Our advisers have now written another paper discussing the thyroid function tests and how they should look at all the tests for a diagnosis, not just the TSH. Dr Midgley explained to me, "In summary what it shows is that combining TSH, FT4 and FT3 values together for each patient is a more accurate way of diagnosing and distinguishing patients in normality and abnormality."
Let's hope the medical community start looking at diagnosis in this way sooner rather than later.
I hope this is taken up by the Endocrinology to forward the appropriate care urgently needed by many on this forum. This part, for me, stood out:-
This demonstrates that statistical analytic techniques heavily influence current TSH-reliant thyroid disease classification. Hence, joint application of the dual roles of TSH as a sensitive screening test and an accurate diagnostic tool becomes highly questionable and consequently the roles must be separated from each other. The current classification of the disease entities of subclinical hypothyroidism or hyperthyroidism, which is solely based on abnormal TSH values when thyroid hormones concentrations remain within their respective reference ranges, seems no longer tenable (31, 32). New markers for clinical endpoints or tissue-based definitions of thyroid function are therefore urgently needed. Over-reliance on TSH as a gold standard has long impeded the advancement of the field, since the first doubts were raised and disagreements emerged on the setting of the reference intervals (34–54). While sole reliance on TSH must therefore be scaled back, good clinical practice taking into account the full history and symptoms displayed by a patient has to be re-instituted as a primary tool (65, 66).
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