Problems with the assessment of thyroid function and levothyroxine replacement levels in pituitary disease

[abirose311]

This is the title of a paper written by Dr Trevor A Howlett, MD FRCP

Consultant Endocrinologist, Leicester Royal Infirmary

I'd like to copy and paste the entire document here, for everyone who feels they are struggling with insufficient T4 while their TSH suggests otherwise!

Am I allowed to do this please moderators?

The alternative is that I can share by private message

[greygoose]

Did you find this paper on-line? If so, just give a link to it.

[abirose311 in reply to greygoose]

It was emailed to me but SeasideSusie has found it online. Very informative I thought

[SeasideSusie Remembering]

abirose311

There may be copyright issues in which case you'd need permission to paste the whole article. You can paste a small part of it then link to the article itself.

But I have an idea this may be what you are referring to, easily found on Google by putting the title into the search bar.

Quote:

Doctors who are not specialists in endocrinology often have difficulty interpreting thyroid blood tests in patients with pituitary disease which can lead to failure to diagnose a mild deficiency and inappropriate changes in levothyroxine dosage in patients taking replacement.

Rest of article here:

pituitary.org.uk/news/2017/...

[abirose311 in reply to SeasideSusie]

Thank you SeasideSusie! That is the very same paper!

[shaws Administrator in reply to abirose311]

Few GPs seem to have any knowledge at all about who has hypothyroidism.

Our old-fashioned doctors diagnosed by clinical symptoms alone and prescribed NDTs and if health improved we were hypo and had small increases until symptoms resolved..

Natural Dessicated Thyroid hormones was the very first roriginal replacement and made from animals' thyroid glands. This was withdrawn by those 'in power' in the UK about a year ago and who we'd expect to be more knoweldgeable than members on this forum but who are not.

Mine phoned to tell me 'there's nothing wrong and your blood tests are fine'. I cried as I felt awful.

He did not seem to be aware that a TSH of 100 meant that the patient had hypothyroidism.

[abirose311 in reply to shaws]

That's shocking. Wasn't it flagged by the lab as way too high? 100!? Or should there be a dot in there somewhere. My TSH is 0.01. Doctors have proved that they can raise my TSH slightly by lowering my T4 and making me extremely unwell. I believe NDT is the only way to go!

[shaws Administrator in reply to abirose311]

To think that we used to be diagnosesd upon clinical symptoms alone (before levothyrxone and tests) and given a trial of NDT. The money the NHS would save if we were diagnosed upon symptoms alone.

Instead we've to rely upon doctors who seem to have no knowledge of any clinical symptoms and so the patients have to get on a merry-go-round to try to get someone who has knowlege of clinical symptoms and, in particular be able to prescribe other than levothyroxine if patient isn't improving or getting more clinical symptoms..