The proof of the paper I mentioned a little while ago is now available to read through Louise Roberts. It describes the role of the thyroid's production of T3 in controlling overall T3 production in the body, and the consequences for losing this by loss of thyroid gland.
DOI: 10.1111/eci.13003
European Journal of Clinical Investigation
The role of functional thyroid capacity in pituitary thyroid
feedback regulation
Rudolf Hoermann | John E. M. Midgley | Rolf Larisch | Johannes W. Dietrich
2 1
Written by
diogenes
Remembering
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Essentially it says that there exists in the working thyroid, both direct T4 and T3 production. The thyroid is not just a factory producing the raw material T4 for the body to convert to T3. The T3 that the thyroid produces closely controls the production of T3 by the body to make sure this doesn't get out of control. As the thyroid loses activity, the system desperately tries to maintain T3 production from the steadily lowering T4 production to maintain as good a level of health (though not optimal) as possible until the bitter end. When the thyroid gland is close to total extinction this can no longer go on. The system collapses and we now enter a new less stable situation. Those with no thyroid who take T4 respond differently to this, than when the T4 came from the working gland. This has implications for the TSH range that monitors T4 therapy, as opposed to the healthy range. It means that those with no thyroid left respond quite differently to T4 than when they had a working gland and those with some left respond in between the no-gland situation and full health.
Thank you very much. I think it needs to be distributed to all of the Endocrinology in the world so that they can learn how to treat their patients as patients and not troublemakers and a nuisance. GPs also of course.
It won't really apply to secondary hypothyroidism. This is because it isn't the thyroid at fault but the pituitary. What stimulus the thyroid does get from the inadequate TSH production will result in it still producing T4 and T3 but at an inadequate level for health.
This is exactly what I need to show my Endo. When I showed him the results of my DIO2 test in an attempt to get T3 on prescription, he just said he didn’t understand anything about genes and if it did effect T4 to T3 conversion, why hadn’t this been a problem before I had RAI. As usual, I thought of all the things I should have said afterwards, but my mind went blank (blame the usual culprit) and I just said that I had read articles on ThyroidUK, of research studies which explained this and I would let him have this. When I got the expected reaction to the mention of ThyroidUK, I quickly added that it is recommended on the NHS website.
Now I have to try to remember which articles and where to find these articles.
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