Defining paper accepted

[diogenes]

After over a year writing and refining our key paper on how the hypothalamus/pitutiary/thyroid/body combination works in controlling the proper responses for health, it has been accepted by Frontiers in Endocrinology. What we had to explain was how in health the body's thyroid production strongly resists any change, but when illness comes, it does change smoothly to the new appropriate level. It is important to discover this because explaining this ability also uses our knowledge about the value or otherwise of TSH testing, and the role of the working thyroid to produce its essential expression of T3 production - thus having implications for TSH as a reliable test (it is not) and treatment. There is some pretty apparently formidable maths to explain things, but this is misleading, as the basic science is straightforward for one reaction, but for 5 working together, a computer is needed. Present beliefs cannot explain and link the phenomena studied here, so that to have a complete picture, we think this is the way to go. At the moment there is no access because of editing etc, but when the paper is published finally it is downloable from Frontiers in Endocrinology. Its implications will be difficult to ignore but I'm sure the Thyroid Establishment will succeed. For a working scientist this is close to a magnum opus.

[tattybogle]

congratulations to you and your group . i'm very much looking forward to reading it.

(and then reading it again one sentence at a time with a puzzled look on my face, and then asking you for an analogy that helps me see past the 'maths and the computers' which are not my strong points)

[diogenes Remembering in reply to tattybogle]

A reasonable parable would be:Present thinking likens to a tug o war team pulling against the rope being fixed to a wall. There is only one variable factor - how hard the team pulls. The tension in the rope is an indication of the whole situation - it is partly static. Our idea is that there are two teams as in the usual situation. They pull against each other and the coloured tassel that marks the middle switches back and forth over the start line, but not too much - the situation is finely balanced (robustness to change). Suddenly perhaps one of the pullers on one side drops out to take a wee - the other side can then pull them forward until a new balance is reached (adaptation to change). Later on, the absent puller returns and the old situation is restored. It's not a perfect analogy but it shows the basic idea. You have to allow for flexibility and/or constancy as the situation reqires.

[helvella Administrator Thyroid UK in reply to diogenes]

Would it be reasonable to push that to the extent of suggesting that once the absent puller has returned, it could still take some time for the tassel to return - as the team have to recover what they lost while that puller was relieving him/her-self?

[diogenes Remembering in reply to helvella]

That would be a fair comment. One doesn't leap up from nonthyroidal illness "just like that"

[tattybogle in reply to diogenes]

I think i get where you're coming from ...thankyou .

Are we likening 'the movement of the tassel' to ;

a) the thyroids 'production of hormone', in a broad sense ?

b) the thyroids direct T3 production ?

c) the TSH level ?

d) none of the above, because if it was that simple to describe you wouldn't have needed to write a paper and do fiendish maths and computers

[diogenes Remembering in reply to tattybogle]

It combines what the thyroid makes re T4 and T3, and the corresponding T4-T3 conversion in the general body. In health, these equate to the likely permitted moment-by-moment fluctuations of the whole system (but only within narrow permitted boundaries (robustness). When one of the system elements changes enough, eg nonthyroidal illness) the whole system resets itself to the new requirements (adaptation) but with the new robustness maintained in the new state until the system changes again .

[tattybogle in reply to diogenes]

I see.

So have we relegated TSH to being 'the commentator shouting on the sidelines who was supposed to be telling the crowd what's going on' , but who might have had one beer too many , so can't always be relied on to get it right ?

[diogenes Remembering in reply to tattybogle]

Or might be shouting for the wrong team!

[tattybogle in reply to diogenes]

lol x

[tattybogle in reply to tattybogle]

ok , so more like a combination of (coach / commentator)+ beer .

...makes lot's of noise when something spectacular happens ,and one team is noticeably loosing /winning... but a bit too dim witted to notice straight away when that missing bloke has come back from the loo ?

[DippyDame]

Thank you....again!!

[Elisabeth52]

Thank you and Congratulations!

[helvella Administrator Thyroid UK]

Congratulations on getting this far.

Knowing how slowly the wheels of academic publishing turn, I'll not hold my breath. But will keenly anticipate its release.

[shaws Administrator]

I congratulate all of the scientists who put all of their efforts into producing a tablet that will allieviate the awful symptoms some have to go through and the fact that few GPs know how to diagnose/treat those who have hypothyroidism. Dr Peatfield and Dr Skinner and others taught within a period of time could diagnose patients' by clinical symptoms alone and prescribed NDTs.

Re TSH - I felt so unwell and in fact my TSH was 100 by then but was told I had no problems!

Another GP told me that T3 converts to T4, for instance. He didn't like my answer.

[wellness1]

Heartfelt congratulations to you and your co-authors! Thank you so much for your work. May it (someday) get through to the Thyroid Establishment.

[Imaaan]

To you and all those involved in paving the way to educate and improve thyroid health, I sincerely thank you. Congrats on the paper

[Yeswithasmile]

Congratulations. Thank you. I also look forward to the vain hope of at least something being absorbed after reading it over and over and over and over….

Thank you Diogenes for such constant hard work.

[jgelliss]

Job well done diogenes. The hard work that you and your great teams contributions to our thyroid community is to be commended. Thank You Over and Over Again and Again.

[dolphin5]

Well done and thank you!! 🙏🙏🙏

[amala57]

Deepest gratitude & many congratulations!

[JGBH]

Congratulations! Many thanks. Looking forward to reading the paper and no doubt asking for explanations…

[Hidden]

Very happy for you, Diogenes, and well deserved!

[Musicmonkey]

Congratulations on getting this important paper published. Hopefully, this will be enough to challenge the current unhelpful paradigm that exalts the TSH above symptoms.

[Localhero]

Thank you diogenes I’m so grateful for the work you are doing.

[Divine1990]

Thank you all so very much.

[LindaC]

💚😍💚🎶👂🌷 Thanking You/All So Much xox

[Lovecake]

Thank you for all your constant hard work. It is very much appreciated by those of us who know what needs to be done but haven’t got a clue on where to start, let alone how to do it.

[Littlebee]

Thank you Diogenes you and your team really are doing great work and surely the tipping point will come.

[linda96]

Thank you ... thank you ... thank you ... all for your unselfish noses to the grindstone, never giving in attitude, and being right.

[TSH110]

Wonderful news - congratulations!

[BB001]

Thank you for all your and your team's efforts on our behalf. I look forward to reading it

[Zephyrbear]

Thank you to you and your colleagues for trying to bring some sanity to the crazy world of thyroid endocrinology where most of the consultant endocrinologists are diabetes focused. We will do all we can as patients to spread your words by taking copies of the articles to our own respective endos and GPs and, hopefully, contribute to their education!

[Reefseeker]

Thank you so much, all of your posts plus your commitment are a source of great comfort to those of us trapped in a largely ignorant system of thyroid 'care'. To me, the TSH is a 'proxy indicator', not the indicator itself (T3). Hence I am always puzzled as to why a suppressed T3 and symptoms of hypothyroidism are considered less important than a suppressed TSH. In such circumstances (mine) the patient is then treated as overmedicated rather than undermedicated as we all worship at the god of TSH. Thank you again.

[Jasp6]

diogenes do you know when your paper will be available? I would be very interested in reading it before my T3 trial appointment later this month. I am expecting a battle as my TSH has gone low and they don’t like using FT4 and FT3 tests, which show I am only mid range.

[diogenes Remembering in reply to Jasp6]

It will be any time soon. It's accepted and is being set up for open communication. I'll give TUK the doi number to access it on publication.