Dr. Tania S. Smith Replies To The New Subclinical Guidelines Via BMJ Rapid Response

[PR4NOW]

For those that are interested the link follows. You have to scroll down a bit to get her response. PR

bmj.com/content/365/bmj.l20...

[SilverAvocado]

A brilliant rebuttal! The paper has so many problems its hard to even know how to approach it to critique.

Its shocking to hear that only 2 out of 21 studies included patients with TSHs over 10, and yet they considered that sufficient evidence to propose a cut off of 20!

I strongly agree that the report itself stands as a huge critique of diagnosing (and monitoring) on TSH and freeT4 only, because it makes clear these create a very muddy interpretation.

[Greekchick]

Thank you for posting! I have already passed this along to a friend here in Canada.

[hjh88]

Her rebuttal in itself reads like great points to take to a doctors appointment. Definitely saving this for reference!

[Angel_of_the_North]

Oh Dr Tania Smith - I think I love you!

[Minimol]

The report is the Handmaid’s Tale instruction manual for GPs and it takes a female - Dr Tania Smith, to challenge it.

[AmandaK]

Some of the other responses are worth reading too - and perhaps some on this forum would like to respond, not just anecdotally but also citing rigorous peer-reviewed papers.

Is Britain the only country which currently has a TSH cut-off of over 10?

[vocalEK]

My favorite line: "Research on the pituitary and hypothalamus has revealed TSH is a unique, local, organ-specific response that cannot speak for the rest of the body's T3 sufficiency. (13)"

13. Dietrich, J. W., Landgrafe, G., & Fotiadou, E. H. (2012). TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis. Journal of Thyroid Research, 2012. doi.org/10.1155/2012/351864