Tania Smith on thyroid patients.ca has carefully dissected an article by Anderson et al which examined thyroid parameters in a very large group of patients over many years. She has abstracted out the groups one by one from the mass to see how their thyroid parameters respond, A valuable analysis in depth as to what is the outcome for patients with comorbid diseases regarding thyroidal response. Also there are her criticisms of patient choice for the study.
Prevalence rates for 10 chronic disorders at various FT4, TSH and FT3 levels
BY THYROIDPATIENTSCA on OCTOBER 21, 2020
Written by
diogenes
Remembering
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I'm still in the early stages of reading this but my first major stumbling block is the section entitled "Where do the 4 Quartiles fit within reference range? "
The way of splitting the subjects up into groups is completely at odds with the way my brain works.
The people who did this (Anderson et al) have split the people into equal sized groups with no reference to the range. Personally, I find it easier to get my head around splitting the reference range into quartiles then allocating people to the appropriate quartile based on their result.
So, to illustrate with made-up numbers ...
The way Anderson et al did it :
Let's say that there were 1000 people who had their FT4 measured and had a result in the normal range, which was 0.75 to 1.50 ng/dL. They put these 1000 results into order of magnitude, then split off the first 250 results into Q1, the second 250 into Q2, and so on. They also had a group which were below the range for FT4 and another group that was above the range.
But I would find it easier to grasp the data if they had divided the reference range into four and put people into each quartile according to their level of FT4.
So, I would have split the FT4 reference range into :
Q1 = 0.75 - < 0.9375
Q2 = 0.9375 - < 1.125
Q3 = 1.125 - < 1.3125
Q4 = 1.3125 - 1.50
and then I would have allocated each person to the appropriate quartile. So in my method the groups would have been of unequal size, but you would have known how high or low someone's level of FT4 was just by knowing which quartile people were in.
But with Anderson's method you wouldn't have a precise idea how much Free T4 someone had from the quartile they had been allocated to. In his method, for example, people in quartile 2 could have been in the bottom quarter of the reference range or the second quarter of the reference range. And some people in quartile 3 had a FT4 result which was actually over the mid-point of the range.
I just can't see the advantages of what they did. I'll just have to let things simmer for a while.
The basic problem with Anderson's approach is that he rather looked at patient groups in "chunks" of nonthyroidal illness. I think what Tania is trying to do is to bring more individiual response into the argument for each illness. The whole analysis once again puts the person in front as to the range they inhabit. This is what many huge studies fail to do - categorisation into and out of range is the Achilles Heel of many of these investigations.
In Graves’ hyperthyroidism, the D1 enzyme that converts T4 to T3 tends to be upregulated (Chen et al, 2018). That means that D1 is overactive in three glands where DIO1 gene is most strongly expressed: Thyroid gland, liver, and kidney.
Does this mean that people who have been diagnosed as having Graves' should be encouraged to get their liver and kidney function tested and then change/improve their diet and/or take supplements which improve the health of the liver and kidneys?
No, the thyroid is the main culprit and the other organs seem to be decontrolled in some way I at the moment can't explain. Have to look into this more.
Interesting question and reply, thank you. I look forward to hearing more. As the liver needs thyroid hormone input but T4 to T3 conversion needs a fully functioning liver, it would seem sensible, for any thyroid dysfunction, to pay some attention to the health of the liver, as you would the gut or gallbladder (particularly if, like me, you are unable to get anyone to recognise a thyroid issue and are therefore trying to cover all possibilities for self-improvement). I shall investigate kidney support. Cheers
Optimal FT3 and FT4 levels are highly individualized, even in a state of perfect thyroid and pituitary health, where the TSH adjusts the FT3 and FT4 level very precisely to a narrow part of reference range–some people are high in range, some are lower. The “index of individuality” is so narrow and unique in thyroid hormones that merely targeting the population “average” or staying in the wide population statistical “range” for TSH, FT3 or FT4 is never precise enough to induce euthyroid status in all individuals.
In thyroid therapy, individual adjustment must be done manually with full participation of the patient.
I doubt this will ever happen. Doctors simply don't trust women (the main sufferers of thyroid disease), and have compared thyroid hormones to heroin, cocaine and speed (so of course women want more - we're all drug addicts!), and have told some women that they want more thyroid hormones to help them get through their housework more quickly.
The extremely high association of depression with Low FT3 makes one consider this may be one reason why T3 hormone therapy has often been pursued as a way of treating depression that is resistant to common depression medications.
This comment begs the question...
Why do doctors treat depression with anti-depressants as a first-stage treatment rather than test T3 and treat it if it's low? The body never has an anti-depressant deficiency, but it can very easily have a T3 deficiency. T3 is a hormone which the body needs and creates for itself when possible and when necessary. No human has ever created an anti-depressant in their bodies.
I can think of some obvious answers to my own question in this case. Pharma companies could never risk patients finding out that improving a low T3 level will fix loads of health conditions, without the patient having to take a dozen other medications. And doctors have been well and truly brainwashed into believing that anti-depressants are wonderful and T3 is practically lethal.
Dr’s treat depression with T3 and people who are hypothyroid are frequently offered anti- depressants! Mmmmmm. Something’s not right there.
To be fair, you can have an anti- depressant deficiency if you don’t have enough of some of the naturally occurring chemicals in your body that make you happy which the anti- depressants try to mimic.
To be fair, you can have an anti- depressant deficiency if you don’t have enough of some of the naturally occurring chemicals in your body that make you happy which the anti- depressants try to mimic.
Are you talking about people having low serotonin? I'm not clear on what you are referring to.
How right you are humanbean. It's called follow the M-O-N-E-Y. Big Pharma is in Dr pockets. It's their incentive to keep society sick and to keep patients coming back for more medications. For Eg: sleeping pills blood pressure pills cholesterol pills weight loss pills anti depression pills etc. . You name they got it the pill for it.
We must be informative/savvy about and *Not* buy into their game.
Should it not be a unanimous decision that by far majority of us (if not all) need varying amounts of t3! ?
Should 'some/many' not go to a National Newspaper with all the 't3' evidence with the hope of 'shaming GP's/Endo's' into Actual saving 100,000's, 1000,000,000's of lifes
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