American Thyroid Association info is out-of-date

[vocalEK]

I left the following comment today on the web site for the American Thyroid Association.

Under Thyroid Function Tests, your site states: "Measurement of free T3 is possible, but is often not reliable and therefore not typically helpful." That's outdated.

See ncbi.nlm.nih.gov/pmc/articl...

"We suggest evaluation of thyroid hormone levels by ultrafiltration LC-MSMS for patients who continue to experience hypothyroid symptoms on LT-4. This may help identify the approximately 20% subset of patients who would benefit from addition of T3 to their treatment regimen (combination therapy)."

[helvella Administrator]

Simply saying that it is often not reliable is as useless as a truly unreliable test.

It says nothing about the specific test being considered, even if there is (or was) some general truth. And just who allows a test which is not reliable to be sold into the healthcare market? Doesn't the FDA have some say? So shouldn't the ATA be lobbying the FDA to get the standards for the Free T3 test checked/raised/whatever is necessary? Rather than just saying it is not typically helpful?

I suspect that the LC-MSMS will be regarded as too expensive and too "difficult" for everyday use for real patients who might benefit.

[Hidden]

"...the approximately 20% subset of patients who would benefit from addition of T3 to their treatment regimen (combination therapy)."

Wow, that many! So they are ignoring and potentially depriving about a fifth of their thyroid patients!

[shaws in reply to Hidden]

They have to keep Big Pharma happy and prescribe levo to patients and for those who may not be improving are then offered 'extra' prescription for the still disabling symptoms when they actually need an optimum dose of thyroid hormones which allow them to recover their health, i.e. T4/T3, or NDT.

[diogenes Remembering]

This is an American propaganda exercise conducted through a Dr Steven Soldin. This unsatisfactory and untrustworthy person developed a LC-MS method for measuring FT4 and FT3. From my knowledge the FT4 test range was compromised by using the wrong temperature and his FT3 test gave a range hilariously different from any FT3 immunoassay. Nevertheless, if you stand on your head, the rest of the world is upside down - ie I'm right, everyone else, because MY method is gold standard! As if.! This poison has obviously spread itself into the ATA thinking. Pay no attention - it is silly bluster. No way could 10's of thousands of patients be measured by his cumbersome, expensive and unreliable method.

[Hidden in reply to diogenes]

Do you have any hard evidence for this, Diogenes? (just the brief facts and dates etc if possible). It might help in our attempts to enlighten our doctors and endos!

[diogenes Remembering in reply to Hidden]

All Soldin's published work before 2010 on measuring FT4 and FT3 is not valid because he used the wrong temperature in his method. However post-2010 he quietly changed to the right temperature without admitting as much, whilst referring back to his old work in subsequent papers as if it was valid and blustering and dodging his excuse for this action. For example his early results for FT4 in pregnancy violently differed from the routine methods, but his later results more or less agreed with the routine assays. Next regarding FT3. A FT3 range should be narrower than a total T3 range, because the former corrects for differences in the proteins that bind T3 in blood, whilst total T3 doesn't. Soldin's ranges actually indicate the opposite: that the FT3 range is wider than the total T3 range. This is impossible and this very fact destroys the basis of his measuring method. Unfortunately, US medical people have no clue about the invalidity of his method and he succeeds with them merely by shouting his nonsense louder. So in short it's the Soldin method for FT3 measurement tht is wildly out of being correct not the immunoassays he choses to compare against, Note also that he has carefully chosen the FT3 tests to use wich are not very good - there is no evidence on other tests, and his conclusions are based only on the few test sources he explores. I published a critique of Soldin's method in a Canadian journal Clinical Biochemistry entitled "All that glisters is not gold" which drew yet more blustering and refusing to address the problem.

[Hidden in reply to diogenes]

Thank you.

What about the UK?

[Hidden in reply to Hidden]

"Soldin's ranges actually indicate the opposite: that the FT3 range is wider than the total T3 range. "

Even I know that's wrong!!!

[vocalEK in reply to diogenes]

There you go, trying to introduce logic and common sense into science! Tsk! Tsk!

[LAHs in reply to diogenes]

LC-MS? Liquid Crystal Mass Spectrometry?

[diogenes Remembering in reply to LAHs]

Chromatography, not crystal.

[LAHs in reply to diogenes]

Thanks, spelling error correction also appreciated - it must have been midnight. (Yes I know that's no excuse))

[Hidden]

Most unlikely you will ever get a reply from them. I was, however, successful when I wrote to the manufacturers of Armout NDT pointing out to them that their allegation that NDT was comprised of Levothyroxine and Levothyroxine was laughingly ridiculous. They did, eventually change their web site to reflect the truth that Armour is natural but never replied to my email.

I had previously contacted the MHRA as to why they made the same allegation and was told that they always believed what the drug manufacturer told them.

[LAHs in reply to Hidden]

Yes, I phoned Armour ("Forest Pharma") because I noticed they do put Levo in their NDT. I don't think they used to. Nobody had a good answer, in fact wasn't sure what I was talking about. I had a think and came up with the theory that maybe they were bringing it up to the human 4:1 ratio rather than the 3:1 which it would be if they were using straight pig thyroid. I did ask if they were still using pig, and they assured me that they were.

[Ell17]

It's smoke and mirrors. They would never have allowed the paragraph stating the name/description of the evaluation itself to see the light of day if that test were actually effectual or affordable for the average person. There is zero motivation in identifying any person that doesn't respond to T4 therapy. They make too much money from Synthroid, et al.

Either way, very few would ever have access to this evaluation because most patients wouldn't be made aware it even exists. Gaslighting by the doctors (for those who still use their services) combined with our near useless (though exorbitantly priced with sky high deductibles) insurance (that most likely wouldn't cover this particular test...no surprise there) woud handle the rest. Mission accomplished. Psychiatric and other meds prescribed. Status quo intact.