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In 1998, Richard A. Marschall, N.D., a naturopath licensed in the State of Washington, was found guilty of unprofessional conduct on one count of diagnosing and treating an out-of-state patient without a physical examination. The charges brought against Marschall alleged that he had treated these patients for "functional hypothyroidism." The case was resolved with a consent order under which he agreed not treat out-of-state patients without physically examining them and coordinating their treatment with a health-care professional from the patient's home state. The proceedings did not address whether Marschall's diagnosis or treatment of his long-distance patients was appropriate.
For about ten years, "functional hypothyroidism" has been promoted as "Wilson's Syndrome," a term concocted by E. Denis Wilson, M.D., who practiced in Florida in the early 1990s. The syndrome's supposed manifestations include fatigue, headaches, PMS, hair loss, irritability, fluid retention, depression, decreased memory, low sex drive, unhealthy nails, easy weight gain, and about 60 other symptoms. Wilson claims to have discovered a type of abnormally low thyroid function in which routine blood tests of thyroid are often normal. He states that the main diagnostic sign is a body temperature that averages below 98.6° F (oral), and that the diagnosis is confirmed if the patient responds to treatment with a "special thyroid hormone treatment." 
In 1992, the Florida Board of Medicine fined Wilson $10,000, suspended his license for six months, and ordered him to undergo psychological testing . Although he does not appear to have resumed practice, his ideas are still promoted by the Wilson's Syndrome Foundation.
In May 1994, a local newspaper reported that Marschall had learned about "Wilson's Syndrome" by studying Wilson's publications and had consulted Wilson by phone. The article said that Marschall was treating more than 200 Wilson's Syndrome patients and that the cost of the initial diagnosis, including the blood test, was $400 . Court documents filed on September 30, 1997, by Washington's Secretary of Health state:
In March 1998, Marschall claimed that he had based his diagnosis of Patient A on laboratory records obtained from the Kaiser Foundation Hospital/Kaiser Permanente Medical Group. However, Kaiser personnel stated that the records were not requested until 1998, and Patient A stated that she had not signed any release for Marschall to get her records .
In July 1998, the Washington State Department of Health suspended Marschall's license for 30 months with the provision that he could continue practicing if he did not treat out-of-state patients without physically examining them and treating them in tandem with a health-care professional from the state where the patient resides. He also agreed to pay a $3,000 administrative fine and to permit a Health Department investigator to audit records and review what he was doing twice a year for a two-year period . The proceedings did not address whether "Wilson's Syndrome" is a genuine entity or whether the factual details in the complaint were accurate.
In 1999, the American Thyroid Association concluded that there was no scientific evidence supporting the existence of "Wilson's Syndrome."  In a strongly worded statement, the association concluded:
Note: Although "Wilson's Syndrome" -- as defined by E. Denis Wilson, M.D. -- is a bogus diagnosis, there is a Wilson's disease, a rare condition caused by a defect in the body's ability to metabolize copper.