We've just had published in Frontiers (downloadable) a paper which, using the results of a large meta-analysis, challenges the authors' relationship of TSH to risk factors in other diseases, and by a better, more focussed analysis shows it is FT4 that is more important. FT3 was not considered so that there are additional unknown possibilities linking to FT3 as well. This big study is regarded as gospel by the establishment, and yet its conclusions are fatally flawed by faulty analysis. Also the original authors just compared FT4 and TSH in groups, rather than first pairing TSH and FT4 together for each patient. This blurs their results. We also show how depression, psychosomatic problems, and other problems such as cardiac can affect results. The paper and abstract is:
PERSPECTIVE ARTICLE
Front. Endocrinol., 26 October 2020 | doi.org/10.3389/fendo.2020....
The Two Faces of Janus: Why Thyrotropin as a Cardiovascular Risk Factor May Be an Ambiguous Target
Johannes Wolfgang Dietrich, Rudolf Hoermann, John E. M. Midgley, Friederike Bergen and Patrick Müller
Endocrinology and Diabetes Department, Medical Hospital I, Bergmannsheil University Hospitals, Ruhr University of Bochum, Bochum, Germany
Ruhr Center for Rare Diseases (CeSER), Ruhr University of Bochum and Witten/Herdecke University, Bochum, Germany
Private Consultancy, Research and Development, Yandina, QLD, Australia
North Lakes Clinical, Ilkley, United Kingdom
Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Düsseldorf, Germany
Department of Cardiology II, Münster University Hospitals, University of Münster, Münster, Germany
Elevated concentrations of free thyroid hormones are established cardiovascular risk factors, but the association of thyrotropin (TSH) levels to hard endpoints is less clear. This may, at least in part, ensue from the fact that TSH secretion depends not only on the supply with thyroid hormones but on multiple confounders including genetic traits, medication and allostatic load. Especially psychosocial stress is a still underappreciated factor that is able to adjust the set point of thyroid function. In order to improve our understanding of thyroid allostasis, we undertook a systematic meta-analysis of published studies on thyroid function in post-traumatic stress disorder (PTSD). Studies were identified via MEDLINE/PubMed search and available references, and eligible were reports that included TSH or free thyroid hormone measurements in subjects with and without PTSD. Additionally, we re-analyzed data from the NHANES 2007/2008 cohort for a potential correlation of allostatic load and thyroid homeostasis. The available evidence from 13 included studies and 3386 euthyroid subjects supports a strong association of both PTSD and allostatic load to markers of thyroid function. Therefore, psychosocial stress may contribute to cardiovascular risk via an increased set point of thyroid homeostasis, so that TSH concentrations may be increased for reasons other than subclinical hypothyroidism. This provides a strong perspective for a previously understudied psychoendocrine axis, and future studies should address this connection by incorporating indices of allostatic load, peripheral thyroid hormones and calculated parameters of thyroid homeostasis.
