They interviewed two consultant endos that people might find beneficial in seeing. Don't know if they're already on the Thyroid Uk lists. Dr Salman Razvi, a consultant endocrinologist and a senior clinical lecturer at Newcastle University and Dr Peter Taylor, a consultant endocrinologist at the University Hospital of Wales.
One talks about how the ranges are arbitary figures based on 95% of the healthy population and really not for for purpose. Symptoms are what doctors should be going by. The other doctor was discussing how some people need T3 despite being within "normal" range.
They also highlight misdiagnosis - and how doctors typically think menopause or depression rather than thyroid problems.
Could we finally be getting somewhere???
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FAB-jellybean
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As a rule, I also wouldn't normally open a link for the Daily 'Hate' Mail, but I found it quite interesting on your recommendation. One of the issues raised was a suggestion that T4 doesn't always work and that T3 should be considered in this case, which is something that needs to be shouted loud and clear. I've pasted this bit below for ease.
'When your thyroid pills don't work
Symptoms of an underactive thyroid, such as weight gain and fatigue, don’t always improve on levothyroxine — a synthetic version of the natural thyroxine hormone, T4 — even when blood tests suggest hormone levels have returned to normal.
For some, this may be because their condition is borderline and perhaps they don’t need to be on levothyroxine in the first place, says consultant endocrinologist Dr Salman Razvi.
However, another explanation is that they may also need supplementary T3 — the other hormone produced by the thyroid. Normally, T4 accounts for 75 per cent of the hormones produced by the thyroid gland, T3 the other 25 per cent. The body then converts T4 into the more active T3 as required.
‘We think some people might not be able to convert T4 into T3 as well,’ says consultant endocrinologist Dr Peter Taylor.
‘In clinic we find that a third of people don’t notice any difference on T3 as well as T4, a third feel a bit better and a third feel much better,’ adds Dr Taylor, who believes it’s worth considering T3 treatment if someone doesn’t see improvement on T4 alone. But research on T3’s long-term safety combined with T4 is still in its early stages.
And, as Dr Taylor acknowledges, ‘if you’re not feeling right on T4, it may have another cause aside from the thyroid — and it can be quite hard to find a doctor who will keep an eye on your T3 on the NHS’.
There have also been supply issues for T3, with many NHS commissioning bodies restricting its use after manufacturers hiked up the price by 4,600 per cent, as previously reported by Good Health.'
The article does also suggest that 'older' people may be overprescribed for Hypothyroidisam as the suggestion was that metabolism slows as we age, which sounds plausable.
I'm just left wondering whether this is a dangerous theory to propose?
Well, my experience in 1996 as posted yesterday and not much changed. About 2000 this was covered in a phone in by Womans Hour Radio 4. One hour just on thyroid disease and women! I always remember the statistic: One in ten population have thyroid disease and of that figure nine out of ten are women. In the phone in typical experience was being treated for depression -- hypo and hyper - it's lazy and underlying sexism.
One talks about how the ranges are arbitary figures based on 95% of the healthy population and really not for for purpose.
The method of working out the reference range for TSH is the standard one used for every blood test that can be done on the human body. It isn't unique to thyroid disease.
It has its drawbacks. For example, with their test group of supposedly healthy people with healthy thyroids, they say that they knock off the lowest and highest 2.5% of TSH results to give them the range.
But ( made up numbers ) suppose that only 1% of the population ever gets hyperthyroidism and 10% of the population gets hypothyroidism, then it is likely hyperthyroidism will be over-diagnosed and hypothyroidism will be under-diagnosed.
Another thing is that just because some rare people with hypothyroidism don't get symptoms until their TSH is 30, doesn't mean that this will be true for everyone with hypothyroidism. The most likely outcome of doctors believing this is that they won't believe patients when they have symptoms with a TSH of 5.
And another thing that throws a spanner in the works for patients is that hypothyroidism reduces stomach acid and therefore reduces nutrient absorption. It might be possible to live without treatment for hypothyroidism for a little bit longer if nutrients were optimised routinely, not just ignored until they are way under range.
But is making it possible to live without treatment for hypothyroidism a good idea? I don't think it is. Hypothyroidism increases the risk of miscarriage, atrial fibrillation, heart failure, slows down the heart, increase the risk of some cancers, and increases the risk of dementia. It reduces energy levels and quality of life dramatically, and causes lots of pain. I've sometimes wondered if the slowing down of the gut increases the risk of appendicitis, polyps, and gut cancers. And what about gynaecological problems - how many of those occur more often and more severely in people with hypothyroidism?
Doctors have been given a simple recipe for dealing with thyroid disease. If TSH is under range the patient is hyperthyroid, and if TSH is over 10 they are hypothyroid. But as a result of this simple recipe they think the effects of hypothyroidism are simple and minor too.
Just wondering about the test group. If they know for a fact that women are more likely to develop thyroid issues, was this taken into account with the ratio of men to women in the test group?
Thank you for bringing this to our notice. Both these of consultants look like they are not seeing patients, their main line of work looks like it is most definitely research. I can’t make out absolutely from their bios. I watched Dr Peter Taylor recently on YouTube. He is enthusiastic about hypothyroidism. A very rare commodity I would say and someone we could definitely benefit from. Dr Salman Ravi is from my area and boy do we need someone with fresh ideas here. Does anyone know if he actually sees patients? I also agree very much with other comments. The age one in particular. Young people have no concept of ‘old’ age and their assessments count for nothing but can indeed be damaging.
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