Our Review in "Drugs in Context" now available - Thyroid UK

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Our Review in "Drugs in Context" now available

As I said before, we have written a comprehensive review about our current understanding of thyroid action, diagnosis of disease, treatment options, details of preferred dosing schedules etc etc. The review is easy in parts, more difficult in others but there is plenty in it to cut and paste for any patient to give to their doctor/endocrinologist. There is however one difficult term I ought to explain. It is the term "ergodicity". What it essentially means that, say, you have a patient panel and you measure their TSH, FT4, FT3 parameters through time. Then if the panel is ergodic, all patients will go through the same proportional changes in values and therefore the average values for each parameter will be the same over time as when measuring at any particular time. If the panel is nonergodic then it is not the case that all patients will behave the same way over time. Taking foreign substances like a drug will give an ergodic response - all patients will go through the same drug values over time. But the thyroid homones are different in that each person has their own track of values which will not overlap with another's (nonergodic). It's this that destroys the value of unselected clinical trials, where any value of combined T4/T3 treatment for a minority is lost in the indifference of the majority. And it also destroys the value of trials relating TSH to osteoporosis and AF. The paper is downloadable as:

Individualised requirements for optimum treatment of hypothyroidism: complex needs, limited options

Rudolf Hoermann, John E M Midgley, Rolf Larisch, Johannes W Dietrich

Review DOI 10.7573/dic.212597


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Thanks @diogenes πŸ˜ŠπŸ‘


Brilliant! Thank you, keep them coming!!! πŸ™πŸ™πŸ™


Thank you very much.


Thank you so much diogenes! In this McCarthy-like climate, you remain a breath of fresh air. Indeed, keep them coming.


Thank You Diogenes . You are our *Voice Of Reason* . Keep It Going Strong .


Thank you Diogenes, I look forward to reading it. Thank you for explaining ergodicity, didn’t know this word existed. I did make the point of ergodicity and the flaw in the assumption that the relationship between the free thyroid hormone levels and the TSH is constant in my response to the draft NICE guidelines.


This article is a companion to our earlier one "Time for a reassessment ----" which I posted earlier. The two complement each other in the arguments.


Absolutely b****y brilliant paper! Fascinating read. Good for receptive GP's?


Diogenes, that is the most thorough discussion of the problems with the science behind endocrinology that I have read. Thank you, and the group, for all your work. PR

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