I said a week ago that Drugs in Context were offered a paper from us and with modifications would accept it. It has now been formally accepted. Will inform when available as a simple download. If anyone wishes to read it in full, then I suggest they take a weekend or longer off to do it. In 7000 words it is a comprehensive review of diagnosis, choices in treatment, and the effect of individual biochemistry on making such choices. It is written in a way that is readily understandable and the dilemmas for the doctor in making a diagnosis and chosing and controlling treatment (ie T4, combination or DTE) are carefully laid out.
We also have seen a preprint of another paper we have submitted, in the Lancet. This is odd because we submitted it and they rejected it, so we've submitted elsewhere. This is weird because a journal that had rejected a paper shouldn't then hijack it iin their own publication.
Excellent diogenes I'm sure it will be very well worth the weekend or more to read it! Looking forward to seeing it. Thank you. And how odd about the Lancet? Maybe...just maybe...this is a sign of things looking up and of them opening their ears? I've just managed to download it from the Lancet link so lets hope they print it for you too.
It sounds like the lancet are feeling the pressure.
Well done, let's hope it doesn't fall on deaf ears 😊
Would you mind explaining to me the part that suggests caution in indiscriminate medical intervention in early autoimmune thyroid disease. That use of T4 may be counterproductive if I have understood correctly? Much appreciated.
Simply because you are unstable in that early stage. If at random on a recovery (partial), therapy could be harmful. There has to be consistent evidence of a hormone shortfall permanently for lifelong therapy to be justified. This is one problem: early signs can be slow to develop or very quick..
I see what you mean. So if a person is symptom free and has mildly abnormal blood results it’s reasonable to monitor things? Is there a particular blood result ‘threshold’ for treating or would it depend on symptoms (or both)?
Ah ok. I was just curious about the approach to initial diagnosis and treatment of autoimmune disease and whether this paper was suggesting a different approach?
Yes. The one in Lancet I am grumbling about is one they rejected yet have published un-refereed. That action torpedos our attempt to get it published elsewhere.
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Myxedema Madness - Systematic literature review of published case reports 
