The questioning of using TSH as a standard diagnostic in therapy and the realisation that patients exist outside the "norms" of T4 treatment is coming out all over the place. So far I can't raise this MS in total because of the paywall but the summary gives a good idea. One of the authors is from Newcastle on Tyne so even the UK is taking notice. I do hope that this is in time to influence the new NICE guidelines coming out later this year.
Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypothyroidism on replacement thyroid hormone therapy: a review
Salman Razvi & Ulrike Hostalek
Received 11 Dec 2018, Accepted 08 Jan 2019, Accepted author version posted online: 16 Jan 2019