This paper shows that quality of life in so-called well treated hypothyroidism is dependent on TSH values even in the higher reachs of the healthy TSH range. Now our group can explain this easily. The TSH range for controlled hypothyroidism is NOT the healthy range, but a TSH range much lower than this with little overlap. This is because without a thyroid making some of the T3 needed for health, the larger amount of T4 that must be taken to make up for this partially suppresses TSH. No wonder patients in the higher area of the reference range have a poorer QoL. They simply aren't being well controlled. But the authors are oblivious to this. It's a good example of how making the healthy TSH range the determinant of good treatment misleads the medics who write paper like this. It is an excellent example of how far the discipline has to travel to realise its ignorance of these facts.
It has been suggested that increasing levothyroxine dose to lower TSH levels within the normal laboratory range might be a therapeutic option for patients with apparently well-controlled primary hypothyroidism who are dissatisfied with their treatment and complain of physical or psychological symptoms. '
Why do such people insist on using words like 'dissatisfied' and 'complain'. It's patient blaming! The reality is that the prescribing medics are the ones who should take the blame for not acknowledging that they are under medicating their patients to comply with irrelevant test ranges.
They talk from two heads and both aren't giving the correct statement for many of us on this forum, for whom levothyroxine only gives us more symptoms than before we were diagnosed.
This phrase:-
"and complain of physical or psychological symptoms"
shows they have not one clue why the patient isn't improving and if we are taking medication we don't expect to be far more unwell with symptoms we've never had previously.
The psychological symptoms must be worse than physical for those people struggling to understand why they are more unwell on levo than before they were diagnosed as hypo.
Thank You Diogenes for another Great Post for our embetterment . I'm just wondering when will Dr's partner with thyroid meds depended patients and learn to Listen and Treat patients how patients feel over TSH ?I hope that day is closer than further with all your Hard work and time you invest into our well-being.
Thank you diogenes and your summing up well put. It is heartwarming to know there is an acknowledgment (at least), that these samples came from living breathing humans who desire a quality of life. Time for medics to stop treating the lab work and start treating the patients……
I have a suppressed TSH, my last hypothyroid symptoms left me when I reached my therapeutic dose (I noted a succession - very interesting). Had I been deferential, I would have been held on half the dose because, as the GP put it, I was “normal”.
Why do these people insist on spending all their time on such research and only ever test patients TSH. Once again I see they didn’t test FT4 and/or FT3. What a waste of time and resources.
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