From Pulse-Learning. How (not) to diagnose thyroid problems.

[rosetrees]

I've been working my way through a CPD module on pulse-learning.co.uk - all about the diagnosis and treatment of thyroid issues. You have to despair if this is what our GPs are taught. Here are two quotes from the test and post test assessment.

The first is from a page on the diagnosis on hypothyroidism. The SAME PAGE contains both of the following statements:

1) How should hypothyroidism be diagnosed? .......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.

(Then, further down the same page)

2) Secondary hypothyroidism. TSH low/low-normal FT4 low

(It seems clear to me that on the basis of 1) a diagnosis of secondary hypo cannot be made as if TSH is low-normal it cannot go "above the upper limit of the normal reference range", FT4 will not be tested and the patient will be pronounced not to have hypothyroidism.)

The second quote is from the post test assessment. This time referring to auto-immune thyroid conditions. The question asked is "which of the following statements on thyroid antibodies are CORRECT - tick all that apply"

It's question 3. There are four suggested answers and one of them is this:

"It is worth testing for thyroid antibodies if a diagnosis of over hypothyroidism is in doubt"

Apparently the correct answer to this question is "no" as (and I quote) "it is only worth testing for thyroid peroxidase antibodies in patients with subclinical hypothyroidism as their presence increases the risk of progression to overt hypothyroidism."

If anyone doubts what I've said, I have uploaded the screenshots and you can see them here aboutmy.me/quotes/

I've emailed Pulse twice for clarification on the first one. Not surprisingly, I haven't received and answer.

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Thanks for posting