Broda Otto Barnes
Encyclopedia
Broda Otto Barnes was an American physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 who studied endocrine dysfunction, particularly hypothyroidism
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...

. In the 1970s, Barnes published several books arguing that hypothyroidism
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...

 was underdiagnosed in the U.S. and was responsible for a wide range of health problems. Barnes' views on the prevalence of hypothyroidism were never widely accepted by the medical community and run counter to the current medical understanding of thyroid function, but they have been embraced by some elements of the alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 community.

Career

Barnes was born on April 14, 1906 in a log cabin in Missouri
Missouri
Missouri is a US state located in the Midwestern United States, bordered by Iowa, Illinois, Kentucky, Tennessee, Arkansas, Oklahoma, Kansas and Nebraska. With a 2010 population of 5,988,927, Missouri is the 18th most populous state in the nation and the fifth most populous in the Midwest. It...

, the son of Addie and Robert B. Barnes. Barnes studied chemistry at the University of Denver
University of Denver
The University of Denver is currently ranked 82nd among all public and private "National Universities" by U.S. News & World Report in the 2012 rankings....

, and became an instructor of physiological chemistry at Western Reserve University for two years, receiving his M.S.
Master of Science
A Master of Science is a postgraduate academic master's degree awarded by universities in many countries. The degree is typically studied for in the sciences including the social sciences.-Brazil, Argentina and Uruguay:...

 in 1930. Barnes received his Ph.D.
Doctor of Philosophy
Doctor of Philosophy, abbreviated as Ph.D., PhD, D.Phil., or DPhil , in English-speaking countries, is a postgraduate academic degree awarded by universities...

 from the University of Chicago
University of Chicago
The University of Chicago is a private research university in Chicago, Illinois, USA. It was founded by the American Baptist Education Society with a donation from oil magnate and philanthropist John D. Rockefeller and incorporated in 1890...

 in 1931 and taught physiology there from 1931 to 1936. He completed his M.D. in 1937 at Rush Medical College
Rush Medical College
Rush Medical College is the medical school of Rush University, a private university in Chicago, Illinois. Rush Medical College was one of the first medical colleges in the state of Illinois and was chartered in 1837, two days before the city of Chicago was chartered, and opened with 22 students on...

, and for two years he was an Assistant Professor of Medicine at the University of Illinois. He was named chairman of the Health Education Department at the University of Denver
University of Denver
The University of Denver is currently ranked 82nd among all public and private "National Universities" by U.S. News & World Report in the 2012 rankings....

. He became professor affiliate in the department of physiology at Colorado State University
Colorado State University
Colorado State University is a public research university located in Fort Collins, Colorado. The university is the state's land grant university, and the flagship university of the Colorado State University System.The enrollment is approximately 29,932 students, including resident and...

 from 1963 to 1968. On 13 September 1981 he married Helen Tucker Morgan (1905–2002) in California. She was his second wife.

In 1984, Barnes established a not-for-profit foundation, the Broda O. Barnes Research Foundation, to continue to advocate his arguments about hypothyroidism. Barnes and his wife also established a program of interest-free student loan
Student loan
A student loan is designed to help students pay for university tuition, books, and living expenses. It may differ from other types of loans in that the interest rate may be substantially lower and the repayment schedule may be deferred while the student is still in education...

s to aid "worthy and needy chemistry students" at the University of Denver. The University of Chicago
University of Chicago
The University of Chicago is a private research university in Chicago, Illinois, USA. It was founded by the American Baptist Education Society with a donation from oil magnate and philanthropist John D. Rockefeller and incorporated in 1890...

 library retains a collection of memorabilia, consisting largely of photographs related to Barnes' time there.

Hypothyroidism perspective

Barnes developed and promoted a diagnostic test for thyroid function that became known as the "Barnes Basal Temperature Test". This test is performed by placing a thermometer in the armpit for 10 minutes immediately upon waking. Barnes considered a measurement of 97.8 °F (36.6 °C) or below to be highly indicative of hypothyroidism, especially when hypothyroid symptoms are present. Barnes believed that a reading over 98.2 °F (36.8 °C) was indicative of hyperthyroidism
Hyperthyroidism
Hyperthyroidism is the term for overactive tissue within the thyroid gland causing an overproduction of thyroid hormones . Hyperthyroidism is thus a cause of thyrotoxicosis, the clinical condition of increased thyroid hormones in the blood. Hyperthyroidism and thyrotoxicosis are not synonymous...

, unless a patient had advanced arthritis, which he claimed would falsely elevate the temperature due to muscle contractions.

The details of the test were published in the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...

(JAMA) in August 1942. The test has never been adopted by the medical profession; however, it was subsequently promoted by Barnes in a series of books, and is currently advocated by some alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 practitioners. In modern medical practice, the most accurate means of assessing thyroid function is through specific biochemical tests which measure blood levels of thyroid gland hormones and regulators.

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 superior to blood tests of thyroid function. In his books, Barnes argued that hypothyroidism affected more than 40% of the American population, significantly higher than the prevalence
Prevalence
In epidemiology, the prevalence of a health-related state in a statistical population is defined as the total number of cases of the risk factor in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population...

 of approximately 5% reported in the peer-reviewed
Peer review
Peer review is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field. Peer review methods are employed to maintain standards, improve performance and provide credibility...

 medical literature.

Barnes believed that many common diseases, including heart disease, cancer, depression, arthritis, diabetes, the common cold
Common cold
The common cold is a viral infectious disease of the upper respiratory system, caused primarily by rhinoviruses and coronaviruses. Common symptoms include a cough, sore throat, runny nose, and fever...

, tonsillitis, ear infections
Otitis media
Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...

, apparent laziness in children, various menstrual disorders
Dysmenorrhea
Dysmenorrhea is a gynecological medical condition of pain during menstruation that interferes with daily activities, as defined by ACOG and others. Still, dysmenorrhea is often defined simply as menstrual pain, or at least menstrual pain that is excessive...

, and skin disorders, were all caused or exacerbated by hypothyroidism.

Treatment

Barnes treated hypothyroidism by prescribing patients a daily dose of thyroid hormone. He recommended starting with a small dose, and 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 weaned off. Barnes used a desiccated thyroid extract
Desiccated thyroid extract
Desiccated thyroid or thyroid extract, refers to porcine thyroid glands, dried and powdered for therapeutic use. As an animal product, it is not suitable for use by vegetarians. Some religious dietary laws object to the use of pork products as well, although exceptions are sometimes made for...

, Armour Thyroid, almost exclusively, based on his anecdotal observation
Anecdotal evidence
The expression anecdotal evidence refers to evidence from anecdotes. Because of the small sample, there is a larger chance that it may be true but unreliable due to cherry-picked or otherwise unrepresentative of typical cases....

 that it was superior to synthetic hormones.

During his years of practice, Barnes also began to believe that virtually all his hypothyroid patients had concomitant undiagnosed adrenal insufficiency
Adrenal insufficiency
Adrenal insufficiency is a condition in which the adrenal glands, located above the kidneys, do not produce adequate amounts of steroid hormones , primarily cortisol, but may also include impaired aldosterone production which regulates sodium, potassium and water retention...

. Based on this speculation, he routinely prescribed an accompanying dose of the synthetic corticosteroid
Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte...

 prednisone
Prednisone
Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...

. Barnes argued that it was mandatory to give prednisone to patients with a systolic blood pressure below 100.

Pregnancy mistest hormone research

In 1932, W. Fleischmann and S. Kann reported in a German gestational physiology journal that female bitterings, small carp-like fish, "...show an enlargement of the ovipositor following injection of an estrogenic preparation...".

Since human pregnancy urine contains estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

, Drs. Aaron E. Kanter, Carl P. Bauer and Arthur H. Klawans of the University of Chicago added a teaspoon of urine from a pregnant woman to a bowl in which a bitterling was swimming. This experiment produced ovipositor lengthening, as expected by reasoning from the earlier results of Fleischmann. In 1935, TIME Magazine nationally reported their announcement of this potentially useful new test for human pregnancy, which was then currently determined by rabbit and mouse tests
Rabbit test
The rabbit test was an early pregnancy test developed in 1927 by Bernhard Zondek and Selmar Aschheim. The original test actually used mice. The test consisted of injecting the tested woman's urine into a female rabbit, then examining the rabbit's ovaries a few days later, which would change in...

. But subsequent to the announcement, Kanter, et al., found that urine from non-pregnant women or men had the same effect.

Barnes was the principal investigator, with obstetricians Kanter and Klawans, in an experiment reported in 1936. They sought to determine the source organ of whatever non-pregnant urine substance was causing the same bitterling ovipositor response as Fleischmann's estrogenic preparation. Barnes, et al., extracted juice from 14 different organs of seven species (including both genders of humans) and exposed bitterlings to them. The organ they found responsible was the adrenal cortex
Adrenal cortex
Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress response through the production of mineralocorticoids and glucocorticoids, including aldosterone and cortisol respectively. It is also a secondary site of androgen synthesis.-Layers:Notably, the reticularis in...

. The Barnes, et al., 1936, publication in Science was also reported in TIME.

In 1938, Fleischmann and Kann determined that in addition to estrogen, a specific adrenal hormone, corticosterone
Corticosterone
Corticosterone is a 21-carbon steroid hormone of the corticosteroid type produced in the cortex of the adrenal glands.-Roles:In many species, including amphibians, reptiles, rodents and birds, corticosterone is a main glucocorticoid, involved in regulation of fuel, immune reactions, and stress...

, could cause the observed bitterling ovipositor reaction. This additional non-pregnant hormone reaction made the bitterling test not useful for its originally announced purpose, though it did open the door to an investigation of why corticosterone is significant in urine.
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