A recent review of the failings of the currently held model for thyroid treatment

[diogenes]

I don't think I've already posted this. This review again sets out the failings of the TSH-T4 dominated model of thyroid therapy and treatment. Open to download

 Endocrine doi.org/10.1007/s12020-021-...

VIEWPOINT

Thyroid testing paradigm switch from thyrotropin to thyroidhormones—Future directions and opportunities in clinical medicineand research

Stephen P. Fitzgerald 1,2●Nigel G. Bean 3●James V. Hennessey 4●Henrik Falhammar 5,6,7

Received: 10 June 2021 / Accepted: 12 August 2021© The Author(s) 20

[TSH110]

Thanks for posting

I seem to get the impression from this paper that because free T4 is a bit like TSH it’s a pretty safe bet and we can but just use free T4 levels to treat hypothyroidism rather than TSH and oh yes FT3 Is sort of helpful for demonstrating very very rare thyrotoxicosis or cancer or non thyroidal illness so we don’t really need that value, job done. I find it a frightening proposition. They need to test all three every time, or we are lost. They just don’t get it. I haven’t read it all yet so perhaps I am mistaken…..don’t think so after going through it, I saw not one mention of free T3 being the hormone that’s being protected. Have I misunderstood it?

I also wonder where this protocol would leave users of combination therapy or T3

[diogenes Remembering in reply to TSH110]

You are right in protesting about the absence of serious attention being given to FT3. We find it as another example of researchers inching towards giving FT3 a key role in diagnosis, but being unable to let go of nurse's hand to bring it about. Or dipping a toe in the water but afraid to splash out. At least one step has been taken, to promote FT4's value over TSH in diagnosis of treated patients. But until such researchers grasp hold of the crucial importance of thyroidal direct T3 supply as being a key balancer in health and the consequences of a dead thyroid in this respect as per what to replace its lost actions by, the field will simply run up against the buffers and cannot proceed further without more reflection of the real situation in health and disease.

[BB001]

This made interesting reading. There are some very good points raised, particularly that they're questioning the use of TSH as the basis of monitoring thyroid euthyroidism. It's just a shame they're hung up on fT4 as the replacement marker

[aspidistra12]

In Canada they will do only the TSH or the T4, and only do T3 if results are out of range and the doctor tells them to. This was bad for me on combination T3 and T4 because I could not know if I was taking the right amounts of either while fine tuning the dose. I used to be able to talk my dr. into filling in the blood test form right so they'd do all three, but apparently they started refusing so I gave up, and all I know now is the TSH, for the past few years. I've become used to health care being totally inept and uncaring, and decided the tsh is good enough to at least tell me if I am massively hypo or hyper. So far no, it's 1 or less, which for me has always been the best.