Ranges: Hi, waiting at home for visitors, my mind... - Thyroid UK

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Ranges

Gcart profile image
Gcart
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Hi, waiting at home for visitors, my mind wondering.

Thinking about ranges and how they are used by doctors.

Very simple analogy, average height is about 5'8" so range about 4' 11"- 6'4"

So, now we have a running race, all those 4'11" against those who are 6'4".

Surely those with the longest legs will probably winπŸ˜‚

Why, I ask myself do they all not use optimum as the aim for best outcome.

Guided by those on this site its now the thing I aim for, I shall also make a point of suggesting πŸ€” best practice to doctors I may encounter.

Not sure if I should post this

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Gcart
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18 Replies
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shaws profile image
shawsAdministrator

It's fine to post anything you like - obviously within the guidelines :)

Doctors are badly trained in that they believe once on levothyroxine (which is the only one to be prescribed in the UK by NHS) anywhere in the range is fine and many stop increasing. Wrong - the aim for the patient is to have a TSH of 1 or lower and a FT4 and FT3 towards the higher end of the range - rarely are these tested.

Levothyroxine is T4 only. It's job is to convert to T3. T4 is levothyroxine (thyroxine) and T3 is liothyronine. T3 is the only Active hormone which is needed in the billions of our receptor cells, the brain contains the most and heart depends on it to function normally. Sometimes too low a dose and we feel our heart acting up a bit. Too much and it will be too fast and we'll feel hyper.

I don't think height or weight can be used for 'optimum' as some people need quite low doses and others need higher ones, particularly if someone is Thyroid Hormone Resistant. I think that once diagnosed we don't really need many blood tests as it is how the 'dose' affects us and once raised high enough to eliminate symptoms, that's our optimum and we feel well. :)

in reply to shaws

And we should all be tested when well to find our healthy golden number, that is different for everyone, so that if we succumb to thyroid problems then meds can be prescribed until that magic number is reached. I really, really mean this. It would save the NHS and worldwide personal cost traipsing backwards and forwards to surgeries feeling ill and coming up against so much grief. Not to mention the knock on illnesses thyroid problems cause that then need to be treated. Of course the human cost in lives half lived and the effect on families is more important.

SeasideSusie profile image
SeasideSusieRemembering in reply to

Absolutely agree. I wonder how much a TFT costs a surgery. It would be so good to have a baseline.

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

I think you could probably ask your surgery, CCG, lab or whatever - if necessary make a formal Freedom of Information Act request for the information.

If you do, it would be good to know - even though it is likely to vary across the UK.

And happy birthday!

in reply to SeasideSusie

Β£36, buttons!

nbt.nhs.uk/sites/default/fi...

SeasideSusie profile image
SeasideSusieRemembering in reply to

I think I've found it for peanuts.

From page 4 of

ncbi.nlm.nih.gov/pmc/articl...

"The local cost of a standard TSH test is Β£1.67 (to which must be added the costs of phlebotomy, transport, and clinic time). Nationally, 10 million thyroid function tests are requested each year, at a cost of over Β£30 million to the NHS."

North East Lincolnshire Β£1.68 for TSH plus FT4 if required.

North Devon Β£0.97 for TSH plus FT4 if required (cost in 2015/16)

Then I stopped looking.

No real financial reason not to bring in some kind of routine baseline testing when compared to the cost of some other services offered.

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

FT3? :-)

SeasideSusie profile image
SeasideSusieRemembering in reply to helvella

I didn't see FT3 on any of the lists I looked at. I did wonder why.

Clutter profile image
Clutter

GCart,

Poor training and lack of understanding. Unfortunately many doctors think anywhere within range, no matter how low or high, is good and don't consider individual requirements within those ranges. My optimal FT3 is >4.5 in a range 3.5 - 6.5 but others would feel very symptomatic and require FT3 6.0 - 6.5 to feel well so our optimal is very different.

SeasideSusie profile image
SeasideSusieRemembering

That made me laugh Gcart :D Random thoughts can be very funny. I'm picturing my late aunt and uncle, he was 6'2" and she was 4'10". His shoe size was 14, hers was 2. Thank you for bringing back some lovely memories for me today, it's my birthday and I'm on my own except for the dog and some Ferrero Rocher (present :D ).

Enjoy your visitors.

beh1 profile image
beh1 in reply to SeasideSusie

Happy birthday! 😘

SeasideSusie profile image
SeasideSusieRemembering in reply to beh1

Aww, thank you 😚

in reply to SeasideSusie

Happy Birthday πŸŽ‰ 🎈 🎈 🎈 You have just described my mum and dad SeasideSusie, mum was also 12 years older than dad.

SeasideSusie profile image
SeasideSusieRemembering in reply to

Thank you Hidden I hope your mom and dad were as happily married as my aunt and uncle, they were married for over 60 years.

shaws profile image
shawsAdministrator in reply to SeasideSusie

Many happy returns SeaSideSusie and you've had some happy unexpected memories as well. Dog will enjoy watching you eat your Ferrero Rocher.

SeasideSusie profile image
SeasideSusieRemembering in reply to shaws

Thank you shaws 😊

I'm just about to open the Ferrero Rocher 😁

Dog spark out, she knows I don't share anything so she doesn't bother asking (meany doggy mom πŸ˜‚ )

webar4780 profile image
webar4780

Happy Birthday!!

SeasideSusie profile image
SeasideSusieRemembering in reply to webar4780

Thank you webar4780 πŸ˜„

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