We've had another paper accepted by the European Thyroid Journal which will be published shortly. In brief, it proves that in healthy people, before thyroid problems arise, each person has their own setpoint in the normal ranges of TSH, FT4 and FT3. An individual does not have different results at different times, that might cover the whole range, but persists with their own narrow range that typifies them as a unique person. Therefore if a subject has a result outside their setpoint but still in range it could mean that a thyroid stress is taking place even if they are not openly hypo or hyper. Furthermore, when patients get thyroiditis, and the thyroid is damaged but not yet treated, they still show their individualism in the setpoint but at a lower level, as you'd expect for a damaged gland producing less hormone. Only when they are frankly hypothyroid and then treated does this basic difference in setpoint show up in their unique response to treatment. The higher in the range the FT3 when well, the more likely is a patient to require T3 as additional treatment when thyroid disease strikes. So the paper points out the wholly individual nature of people and the resulting need to treat them as such in thyroid hormone treatment as required. Finally, this finding strongly supports the idea, which was written into the paper, that everyone should have at (say) 20 years old or perhaps sooner, a FT3 and FT4 measured when perfectly healthy, to be stored as information to help the doctor use appropriate treatment early when needed, knowing where in the ranges the healthy subject was originally. Of course whatever one does, some people will get thyroid disease before any chosen age, but at least this approach would help the majority. No doubt the cost of doing it will be raised against this, but the social cost of misdiagnosis , wrong treatment over time, and inability to work in my opinion far outweighs that.
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