never widely adopted in mainstream medicine, yet they continue to be vigorously supported by some practitioners.

Diagnosis of Hypothyroidism

Perhaps Barnes' most celebrated accomplishment was the invention of a diagnostic test for thyroid function, now known as the "Barnes Basal Temperature Test". This test is performed by placing a thermometer in the armpit for 10 minutes immediately upon waking. A measurement of 97.8F (36.6C) or below was considered by him to be highly indicative of hypothyroidism, especially when hypothyroid symptoms are present. A reading over 98.2F (36.8C) was indicative of hyperthyroidism. (Menstruating women must take this test on day 2-4 their cycle; When using a digital thermometer, the button must be pressed at the 10 minute mark)

The details of the test were published in the Journal of the American Medical Association (JAMA) in August of 1942 ("Basal Temperature vs. Basal Metabolism"), and again in The Lancet in 1945. Though the test was not widely adopted by the medical professional as a whole, it was and continues to be enthusiastically endorsed by a minority of medical doctors and many alternative practitioners.

Barnes didn't consider his Basal Temperature Test to be 100% conclusive, and acknowledged there were other causes of lowered basal temperature. Nevertheless, he maintained that it was the most useful diagnostic test in the diagnosis of hypothyroidism, superior even to all modern blood tests. Barnes considered modern blood tests--like the Basal Metabolism Test and the Protein Bound Iodine Test--to be unreliable, leaving many patients with clinical symptoms of hypothyroidism undiagnosed and untreated. Barnes estimated in the 1980's, that the prevalence of undiagnosed hypothyroidism had risen to affect more than 50% of the American population.

Treatment of Hypothyroidism

Barnes treated hypothyroidism by prescribing patients a daily dose of thyroid hormone. He recommended starting with a small dose (1 grain for a healthy adult, 1/4 grain for children), then slowly increasing the dosage in monthly intervals until symptoms resolved. For most patients, he recommended continuing thyroid medication for life at that optimal dose, though some could be slowly weened off. He advised patients to take the thyroid medication first thing in the morning on an empty stomach, at least 20 minutes before food.

Barnes used desiccated thyroid extract almost exclusively, noting that patients experienced much better improvement of symptoms with the natural extract, rather than synthetic drugs. He claimed that the even with synthetic combination drugs containing T4 and T3, patients were left with symptoms (dry skin & fluid retention), that upon switching to desiccated thyroid extract would resolve. This observation lead Barnes to speculate that there are additional undiscovered active components in the natural extract besides T4 and T3. Modern research has revealed that T2 (diidothyronine) and T1 (monoidothyronine) are also present, thought their function is still not fully understood.

During his years of practice, Barnes also began to conclude that virtually all his hypothyroid patients had a concomitant adrenal insufficiency. Following this discovery, he routinely gave an accompanying physiological dose of adrenal steroid (Prednisone 5mg/day) together with desiccated thyroid extract. Barnes found this especially mandatory in patients showing more severe adrenal insufficiency exhibited by low systolic blood pressure (below 100).

Heart Disease

Barnes performed significant research into the cause of heart disease. During his lifetime he spent many summers in Graz, Austria, reviewing and researching autopsy reports in the city hospital. The Graz autopsy records are widely considered to be the oldest and most complete in the world, and came as a result of the decree of empress Maria Theresa of Austria over 200 years ago, that autopsies are mandatory for all hospital deaths in the city of Graz.

His study of over 70,000 of these autopsy reports spanning the war years of 1939-1945, lead Barnes to conclude that atherosclerosis--the underlying cause of heart disease and heart attacks-- was not caused by diet and cholesterol as is widely believed, but instead by hypothyroidism.

The cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods.

Barnes’ autopsy research however, showed that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—largely due to Tuberculosis--had greatly accelerated rates of atherosclerosis. Barnes pointed out that the vast majority of patents who had died would have died from a heart attack soon after if the infection had not killed them first, and furthermore that the patients were largely hypothyroid.

Barnes concluded then, that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. Thus the drop and rebound of heart attacks during the and after the war years can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics.

Barnes also conducted a multi-decade study of his own patients, that showed a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes concluded that this was due to the thorough screening for and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis.

Cancer

Barnes claimed there was a strong connection between the hypothyroidism and cancer. He often referred to research showing that tumor transfers in mice will not succeed, unless the thyroid of the receiving mouse is removed first. He also pointed out that given the thyroid's role in immunity, it should not be surprising that depressed thyroid function will depress the bodies ability to fight cancer.

Barnes' autopsy research in Graz also informed his view on cancer, noticing that specific forms of cancer exploded after World War II with the introduction of antibiotics. In particular: prostate cancer, lung cancer and cancer in children, all had over a 300% increase per 1000 deaths from 1930 to 1970--occurring mostly in the 25 year period after the war. Barnes concluded that these increases were due to the hypothyroid patient now living long enough to acquire the cancers, whereas previously they didn’t survive the infectious diseases. In the same way as heart attacks, the susceptibility to cancer and infections were concomitant, and the removal of one allowed the other to manifest.

Barnes claimed that the cancer rate in his clinic was less than 50% below average, and certain forms of cancer such as lung cancer, were totally absent.

Besides hypothyroidism, Barnes also believed that polyunsaturated fats caused cancer. He believed that polyunsaturated fats were not even fit for animals, and that when the association between polyunsaturated fats and cancer was finally exposed, it would "make Watergate look like church social".

Depression and Mental Illness

Barnes emphasized that mental illnesses are associated with hypothyroidism, especially in the more severe forms. Barnes found that depression in general was a common symptom of hypothyroidism, and was often reversible with thyroid therapy. He also noted that season depression in the colder months was a clue to a thyroid component of depression, as the colder weather puts a higher demand on the thyroid to step up metabolism to keep the body warm. Barnes had concerns that there may be patients in mental institutions who are in fact hypothyroid, but improperly diagnosed.

Hypertension

Barnes also noticed that a great number of patients with pre-existing hypertension would normalize after thyroid therapy. After reviewing his records, he estimated that thyroid therapy was effective in normalizing blood pressure in approximately 85% of his hypertension patients.

Arthritis

In Barnes' experience, virtually all patients with arthritis have hypothyroidism. Barnes claimed to have tremendous success in treating arthritis with thyroid therapy, particularly in combination with Predsnisone (5mg-10mg/day). This lead Barnes to conclude that the adrenal glands play an important role in the development of arthritis.

Diabetes

After many years of practice, Barnes also realized that though he had many diabetic patients, he had not seen virtually a single diabetic complication in his practice. This, along with his previous research into heart disease, lead Barnes to believe that 98% of diabetic patients have a concomitant hypothyroidism. And, when the hypothyroidism in diabetics is properly treated with desiccated thyroid extract, it prevents the atherosclerosis that leads to the various complications seen in diabetics.

Hypoglycemia

Barnes discovered that 95% of his patients suffering from hypoglycemia, would normalize after proper thyroid therapy. Barnes concluded that in hypothyroidism, the liver is sluggish and unable to meet the demands of converting glycogen to glucose when required, causing blood sugar to drop. By restoring the metabolism of the liver with adequate thyroid, it was then able to properly normalize blood sugar levels.

Migraine and Other Headaches

After treading a co-worker for hypothyroidism with desiccated thyroid extract, Dr. Barnes was pleasantly surprised when the co-workers' chronic migraine headaches resolved almost completely. This convinced Dr. Barnes that there was a connection between hypothyroidism and chronic severe headaches including migraines, and he proceeded to successfully treat many patients in the same manner over the years. Dr. Barnes claimed a success rate of 95% in treating patients suffering chronic headaches with thyroid therapy. He hypothesized that the swelling that often occurs in hypothyroidism likely elevated the pressure inside the head, leading to these headaches.

Susceptibility to Infection

Barnes noted that a common feature of Hypothyroidism is a general susceptibility to infection. All infections were more prominent including: sinus infections, respiratory infections, bladder infections etc. Barnes found that when patients hypothyroidism was corrected, their resistance was substantially raised and infections were far less common. Barnes claimed to use antibiotics only 1/10 as much as other physicians because of the proper treatment of hypothyroidism in his practice.

Menstrual Disorders and Infertility

In Barnes experience, vitually all menstrual disorders were related to hypothyroidism, and would resolve under thyroid therapy. The early and late onset of menses also were highlighted by Barnes as symptoms of low thyroid function.

Barnes claimed a high rate of success in treating infertile couples with thyroid therapy. He claimed that most infertile women would become fertile under thyroid therapy, but a small fraction also required adrenal support, usually in the form of Prednisone (5mg/day).

Skin Disorders

Barnes found that many skin disorders would resolve with thyroid therapy including: acne, dry skin, psoriasis, excema, skin itching & scaly skin. Barnes noted that skin circulation was reduced to as much as 1/4 to 1/5 of normal in advanced hypothyroidism. With this lowered circulation, there is a lowered nourishment and a lowered removal of waste products, leading to lowered resistance and a wide variety of skin diseases.

Pregnancy testing

The bitterling was shown to respond to hormones in a pregnant woman's urine, but the work was later discredited.

Legacy

In his last years, Dr. Barnes established a not-for-profit foundation to continue the legacy of his research: Broda O. Barnes Resarch MD, Research Foundation, Inc. .

Publicatons

External links

Books Endorsing Dr. Barnes

Recent books endorsing Dr. Barnes philosophy on diagnosing and treating hypothyroidism:

Doctors Supportive of Dr. Barnes Philosophy

Dr. Jeffery Dach, M.D. Dr. Mark Starr, M.D. Dr. David Brownstein, M.D. Dr. Michael Schachter, M.D.
Dr. Stephan Langer, M.D. Dr. Theresa Hertoghe, M.D. Dr. Thierry Hertoghe, M.D. (late) Dr. Jacques Hertoghe, M.D.

References

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