The Thyroid Gland: Cures, Fallacies and Fixes by S. Yurkovsky, MD, C. 2001 All rights reserved

“I just cannot believe this medication could make such a tremendous difference in the way I feel, both mentally and physically!” This grateful exclamation belongs to a woman who suffered for years from chronic fatigue, depression, severe sensitivity to cold with Raynaud’s disease, constipation and dry hair and skin. In addition, she had a family history of thyroid disease. She had been seen by many doctors and was told “there was nothing wrong with her.”
It appears in view of such a classical presentation that it would be absolutely superfluous to confront an informed reader with an obvious home-run
question: What “this medication” was? Sorry, it was none of the fashionable thyroid cures, but just the opposite – quite unpopular and very “unsexy” with a scary name on top, cortisone, prescribed by her physician in a low dose that happened to turn this woman’s life around.
To make this clinical puzzle more intriguing perhaps, one may only add that many patients with similar symptoms have benefited after being treated for a variety of other problems: lead or mercury toxicity, parasitosis or Candida related complex, severe physical injury or depression, hypothalamic or pituitary dysfunction, adrenal insufficiency and thyroid problem as well. Indeed some of these successes have been reported in popular health related publications and witnessed as well by many alternative or conventional practitioners in their practices.
It has been in fashion lately to have the public diagnose themselves by scoring a certain number of symptom points through questionnaires offered in popular health books. These books make a firm case of – candidiasis or mercury toxicity, food allergies or parasitosis, weak adrenals or nutritional deficiencies. The “right treatment” is offered whenever the “passing number of points” is scored. This
,process resembles conceptually one dropping the right number of coins into a soda machine followed by an emergence of the can in the form of a “correct” medical diagnosis. A few might have benefited for a season from this “soda machine” approach, the majority, however, failEid or the symptoms kept returning and other, worse diseases developed while on the “right treatment.”

The main reason for the opening quiz in this article is to emphasize how precarious it is to seek “ready” solutions based on an isolated similarity in some features or findings under the circumstances where the true roots behind them remain essentially unknown.
One of the leaders amongst these merry-go-round “solutions” has become thyroid hormonal therapy. This has been popularized lately in the way of a “very special” (of course) drug through another health book -Wilson’s Syndrome. The deceptive nature of this “thyroid miracle” lies in the fact that, there is indeed some true correlation between the superficial features described and suboptimal thyroid function.
The purpose of this article is to emphasize that in thyroid, as well as other chronic conditions, the roots of the more fundamental underlying bio-energetic states are the ones that result externally in these similarities in features that are
referred to as diseases. This approach, in the experience of this author, has been far more powerful and rewarding than engaging in senseless match-making between a pile of symptoms and the means aimed at their mere annihilation.
Let us examine first, if only briefly, the physiology ofthyroid hormones and their dependence on the numerous and diverse components within the body.

Physiology of the thyroid system

The thyroid gland produces two main hormones – T4, which is largely inactive, and T3 which possesses full physiologic activity. This process is being closely controlled by the thyroid’s two chief
“supervisors” residing in the brain, pituitary and hyPothalamus, through the feedback loops whereby hypothalamus, upon sensing a certain level ofT3 in the blood, secretes an appropriate amount of TRH – thyrotropin releasing hormone to either stimulate or slow down the pituitary gland in its own production of TSH – thyroid stimulating hormone. The TSH in its turn does the same to the thyroid gland depending upon the amount ofTSH produced. It must be emphasized that the piiuitary runs its own double checking system in case its superior, hypothalamus, fails.
The pituitary samples content ofT3 in its own circulation from a conversion of inactive T4 into active T3 which it carries, out within its own ceUs.1’hethyroid gland, when stimulated by theTSH uses iodine, protein and amino acid tyrosine to produce enzymatically about 90% of the T4 and onlyl0% ofT3. As one can tell from this ratio, prevailing T4 hormone by and in itself is insufficient to ,meet the metabolic needs of the body as its cells call primarily for active T3 hor,mone. So, another physiologic network’ ‘system takes over and assures that with the aid of cortisone secreted by the adrenal glands, a proper conversion ofT4 into T3 takes place in the liver and kidneys through their special enzymes. In the process of this conversion a small amount, we may call it a waste product, is being produced – reverse T3 which does not possess any physiological activity.
The mere, even if normal, production ofT3, however, does not complete the task, for the sole presence of hormones circulating in blood, and for that matter nutrients, is not sufficient by and of themselves to exert their physiologic funct on unless they connect properly with their main target – cells. There the T3 has to get through cellular, membranes and connect with the receptors of energy producing organelles – mitochrondrla and of cell nucleus. In order to complete the list of all the participants of the thyroid system, one has to include another major player – a network of about 15 cytokines. The cytokines are one of;ihe,hottest items, in contemporary medical research and represent hormone like substances known to modulate a broad rlUfge of physiologic functions. Some oftheIll playa key role in the immune systeIll (Interferons, Interleukines, Tumor N rosis Factor etc.) and are lplown to have, direct impact on hypothalamic – pitui!wY – thyroid axis, They also are capable Of blocking T4-tT3 conversion. As a consequence, blood levels of some cytokines have” been found to be inversely related to concentration of active T3 hormone.

To summarize this, the main components of the thyroid system are:
Hypothalamus Pituitary Thyroid gland and its enzymes Iodine and protein supplies Liver and its enzyme Kidneys and their enzyme. Adrenal glands and glucocorticoids Cytokines network Cellular membranes Mitochondria Cell nuclear receptors.

What are the physiologic effects of thyroid hormone?
Thyroid hormones activate over 100 cellular body enzymes which assure the multitude of functions. Among them are: proper energy production and metabolism, tissue oxygenation, synthesis of protein and breakdown of fat and carbohydrates, normal mineral exchange within cells, stimulation of insulin production and other functions. Since all of the body cells are dependent on these properties, most of the major organs and tissues contain within their cells, receptors for thyroid hormones. Brain, heart, lungs, adrenals, gastrointestinal organs, testes, ovaries, muscles and other tissues all owe much to thyroid hormones for their normal functioning. That is why the symptoms that are related to a malfunctioning thyroid system could be very diverse and virtually endless. They may include depression and anxiety, insomnia and fatigue, cardiovascular and weight problems, frequent infections or hypo and hyperglycemia, high cholesterol and sensitivity to cold, malabsorption resulting in dry skin, breaking nails and osteoporosis, numerous hormonal dysfunctions with low libido and infertility in both sexes or retarded growth in children and so on. In addition, the countless secondary effects of a sluggish thyroid system will arise, due to fluctuations in blood sugar or low body temperature or even body pH, which will all impair the function of multiple enzymes in the body.

What’s the fuss?
The question that arises is that if people suffer from what is perceived as classical symptoms of hypothyroidism, and their blood tests show decreased concentration of thyroid hormones, indeed what is the fuss and why not just bump
them up with thyroid hormones and keep things simple? The fact is that in the majority of such cases thyroid therapy is administered an4 this is not an issue. The true issue centers around millions of people who do manifest seemingly typical symptoms of hypothyroid state yet “refuse” to back it up somehow with thenthyroid blood tests which usually read as being “in the normal range” or on “the low side.” .
This strange phenomena has drawn attention for more than 30 years of numerous experts – endocrinologists and thyroid specialists. Because of this mysterious disparity between the presence of classical symptoms of hypothyroidism in the absence of abnormal thyroid tests, and the fact that this picture has been observed in the presence of other acute and chronic diseases, it has been named Sick Euthyroid Syndrome or NTIS – the Nonthyroidal lllness Syndrome.’ Several decades ago, one of the dedicated thyroid experts, Broda Barnes, MD, was the first to advocate the administration of glandular thyroid extract containing actual thyroid hormones T4 and T3, known as Armour Thyroid, to these patients, and reported many beneficial outcomes. He quite correctly suspected that the medical technology and scientific knowledge in any era were always limited (even though many doctors feel this is not for public ears), and he proposed to use only clinical symptoms and a low basal body temperature as indicative of decreased metabolic rate. This, he believed, was sufficient to justify thyroid replacement therapy. As time went on, and some advancements were made in lab machinery, more data concerning the mystery was accrued. Yet, it has not settled the issue and instead only has fueled the controversy further around the cornerstone question “to treat or not to treat”?
The proponents of the treatment with the T4 or T3 hormone use sound arguments that, particularly in the acute care settings,patients who demonstrated lower thyroid blood levels had very high mortality rates. These were primarily those with the concomitant signs of hypothalamic – pituitary insufficiency. The opposition objects and points correctly at possible dangers of T4 or T3 administration, claiming that low thyroid status is not a disease, but a protective compensatory mechanism on the part of the body to lower its metabolism in order to shelter itself from high metabolic demand of thyroid hormones under the circumstance of limited energy and nutritional reserve. The studies conducted so far on humans and animals when treated with either T4 or T3 in acute care settings’ turned in mixed and confusing results. The outcomes varied as the therapy showed either no difference, reduced or even increased mortality rates. Both sides agree that maximum caution is to be exercised in the decision-making concerning the use of thyroid hormones in these settings.
A few years ago, Denis Wilson, MD proposed a simple solution in his aforementioned book to treat the chronic patient group based on the same criteria as Dr. Barnes,’ but only with his “special” active T3 hormone alone. He also, rather unceremoniously from the point of view of the established scientific proprietai-y criteria, attached his name to this syndrome well-known for decades. The only” convincing scientific” explanation he offered for this bold act was “I have taken the liberty to name it Wilson’s Syndrome… ”
We will return to his clinical rationale behind this “simple solution” further in the course of this article, but before we are to arrive at any solution we need to address a very important concept that pertains to this subject. Since we are
dealing with a claim of scientific discovery, alleged by Dr. Wilson, we need to acquaint ourselves with the means of analyzing these discoveries before judging this or the myriads of other “lifesaving medical breakthroughs” that we are flooded with these days.

Science or fiction?
The best way to evaluate properly any information presented, be it the latest medical discovery in the news or educational information, in spite of the seeming plausibility and appeal of the data presented, is subjecting it to a filtering process that has been in use for a long time in science and is known as the scientific discovery process.
This process has been established by the scientists in order to sort out the true and valid scientific facts and theories from the erroneous, shaky, and fly by night ideas.
This, along with the proper understanding of statistical laws, govern any peer review analysis that takes place within the scientific community in considering publications which claim either scientific propriety or validity. The scientists scrutinize the data through well-defined stages in a justified attempt to protect the integrity of scientific knowledge. One of the necessary prerequisites is to uncover any flaws in the material under review.
Among other facts they examine, are the main objective ofthe material and the legitimacy of a discovery in question. Perhaps, the data supports the allegation of being a true discovery; perhaps, just the opposite reveals the evidence as being “borrowed,” maybe it aims to only confmn or refute someone else’s accepted prior hypothesis or theory. Also, the variablescomponents that were chosen for the experiment to solve a problem in question – are analyzed. The overall value of these components is assessed in relation to Qthers that the experimenters or authors were either unaware of or chose to ignore. The reviewers examine the accuracy and integrity of the data produced.
Was there any bias, omissions or factors introduced or removed, intentionally or unintentionally, that might have impacted on the outcome? They also examine the integrity of statistics submitted to make sure they have not been “fudged.” Attention is paid, depending upon the field involved, if these results are reproducible and applicable, particularly in medicine, in the long or only short term. They determine how this discovery or hypothesis fits into the global body of recognized scientific knowledge to rule out a conflict. A discovery then, unless rejected, is being granted a certain scientific weight depending on its overall contribution to the field. This depends on whether it is to playa preeminent role in science, one that establishes global laws of nature called fundamental laws, or perhaps it discovered a new unknown prior field of knowledge, or simply added another piece of useful, or marginally useful information or even one of uncertain value. Sometimes a hypothesis can neither be proven nor disproven due to technological limitations of time.
Last but not least, within what working model or paradigm, as may be the case in medicine, (pharmaceutical, bio-energetic medicine, etc.) is a discovery, applicable? It is only with some of these considerations in mind that one can objectively and intelligently analyze a medicinal substance, intellectual contribution, or even entire specialties within medicine – conventional ‘and alternative alike. Only through this solid scrutiny can one tell to what extent the claims are able to hold up or crumble. With, this criteria mind we must return to reexamine our subject of thyroid “cures.”

What went wrong in the thyroid house?
One of the main reasons we identified: , the main components of the thyroid’ system and their mutual interdependency is to also emphasize that in a given, individual, actual breakdowns may take place in any number of them. The causative factors behind them are multiple and diverse too.
This article cannot logistically attempt to offer their exhaustive account, but only render a brief overview and a far more effective and versatile algorithm toward their correction. This, I wish to emphasize, always has to be carried out as with any disease state, in a strictly individualized way.
Let us begin where most of the contemporary research allocates the main trouble – cells which in the. “thyroid patient” are not receiving quantitatively, or I may add qualitatively, their proper share of thyroid hormones. What are the main reasons?
They are several. One of them is the physical alterations of cellular membranes and nuclear receptors. Here the preeminent role belongs to metals and heavy metals, including the whole array from dental sources, with the precious metals among them. If one compares clinical symptoms of hypothyroidism and toxicological effects, as an example, lead, mercury, or amalgams, one will find a striking similarity indeed. In addition, the destructive effects of metals on the cellular structures, including those of the endocrine organs, are well documented. The same agents commonly invade the thyroid gland itself and interfere with the proper production of thyroid hormones, or induce if only minute alterations in their molecular structure, turning them into “strangers” which are no longer well recognized by the body cells.
A variation in production volume of thyroid hormones may be quite subtle also, so that the blood tests will read them as being within the still “normal range,” yet, this concentration may be below physiologic normal range for that individual. The same rule is applicable to the hypothalamic, pituitary and adrenal hormonal outputs. Speaking of these, they may also enter a stage of subclinical, (Le., undetectable by the lab tests) exhaustion imposed by preexisting undue stress. The sources might be emotional or physical, let it be head or body injury, chronic allergies or infections, anxiety or poor diet and a lack of sleep. In addition, even normal functioning pituitary gland may partially ignore insufficient T3 supplies in the peripheral body cells that are
blocked by the metals, while the pituitary, which is partially protected from them by the brain blood barrier, is being fooled by its own samplings of normal T4 – T3 conversion within its own structure.
Liver arid kidneys and their enzymes, as a rule, are always impaired by metals or xenobiotics at times, and fail as a consequence to carry out normal T4 – T3 conversion.
These and other stressors will also impair the adrenal glands which will fail to maintain a proper concentration of glucocorticoids (cortisone) throughout the 24-hour cycle. Lab tests that rely, as a rule, on one or two samples obtained in a given moment usually miss these deviations. Here again the “normal ranges” lead to dismissal of a problem.
Chronic inflammations or infections which as a rule are rampant in chronically ill or “sub-healthy” people, V’.’ith the latter constituting practically 100% of the American population, lead to a rise of the cytokines, which levels have been found inversely related to T3 concentration. The incidence of infectious diseases such as candidiasis, parasitosis, chronic viral or bacterial infections is also rampant and commonly eludes laboratory detection too.
In addition to the metals and xenobiotics, other factors such as ionizing radiation from medical and dental X-rays, particularly received in childhood, protein deficiency reaching epidemic proportions due to poor gastrointestinal absorption and low consumption of red meat, thanks to the cholesterol hysteria, energetic blocking effect oftonsillectomies, all have an adverse impact on the thyroid gland itself. Many nutritional supplements that contain cruciferous vegetables and soy recommended for daily supplementation may add further, if only mild, inhibiting effect on the already compromised thyroid gland. In addition to protein deficiency, drastic caloric reductions that often accompany the countless yo-yo and weight-loss diets, will also force the body to turn down T4 T3 conversion – its metabolic thermostat. ‘
If in light ofthe information presented, we are to examine now a “thyroid cure” proposed by Dr. Wilson, we will find the myriads of weak, ill conceived, unclear or missing links all together. As this has been the case with many other medical “solutions,” the theory contains only a very limited number of the vital componentsvariables to be of much value.
Dr. Wilson for one, somehow managed to neglect just about the entire thyroid system and merely zeroed in on insufficient T4 – T3 conversion component aloIJ.e, suggesting also that this conversion, no matter what else took place, suffers exclusively because of the accumulated reverse T3, and that is what constitutes the core of this illness.
Firstly, the scientific literature has documented the variety of abnormalities besides T4 – T3 conversion in this condition that was studied in the intensive care hospital settings. Some pointed to the malfunctioning hypothalamus as the most significant culprit, some to insufficient pituitary output, others to low T4 levels, altered thyroid cellular nuclear receptors or high output of glucocorticoids.
Secondly, nowhere in the literature was I able to find that the reverse T3 is:;o. real villain instead of being just another victim along this aberrant metabolic chain, nor that it is the one that hampers T4 – T3 conversion at all or exclusively. Only one study referred to an experiment where reverse T3 had an adverse impact after it was injected into animals in artificially induced hemorrhagic shock. Under such a circumstance, one might think of many substances if injected, as lacking a favorable response. This alone cannot serve as proof that reverse T3 has anything to do with chronic patients suffering from NTIS. Dr. Wilson does refer to this idea entertained by another doctor as a speculation, yet he managed to seal it somehow into a legitimate and solid scientific theory. Indeed, in many ofthese patients the blood tests demonstrated normal reverse T3 levels too. As much as Dr. Wilson took pride in proposing to treat the real causes, but not the symptoms of NTIS, I was personally quite puzzled as to what he regarded as the real causes.
He mentioned some nationalities whose ancestors knew famine, but whose ancestors didn’t? Then he mentioned people being under high stress, but who isn’t? As far as stress is concerned, without making light of it, in many people this issue resembles one of a flu epidemic. Is it the epidemic that makes people sick or are they sick in the first place and that is why they are susceptible to the epidemic? The latter version is undoubtedly far more common. The other causes he mentions are just as nonspecific and vague. They concern drug and alcohol addictions, and that child abuse somehow also results in T4 – T3 conversion problem and increase in reverse T3?!
The main diagnostic tools he uses. are the famous questionnaire point scoring method and low basal body temperature. The basal body temperature depends on many components of the entire thyroid system and changes normally with aging. According to Chinese medicine, the “Middle Burner” and especially its constituents, liver and large intestine, are the main producers of body heat. Of course, if other organs of the Middle Burner are “cold or damp” as it is commonly the case with spleen and kidneys, the net output of heat will be decreased. In. the majority of toxic conditions (xerlobiotics, metals, infections and vaccines) the Middle Burner organs are always impaired,
As a solution to the problem, Dr. Wilson proposes using his “special T3” where one is yet to see any single scientific evidence confirming his claim that “it is much better” than a regular and far less costly T3-Cytomel. . .
In order to back uphistherap’eutic theory, he cited a study where T3, (and by the way not his “special” one), proved to be beneficial in experimental animals. Yet, he neglected to also render a more balanced review of the scientific data indicating that other experiments did not demonstrate any positive difference, or just to the contrary, yielded detrimental outcomes from the administration ofT3. Likewise, the experiments with positive results due to the administration of either T4 or TRH alone were silenced.
Dr. Wilson recommends cycling process, ie., repetitive administration of “special T3” until an alleged excess of reverse T3 is diminished and the thyroid system thereby becomes normalized. He claims symptomatic success in 5,000 patients. Yet, in spite of presenting such a large and exact number of patients, he neglected to mention how many of these patients remained permanently restored after this cycling, and how many found themselves needing endless recycling or becoming dependent on it altogether. He also noticeably avoided a very important issue of the long term outcomes, side effects and failure rates.
Other essential questions that were not raised either concerned the expected side effects of the active and very potent T3 hormone in relation to the suppression of a patient’s own hypothalamic-pituitarythyroid axis, and also desensitization of T3 thyroid receptors in response to their own T3. These expected side effects are real and do undoubtedly lead to the suppression and deterioration of the patients’ own metabolism and its dependency in the long run on the “special T3.”
On the whole, such a style ofreporting is not, unfortunately, unique and is wellknown as selective reporting of data that represents the most common form of deception in science. This reporting pattern is very common in medicine which is not an exact science. The human being is a complex system consisting of innumerable components and in addition is genetically diverse. AB a consequence, there are myriads of drugs, fads, techniques, tests or specialties, even if of marginal value, that can produce some isolated positive responses or findings. They are reflected generously in the scientific studies that are published in the most prestigious peer review journals concerning the latest drug or procedure, or just the claims companies use to promote products and medical equipment or even at educational events. They all fly high at their displays, but just about all have a crash landing in practice.
Getting back to Dr. Wilson’s book and the clinical indications for the thyroid cure, he did not spare any imagination and appeared to have copied just about the entire disease section of a medical textbook with a listing of about 200 maladies listed on the front cover to make sure that the folks will get the point. If this had been the case, such a discovery would be well worthy of a Nobel Prize in medicine, but unfortunately, most ofthese claims are just naive.
As we come to the last stage of analyzing this theory it is incumbent upon us by the scientific discovery process, to examine the data concerning the reproducibility of results. As it has been mentioned in the course of this article, Dr. Wilson himself avoided the issue of failures in his own practice. In the absence of any other documentation available on the subject, I can only cite my own unfortunate clinical experience, in the past, in following exactly Dr. Wilson’s T3 protocol and the experience of other alternative physicians whose patients I saw. With rare exceptions the side effects were the rule and the hormone had to be discontinued. The most common side effects were jittery feeling, insomnia, increased appetite and heart palpitations. Undoubtedly, in the long run osteoporosis or adrenal insufficiency would follow. This is ofinterest since all ofthese patients did appear to have symptoms of hypothyroidism and low basal body temperature.
The reason for this – besides the diverse roots of this condition already mentioned – is the fact that the T3 receptor sensitivity may vary from tissue to tissue and also T3 uptake varies too in different organs. In addition, as it has
been discussed before, these patients have multiple endocrine abnormalities and adrenal insufficiency is one of the most common ones. Very often, when a thyroid hormone is given to these patients, their adrenal glands are incapable of responding to the increased metabolic demand, particularly imposed with the pure T3, and thus resulting in the depletion of glucocorticoid (cortisone) reserve and in a compensatory rise of adrenaline. The detrimental impact ofthe latter and its contribution to premature aging is well-known.

What to do with the thyroid puzzle?
In a nutshell, the state that sustains the puzzle should be changed. This can be done only through the use of skillful Bio-resonance testing conducted in the proper, deep algorithm aimed at the identification of only the most important toxicants and their target organs. Any “red herring” fmdings that are often “fished out” through this testing must be ignored, since they are only the by-products, but not the true causes of the state. A therapeutic program must be composed accordingly: deep, encompassing, safe and effective. The main objective is liberation from the state, not dependency on the fixes. For the general details on this subject, the reader may refer to prior . articles published in this journal by this author. As a rule in the last several years, with the exception of the patients who had
undergone thyroidectomies, I did not have to dispense a single dose of thyroid hormones, no matter how classical the symptoms were. In addition, in numerous patients of this category, under the Bioenergetic approach, their own thyroid medications that had been taken for years were substantially reduced and in the majority discontinued. This took place without any ill effects as the overall and substantial progress in general health followed.

Just a few of the many examples:
A middle-aged woman recently presented with a high score on the “low thyroid” questionnaire and requested to change her “no good synthroid” to “special T3.” These were her 1i.ctual symptoms copied directly off the questionnaire: choking sensation in the throat, hypoglycemia, fatigue, irritability, fluid retention, anxiety and panic attacks, muscle and joint aches, dry skin and hair, perspiration abnormalities, carpal tunnel syndrome, unhealthy nails, dry eyes and blurred vision. Only after a few Bioenergetic testing – treatment cycles, all of her symptoms started rapidly dissipating and her synthroid dosage melted away. There was and there would be no need for the “special T3.”
Another example, a middle-aged woman with chronic anxiety, low energy, freezing all her life, high cholesterol- over 300, and on a blood pressure medication for 21 years.
In spite of her classical low thyroid symptoms, the thyroid therapy was hot administered, but instead the underlying state was addressed. The end result: chronic anxiety is gone, energy level is normal, cholesterol has dropped by 100 points without the “low- cholesterol diet,” and she has been off the blood pressure drug for more than a year. As far as her
body temperature, “it used to be that everybody else felt warm and I was the only one always freezing at work. This winter I am the only one who is hot and they all keep bundling up.”
Another young woman, a classical textbook hypothyroid case, treated in the past by alternative doctors with many things, including thyroid hormones, ended up only with further weight gain from thyroid medications. After only one
treatment, aimed at her underlying state, all of her symptoms improved dramatically, including an impossible prior weight loss. She lost 12 lbs in 4 weeks.
As I share this with my students, when patients inquir-econctirning the “right treatment for my condition,” the only proper and honest answer one can give is “I don’t know.” This is regardless of what one reads in the books or what helped “the same conditions” in others. One may add, however, “but we can find out with the help of Bio-energetic testing. “I ,wish to conclude this article with a phrase of Dr. Wilson’s, which I cannot ‘agree with more: “however…it is generally preferable to remain off medicine when possible.”
Well said, doctor.

S. Yurkovsky, MD
SIT Integrated Health Systems,’ Ltd. 516-333-2929 .
Fax 516-908-3961 .

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