I append here a downloadable article by Anne R Cappola (a member of Bianco's following and who tried to interfere with publication of one of our papers) - the chief editor took her off the case. This is about designing a so-called definitive trial - which her sugestions certainly won't achieve. Its also completely US-based and makes no reference at all to our work and trial suggestions. I t hink we'll try to present our own take now we know it's enemy action as regards paying us any attention. It was published on April 3rd, two days too late for Fools Day.
PERSPECTIVE
published: 03 April 2020
doi: 10.3389/fendo.2020.00168
Frontiers in Endocrinology | frontiersin.org 1 April 2020 | Volume 11 |
Cappola AR (2020)
Design of the
Optimal Trial of Combination Therapy.
Written by
diogenes
Remembering
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The trial proposals all discuss thyroid hormone medicines being supplied by the trial organisers.
No consideration that in many patients that could involve a change of make. Which, as we all know, is not quite as straightforward as some claim. This could distort the results significantly.
Sorry, Anne R Cappola's name is a gift I can't ignore when I'm looking at a £7K quote for a new heating system...Anything that can make me laugh, however juvenile...
Sets the scene for future! IE this absurd denial for thyroid health! Please keep fighting back. So disappointed in Bianco, thought he was going to come through for us patients.
Diogenes can you help with something I’ve never understood please? When researchers are choosing people for this type of trial do they take anyone on T4, even if that person is perfectly happy? Or do they look for those taking T4 but still having hypo symptoms?
This needs careful explanation. Trials done so far take a random (usually consecutive as encountered) group of patients on T4. They are TSH-based for selection (that is, only patients are chosen who have TSH in the reference healthy range). Pregnant subjects and those with comorbidities (illnesses) are excluded. There is no differentation of patients based on either FT3 measurements as they are rarely if ever done. Therefore subjects who would benefit from combined therapy are swamped out (as a significant minority) by the response of the majority who adequately use T4 alone. This is why all trials done so far are fatally compromised. What should be done is to stratify patients into subgroups according to the efficiency of T4-T3 conversion on T4 only. This way one can illuminate how the different groups respond to T4 therapy, and illustrate how then patients needing combination therapy can be seen to be in need of this
Thank you Diogenes, you’ve confirmed what I suspected and the reason nonsense trials reach a nonsense conclusion. T3 isn't tested even while they're trialling it! I despair at how intelligent people can also be so stupid.
Thank-you for posting this. Rather than replying here I've added a comment to the article in the journal frontiersin.org/articles/10.... In the hope someone will read it!
I feel most thyroid research is based on a simplistic understanding of the thyroid axis and patients must conform to this. The data (patient response) has to fit the theory - this isn't how science works youtu.be/kctmPaCkV0g .
Thanks for posting this. I've seen it before, but it's always worth seeing it again. Feynman was such an interesting character and that made him an outstanding teacher.
"The 5 mcg dose of LT3 is the only available dose and an identical placebo can easily be manufactured. "
Where is this the situation? My health maintenance organization has at least two dosages: 25 mcg and 5 mcg. I'm in the U.S. Can you only get 5 mcg tablets in the U.K.?
In the past I have received 20 mcg tablets from an overseas pharmacy.
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Thyroid blood tests don't understand 
My family just don't understand
Still don't feel quite right
BMA booklet 'Understanding Thyroid disorders' - is it still in print?
