Push for Thyroid screening by experts in UK could treat 100,000 cases as a result.

[tegz]

This article found whilst looking at the recent 'Pulse' post about over diagnosing UAT- so it's rather apposite to post it now, to cheer you all up.

Chances of anything happening- who knows? - but in the right direction, for a change.

pulsetoday.co.uk/screening-...

[lynx]

pulse-learning.co.uk/clinic...

This might be worth looking at as well.

[tegz]

Looks good- but I don't want to sign up

[rosetrees]

I signed up a few weeks ago. So I've completed my CPD model on hypothyroidism. Clearly, if the GMC ever catch up with me my licence to practice as a GP will be revoked and I'll be struck off. (In case of doubt, I have no medical training of any kind).

That module includes these two conflicting statements on the SAME PAGE (aplogies for shouting)

1) "The only validated test for thyroid function is the measurement of serum thyroid stimulating hormone (TSH) and free thyroxine (T4) and hypothyroidism is confirmed by an increase in serum TSH above the upper limit of the normal reference range.

Many labs routinely only report serum TSH but if it is abnormal, they will usually also give FT4 levels"

2) "Diagnosis of hypothyroidism

Overt hypothyroidism

TSH over 10 mU/l

FT4 below reference range

Subclinical hypothyroidism or mild thyroid failure

TSH 5 to 10 mU/l

FT4 normal

Secondary hypothyroidism

TSH low/low-normal

FT4 low"

Give the statements in 1) it seems clear that secondary hypothyroidism will never be diagnosed, yet they acknowledge its existence.

Explanations on a postcard, please.

[rosetrees]

I will almost certainly be struck off now. I have just sent this email to Pulse. I couldn't resist. Sorry.

"Reference pulse-learning.co.uk/clinic...

On this page you explain that: "The only validated test for thyroid function is the measurement of serum thyroid stimulating hormone (TSH) and free thyroxine (T4) and hypothyroidism is confirmed by an increase in serum TSH above the upper limit of the normal reference range. Many labs routinely only report serum TSH but if it is abnormal, they will usually also give FT4 levels"

Further down, under Diagnosis Of Hypothyroidism you state: "Secondary hypothyroidism,TSH low/low-normal,FT4 low"

Given the previous statement on TFT, could you please explain how a diagnosis of Secondary hypothyroidism should be made?"

[tegz in reply to rosetrees]

Fair enough point- it's called logic. Maybe they'll get to try it one day ...