Hypothyroidism: a TV diagnosis to remember

To the Editor: One evening in February 1974, my fellow endocrinologist Don Gutteridge phoned me to tell me about an ABC television program that I had missed. It had featured an interview in Perth with Sir Richard Kirby, recently retired as Australia’s chief judge in industrial relations. He was showing typical signs of advanced thyroid deficiency. He had slow, coarse speech, periorbital oedema, sparse scalp hair, and was “not as sharp as a chief judge should be”. Don had phoned him at his hotel to discuss the diagnosis. The judge’s response was that he did indeed have symptoms including marked cold intolerance and he had coronary artery disease. Don firmly advised him to have his thyroid tested as soon as possible and in addition he wrote to Sir Richard’s Melbourne physician pointing out that caution was needed when starting thyroxine therapy if the patient had heart disease. Later a Christmas card arrived: “Sincere thanks for a timely telephone call and advice to an old stager who was in need and did not know it … I’m on the treatment and ever since have been a younger, newer and better man.”