Clinical hypothyroidism

[Pixipot]

Does anyone know what clinical hypothyroidism actually means? I'm so lost with all this.

[SlowDragon Administrator]

See flow chart on page one

gp-update.co.uk/Latest-Upda...

Clinical hypothyroidism = high TSH, Ft4 below bottom of range

Sub clinical hypothyroidism = high TSH, Ft4 within range

[helvella Administrator in reply to SlowDragon]

But as they so often do TSH only testing, people (doctors and patients) don't know the FT4. Which makes a nonsense of flowchart!

[vocalEK in reply to SlowDragon]

I was looking for a flow chart on the landing page for the link. As it turns out, a PDF was automatically downloaded (which I did not see at first) and the flow chart was in that document.

[fuchsia-pink]

It means your TSH is over-range and your free T4 is under-range. In most places, I believe, it's sub-clinical hypothyroidism if your TSH is over 3 but not yet over-range.

[selftreatendo in reply to fuchsia-pink]

I thought Clinical hypothyroidism means you have visual signs of hypothyroidism on examination. Large tongue, puffy eyes, slow pulse, low blood pressure, brittle nails etc.

[fuchsia-pink in reply to selftreatendo]

That would make sense, wouldn't it, rather than blindly going by the TSH result. Although I've never had your first two symptoms and have always had low blood pressure. But we can't have doctors examining their patients and listening to their symptoms when it's soooo much easier to assert that TSH tells them everything they need to know, can we?

[Pixipot in reply to selftreatendo]

I dont suffer from any of these symptoms only that my tongue looked & felt bigger but only a couple of times ages ago. I do suffer from iron+B12+Vit D deficiency , lacking in energy a lot+ breathless + forgetfulness a lot.

[jimh111]

It’s confusing because endocrinologists DEFINE clinical hypothyroidism as an elevated TSH and low fT4. If TSH is elevated and fT4 within interval they DEFINE it as subclinical hypothyroidism. These definitions apply regardless of whether there are clinical signs and symptoms.

In truth clinical hypothyroidism is when a patient has signs and symptoms of hypothyroidism that are corrected with thyroid hormone therapy. If there are signs and symptoms it’s clinical. That’s what clinical means.

The absurdity of these definitions is revealed deep in the text of the NICE guidelines documents where they refer to ‘symptomatic subclinical hypothyroidism’!

[tattybogle]

I use 'clinical' to mean physical signs/symptoms, such as could be observed by a nurse in a clinic.

If i mean blood test results , i tend to use 'biochemical'.

The nhs guidelines seem to use clinical /subclinical to refer to blood tests ,and then add symptoms on as an afterthought, (and also don't seem to know what many of the symptoms are anymore !)

[selftreatendo]

They probably made up sub-clinical once the TSH tests came in. It's just a fake name IMO. You either have Hypo or you don't.

[selftreatendo]

it's also an oxymoron as clinical as I and others have stated means you can see it, sub means you can't. So you can't see what you can see hypothyroidism. LOL

[Evita67]

My doctor (in Poland) declared 'subclinical' as for unknown reason which seems to me absurd having the thyroid diminished to 5ml- TSH 4.2, FT4 50%, ft3 30% (which was considered not a bad case). OMG! I had 86 symptom of hypo as per tests. She gave me 25g T4 and that made me stay in bed for weeks powerless. Now Im on 150T4 and 40T3 and alive. Remember any intake of T will switch off your own production.

[SlowDragon Administrator in reply to Evita67]

Exactly...so many medics don’t understand this concept...if you take any thyroid hormones...you need to take high enough doses to restore full energy levels

Levothyroxine doesn’t “top up” failing thyroid it replaces it

[Evita67]

However a dose shouldnt be too high- not because of the possible symptoms of hiper but because of converting to rT3. Thats another issue docs dont get at all. It takes a hell of patience to teach them the mecanism often because of ignorance or absurd arrogance. I had to go to docs with printouts from sttm blog, medical books etc and privately paid lab tests to prove. I wish one day I would find a doc who keeps up researching.