Each and every day of the year I receive an alert from PubMed of new entries. These usually identify new papers which mention "thyroid". Sometimes they have next to no interest but quite astonishingly frequently they are relevant and potentially useful.
What I think few people realise is the sheer scale of this effort. Today's alert email contains 27 references from around the world. If that happened every day it would mean 9855 papers a year. (I think it must be quite close to that but the numbers do tend to drop a bit on Boxing Day. ) OK quite a number are not worth looking at. But may do contain at least some nuggets.
No - of course I don't read them all! No-one could. And a lot of the actual papers are behind "paywalls" which means that we cannot access them.
It seems important to me that when doctors dismiss thyroid issues as simple - the old "take a little white pill every day" and all will be well - they should see this. If it were that simple, there wouldn't be this scale of research. And even this is nowhere near enough.
To give anyone who is interested a taste of the alert emails, I have posted one here:
hi rod , this just goes to show the FULL extent of ' the thyroid problem ' , and also that no-one actually has been able to pinpoint all the causes ,effects and correct treatments for the myriad of other problems ,both medical as well as psychological that can and often are affected by these conditions as well as exasperated by the conflicting treatments given out by the proffesion . just my thoughts on this matter .....alan x
Yes STTM really says what most of us know already but we need scientific backing in order to get T3/NDT put on the 'approved' list of medications for thyroid illness.
Yes thank you Rod! Have saved but not read as yet! My late husband was involved in thyroid research and then brain peptides so I do appreciate the depth of research. The only name I recognise that crops up frequently is someone from Rotterdam who has stayed with us in the past. I'm seriously thinking of trying to contact him to see if he can point me in some sort of direction! Last year I saw he was editor of a European Endogrinology Journal. So wish I had noted the details. With so much experimental work done on animals though it takes years before it is linked with humans and clinical trials are allowed. My husband worked with mainland Europe, South Africa and USA so good to know that it's a worldwide thing as well. Just wanted to point out that it takes so long to reach this stage and that Big Pharma should be financing such things!
Your forever delving advisers are trying to get the matter sorted out. Just to say that we're trying to get our final paper on the matter past the dunderheads who are posing as objective referees in the journals and then will produce an overarching review bringing everything together. We've found a basically new paradigm to explain the control of thyroid function.In essence what it says is that a) TSH doesn't just control the thyroid; it controls T4-T3 conversion in the other body tissues as well. b) In athyreotic people - posh for having no thyroid working - a good proportion cannot convert enough T4 into T3, because the thyroid contribution of T3 is missing and the shortfall can't be made up by some people, without resorting to direct T3 intake. Many people can get by with T4 if they are good converters but some can't. 3) TSH works on the tissues by promoting T4-T3 conversion; so if you are a poor converter and try to treat yourself with T4 only, then you will try more and more T4 in vain, suppressing your TSH and actually inhibiting the very enzymes in your tissues that are trying to do the conversion. In a sense therefore, in such people T4 is acting like a "poison" in that more and more does less and less. Put simply, those who can use T4 only are on one side of the mountain going up and those who can't are on the wrong side of the mountain going down.
Having once been involved with someone trying to get a paper refereed, I can understand some of the frustration. In that case, the annoying referee was more upset by a split infinitive than any of the actual content.
We have seen several cases where as people descend into hypothyroidism, especially autoimmune, their FT3 initially rises as their FT4 falls. Could this be caused by TSH rising?
Is there a possibility of anything other than TSH affecting conversion rates? A TSH analog, if you like. Whether this would be possible as some form of treatment regime or, what really crosses my mind, whether some other substances could be affecting conversion rates by acting in the same way, or in the opposite way, to TSH.
Does the glycosylation of TSH affect its influence on conversion?
The imbalance between a failing thyroid, rising TSH and the tissue response could temporarily cause a fluctuation in FT3. If the complexity of the many interactions are true, then I'm quite willing to think there may be a substance X-TSH crosstalk in the tissues - nobody knows. Re the glycosylation of TSH again nobody knows, if only because the TSH-tissue crosstalk has only now been found. Regarding rT3 - the problem with this is that it both responds to excess T4 and to nonthyroidal illness. If you have a significant comorbidity - ie illness then the body goes into a semi-fasting mode where the rT3-T3 balance is switched to the former to spare the body while the disease is active. So you have to distinguish this from T4/T3 treatment modalities. We haven't therefore brought rT3 into the argument. It is an advance enough to connect TSH directly with the conversion in the tissues.
This seems to describe what happens to me with t4. I have my thyroid but I don't think it works very much, if at all. T4 does in fact feel like it is "poisoning" me.
It is also interesting what you say about TSH regulating conversion. My TSH is always below range, even when my T4 is also below range. This may, if I am understanding you correctly, explain why I feel so bad on T4 but feel well on T3. It may also explain why it took so long for them to reach a diagnosis. I am, unfortunately, not getting anywhere regarding the reason for my low TSH.
Many years ago, I was warned about those "dunderheads who are posing as objective referees" and told never to submit a paper with my full name but only use my initials and surname. Apparently they didn't take female physicists seriously. They are not as objective as they would have people believe. I sincerely hope you manage to get through to them. Your work is very important and could have a huge impact on thyroid treatment if given a chance. We are lucky to have people like you getting to the bottom of the thyroid mystery.
Excellent description of how I felt on T4, Diogenes. T3 calms the adverse effects I experienced on T4 only and I feel I'm on the right side of the mountain now, although not near the top yet.
Very interesting Rod - do you remember how Prof Colin Dyan of Cardiff was mentioned in that paper article recently saying the difference between NDT and T4 is placebo because he'd done the research? I wondered if anyone had come across his research??
Saravanan P, Dayan C M. Understanding Thyroid Hormone Action and the Effects of Thyroid Hormone Replacement - Just the Beginning Not the End. Hot Thyroidology.
Thank you Rod. as you say, and also a good reminder from one of the articles I scanned about our tendency to atherosclerosis. To that end I searched a few papers on how to reduce both pharmacologically and naturally...ended up at low glycemic diet and allicin. So it's garlic powder for me
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) OK quite a number are not worth looking at. But may do contain at least some nuggets.
