Paper showing long delay of TSH change after thyroidectomy for Graves disease - TSH unsuitable for following up.

[diogenes]

This new paper available in full will help those having had thyroidectomy for Graves disease to realise that changes in TSH are very slow to happen. Also will help patients to explain to doctors and endocrinologists what to expect re TSH.

Front. Endocrinol., 01 March 2019 | doi.org/10.3389/fendo.2019....

Factors Predicting Time to TSH Normalization and Persistence of TSH Suppression After Total Thyroidectomy for Graves' Disease

Rosa Maria Paragliola, Vincenzo Di Donna, Pietro Locantore, Giampaolo Papi, Alfredo Pontecorvi and Salvatore Maria Corsello

[UrsaP]

Isn't it sad that it is the patient that has t explain to their Dr's? Now just need Dr's to listen and learn.

[diogenes Remembering in reply to UrsaP]

This paper shows that the longer the delay between disease onset and treatment, the longer it takes for TSH to rise. This is a perfct example of epigenetic fixation, where the longer the delay, the more fixed the body becomes in its hyper state through gene modification, which won't change easily. This is a parallel with longterm inadequate thyroid hormone treatment, where the same resistance to change is set up, making it difficult to improve. Its a lesson that prompt treatment means more rapid recovery whatever situation we look at.

[UrsaP in reply to diogenes]

Yes, and hopefully very useful. Having had more than 10 yrs of being told not hypo, even though there were intermittent bloods, followed by a 20 yr on T4 that was not working, this makes sense as by rights I should be able to convert some T4 but just cannot take it without it causing CF, Fibre and migraine. I wondered what damage the long term poor treatment left.

I was just getting at the fact that it should be the Endo's who are keeping up to date with new documentation, and not relying on patients to update them.

[nightingale-56]

Thank you for posting this diogenes . I was not treated for 19 years after a sub-total thyroidectomy for Graves. So consider myself lucky to have felt very much better within 3 month she second was Norton and the third was Goldshield Eltroxin. Since then when I was changed to Mercury Pharma (my son also) it has all been downhill. At the moment I am very bad with terrible reflux, which I am trying to heal naturally without PPI's.