A few days ago, Dr Melvin Leow published an article describing a mobile app for continuous monitoring of thyroid treatment and dose adjustment as a personalised computer-driven assessment. This can be accessed via:
Thyroid-SPOT for mobile devices: personalised thyroid treatment management app
put into Google. There are admitted limitations and I think it might struggle with those not on T4 only, but at least it gives some advance in releasing the individual doctor from his/her arbitrary decision-making based on poor understanding of the problem. Its a start to a least unifying diagnostic procedure.
There is hope that someone thinks it worth going down this route. Just hope that we don't get bogged down by patents on algorithms...
There is a certain wry amusement that the author has explained (in Limitations):
In addition, the concentrations of these thyrotropic hormones can differ significantly when sampled at different times of the day due to a natural diurnal rhythm.
Something we here (and, I am sure, other thyroid communities) have been shouting from the rooftops for many years.
It then goes on to explain about the width of TSH reference ranges and the possibility of making fine adjustments to doses. Again, as discussed here many times.
The problem is that our discovery that FT4 and FT3 both have nearly equal effects on TSH suppression has not yet entered into general acceptance or consciousness of the medical public. Leow and co are believers in the FT4/TSH paradigm; that is that FT4 dictates TSH production almost entirely - the old hypothesis. Now this is no longer true, FT3 will have to be brought into the equation as well as FT4 and TSH. But at least this is a start in trying to rationalise relationships between hormones and a method of optimising treatment to the best of current knowledge which is easy to accvess and understand.
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