We are all individuals and must be diagnosed as such

[diogenes]

This describes a finding from an as yet unpublished paper. For copyright's sake I will not disclose it until formal publication. It's findings are: For any individual you can plot changes of TSH and FT4 to get curves for each on a graph where they cross over. This crossover point is called the diagnosing sensitivity of FT4 and TSH responses to each other. However the work shows that thyroid and pituitary sensitivities are linked together in individuals in a non-random pattern. This linkage shows one cannot obtain the curves describing these sensitivities from population data and complicates their derivation by physiological experimentation. This limitation could be evolutionally important by minimising the variation inexpression by individuals in a population to facilitate better survival chances of the species.

In short you cannot use population data to describe an individual's response to T4 therapy and diagnose thereby. Even shorter, therefore it is the individual response that should be used in diagnosis, and NOT by reference to so-called population-derived ranges.

[LindaC]

Without doubt! Human variation is huge, which includes even within our own chemistry.

[Musicmonkey]

So in that case, we each need to know where we are on the curve where our TSH meets our FT4? But what if we have a disjoint between these no's? On diagnosis my TSH was 2.9, but my T4 was below range. Presumably I would be given Levo according to this. But I have conversion issues, so how does this new information deal with that? Doesn't T3 come into the equation?

[diogenes Remembering in reply to Musicmonkey]

No, what's been found is that here is no way to diagnose patients by using the whole population range for FT4 and TSH. This goes for FT3 too. I wrote in another reply that high FT4 giving low FT3, as in conversion problems, should not result in doctors trying to get you to raise T4 so as to try to normalise FT3. It's got future health problems to do this, so combination therapy must be used to keep FT4 properly placed.

[Angel_of_the_North]

Humph. NICE: "Of course we support patient-centred medicine, but we can't be having all that individual nonsense, there has to be RULES - for everyone to obey!"

[TSH110]

Excellent news - thanks for posting

[Gingernut44]

Very interesting, thanks for posting - we’ll have to wait for the publication.

[Lotika]

That gives me hope… I keep telling friends and family - and anyone else who can’t get out of the way quick enough - that one day they will look back on this and realise that the treatment of thyroid patients at this moment in time is the equivalent to treating a fever with leaches. Maybe not in my lifetime, but one day…

[helvella in reply to Lotika]

Which treatment has had a bit of a comeback! Not necessarily for fevers, of course, but ...

10 stomachs, 32 brains and 18 testicles – a day inside the UK's only leech farm

They were once used to treat everything from headaches to strangulation, and leeches are still a vital part of surgery. But how are they farmed?

theguardian.com/lifeandstyl...

[1tuppence]

Isn't that how they used to do things? My mother was diagnosed hypothyroid from her symptoms alone....and she was treated immediately.

[diogenes Remembering in reply to 1tuppence]

Happy days!

[Aurealis]

Wow, far reaching implications. Turns current practice on its head.

[TaraJR]

linda96 MikeM46 a very interesting future publication.