Just received the latest Lancet 'Diabetes & Endocrinology' journal info ( Volume 7, ISSUE 6, P473-483, June 01, 2019), which includes the article 'Reference intervals in the diagnosis of thyroid dysfunction: treating patients not numbers'. Here's the summary:
Although assigning a diagnosis of thyroid dysfunction appears quite simple, this is often not the case. Issues that make it unclear whether thyroid function is normal include transient changes in thyroid parameters, inter-individual and intra-individual differences in thyroid parameters, age-related differences, and ethnic variations. In addition, a statistically calculated distribution of thyroid analytes does not necessarily coincide with intervals or cutoffs that have predictive value for beneficial or adverse health outcomes. Based on current clincial trial data, it is unclear which individuals with mild thyroid-stimulating hormone elevations will benefit from levothyroxine treatment. For example, only a small number of patients with thyroid-stimulating hormone values of more than 10 mIU/L have been studied in a randomised manner. Even if therapy is initiated for abnormal thyroid function, not all treated individuals are maintained at the desired treatment target, and therefore might still be at risk. The consequence of this is that each patient's thyroid function needs to be assessed on an individual basis with the entire clinical picture in mind. Monitoring also needs to be vigilant, and the targets for treatment reassessed continually.
Authors: Prof Jacqueline Jonklaas, MD and Prof Salman Razvi, MD
Not sure what to make of it, is it good news for those of us who don't feel completely better even though are numbers are in "range", I'd like to think it means that our doctors should treat us according to our symptoms and not our blood test results.
fat chance that many GP's will treat on symptoms. They are mostly wedded to the numbers and if you are within the range then you must be fine. Any problems are all in your head! I suffered from this treatment for a number of years. Thanks to this forum I took matters into my own hands and feel mostly much better in spite of a below range TSH and threats of heart attacks and osteoporosis!
It has a habit of changing domain every now and then and sometimes finding the current one can be a bit difficult. Obviously the publishers who are making money for nothing by publishing research papers on the web and then charging for access are constantly trying to chase Sci-Hub off the web. Unfortunately some countries are making it easy for the publishers by making their ISPs block access. I keep expecting the UK to do this but it hasn't happened yet. I'm sure it will though.
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