Companion Paper to our recently published Model Paper

[diogenes]

This as yet provisional paper alongside our in Frontiers in Endocrinology is interesting in its study of BMI versus dosing. I'll inform about the doi when accepted. There is a synopsis available now.

OPTIMIZED REPLACEMENT T4 & T4+T3 DOSING IN MALE & FEMALE HYPOTHYROID PATIENTS WITH DIFFERENT BMIs USING A PERSONALIZED MECHANISTIC MODEL OF THYROID HORMONE REGULATION DYNAMICS

Provisionally accepted

The final version of the article will be published here soon pending final quality checks

Mauricio Cruz Loya1, Ben B. Chu1, Jacqueline Jonklaas2, David F. Schneider3 and Joseph DiStefano III4, 5*

[helvella Administrator]

Sounds extremely interesting. Looking forward to publication.

Can you tell me, have you and your associates reached the status of having the largest number of thyroid papers published in the past few years? A totally astonishing work rate with massive output.

[diogenes Remembering in reply to helvella]

Perhaps so, but with two retired scientists out of the basic four, we don't have the petty problems of having to divert our attention to mundane but essential work demands. It allows concentration of the mind. And once you get on the scent of something, its all go with the aim of reaching the final destination. The to-ing and fro-ing in emails in the last ten years is enormous.

[Musicmonkey]

I note your report says that very little T3 is needed to provide optimal levels of thyroid hormone in Combination therapy. Surely this doesn't hold true if there is a conversion issue in that particular patient?

I can see my Endo waving your report in my face, telling me I need a reduction in T3. I currently take 30mcg T3 daily. My BMI is 26 and I am female. I also take 25mcg T4 daily

[diogenes Remembering in reply to Musicmonkey]

I think that is just an American opinion, as there are several of them on the paper. The main problem with the paper is that it tries to sort out things from a viewpoint of the final response of the HPT system. So it can't really compete with starting from the beginning, because reaching the endpoint in a system is always a not-well-defined slack approximation of something extremely complex. I wouldn't take the comment on needing little T3 as read. Sure, a little T3 will help some, but not all. At present the field is only taking a cautious view of T3 supplementation (up from none at all ).It's like a cautious person dipping a toe in the water and being uncertain as to whether to swim. It is terrified of getting it "wrong" again by too much enthusiasm.

[Musicmonkey]

Yes I can appreciate that logic, but just afraid for patients like me who don't fall within the straightforward regime. I fought so very hard to get my T3 and still fighting to continue on it as every appointment I face threat of reduction, even withdrawal, because my Endo doesn't understand my condition to know how to treat it. He wants to focus on my suppressed TSH and high in range T3. He hasn't appreciated that it's what's in the cells that counts (currently unmeasurable) together with my symptoms.

[TSH110 in reply to Musicmonkey]

Or how you feel! Keep fighting even though we should not have to fight for what I think I should be a basic right