Companion Paper to our recent one in Frontiers

[diogenes]

This newly out paper uses modelling to try to maximise the best and successful therapy either with T4 alone or T3+T4. It does consider both therapies to try to get a handle on what are usually best in the individual circumstances. It's US-based, with the influential Jacqueline Jonklaas as one of the authors. Open source.

Optimized Replacement T4 and T4+T3 Dosing in Male and Female Hypothyroid Patients With Different BMIs Using a Personalized Mechanistic Model of Thyroid Hormone Regulation Dynamics

July 2022 Frontiers in Endocrinology 13 

DOI: 10.3389/fendo.2022.888429

Mauricio Cruz-Loya, Benjamin B. Chu, Jacqueline Jonklaas, Joseph DiStefano

[tattybogle]

link to paper frontiersin.org/articles/10...

[HowNowWhatNow]

Thank you.

Is this a paper whose method and findings you stand beside, diogenes ?

I’m guessing you wouldn’t be promoting it if it wasn’t and asking just to double check.

[diogenes Remembering in reply to HowNowWhatNow]

90% of the way, but I have doubts about the outcome's decisions. The problem is this: our paper started from the base of the system and worked upward from there. This other paper started at the top and went from there. The difficulty is that examining from the top (end point) is far messier than starting from scratch, because there are so many alternative ways of getting to final solutions.

[HowNowWhatNow in reply to diogenes]

Can you please post your paper here too?

Thinking it would be helpful for anyone reading / searching to have both in the one place.

Or if it’s stored somewhere obvious that anyone can access, please let me know.

Interesting to hear your thoughts.

I’m not sure I understand exactly what you mean but I haven’t read the papers so I am a poor student! When you say “starts from the top of the system”, are you referring to how they constructed their model?

[helvella Administrator in reply to HowNowWhatNow]

There is, or will soon be, a limit of 7,000 characters in a single post.

Most papers would be much more than that. Hence (aside any copyright considerations) it might be technically impossible.

[HowNowWhatNow in reply to helvella]

Sorry to be vague - I didn’t mean could you post your entire paper here, necessarily.

What I was hoping was for a link / other internet signpost, if you have one.

But if there are copyright considerations, I understand entirely!

[helvella Administrator in reply to HowNowWhatNow]

Don't worry - it was something I wanted to say anyway! Your response gave an opportunity to point it out to all members. So I took it.

[HowNowWhatNow in reply to helvella]

Now I get it

[diogenes Remembering in reply to HowNowWhatNow]

We started from the baseline of amalgamating all the control elements in the HPT axis and exploring in a theoretical model how they interacted best to explain why & how a subject could both resist change in one situation but change smoothly if the requirements forced the change. It also brought thyroid-produced FT3 into the equation as an indispensable part of the whole system's control. The other paper has used simulations of the thyroid parameter value to discover what treatment might be optimal. This is different, because it looks at the endpoints of action which are achievable in many ways - a more messy analysis therefore,

[HowNowWhatNow in reply to diogenes]

I wonder whether a third paper could usefully bring both approaches / models together to see how they differ and why and what challenges each present to the logic of the other.

[HowNowWhatNow in reply to HowNowWhatNow]

Thanks for sharing this paper and your analysis of it.