This article discusses the inadequacy of T4 treatment and occurence of brain fog.
Brain Fog in Hypothyroidism: What Is It, How Is It Measured, and What Can Be Done about It
Article in Thyroid: official journal of the American Thyroid Association · April 2022
DOI: 10.1089/thy.2022.0139
Mary H Samuels and Lori J Bernstein
diogenes may I ask - are you a fellow hypo sufferer or just interested in research?
If I have one gift, it is that I can ferret out papers for others and myself to digest. I'm a scientist who invented the first one-step FT4 and FT3 test back in '81-'83. These were used sensibly at first until supersensitive TSH assays came along, which were thought to make FT4/3 tests redundant. Evidence since shows what a mistake that was. Only recently have medics gingerly picked up the baton we first started 10 years ago of admitting this.
Oh wow. Appreciate having your wisdom around! You must be so disappointed to see how it’s gone so awry.
Diogenes your are very modest. Your are so well educated and well informed and generous with sharing your time and research with our thyroid journey to inbetter our thyroid journey. Thank you for all you do for us.As for T4 It works great for my brain. I feel the difference if my brain doesn't get enough of the T4. My brain doesn't work as well.
Diogenes is Dr John Midgley B.Sc (Leeds) D Phil (Oxford).
You can find more info on him here on the Thyroid UK website :
thyroiduk.org/about-thyroid...
You'll find many papers that diogenes has been involved with on Google Scholar under the name JEM Midgley.
scholar.google.co.uk/schola...
And a few on pubmed :
Thank you diogenes...not only for this, but for all you bring to our attention..... and the time you spend and give.
We can take all the help we can, so thank you for all that you've done and continue to do Diogenes.
Interesting paper , thanks for posting.
If they use TSH as the measure for dosing patients on T4, T4 /T3 combination therapy and NDT which would seem to me highly inappropriate, how can they even expect to get any meaningful results from any of their studies?
The only way to find out what thyroid hormone protocol best reduces brain fog is to let us freely choose what to take, have sensible measures of individual optimisation including patient reported symptoms, not just TSH, and the answer would become apparent. They could then concentrate study on the poor devils who still feel unwell after trying all three choices. We’d get a true measure of what’s thyroid related brain fog and what isn’t. I imagine the number of dissatisfied patients would plummet. If we carry on with the piecemeal approach at present we’ll get nowhere fast to finding any answers.
I find the T3 explanation by far the most plausible, no doubt coloured by my own experience where my brain fog was hugely improved when I took NDT with near immediate effects, like those poor darn mice my symptoms were reversed even though there was a very long delay before any treatment was initiated, the improvements were rapid once T3 was in the mix.
As for aromatherapy, aerobic excercise regimens and neuropsychology and several paragraphs on research trying to insinuate women really do not know anything about how they feel, symptoms come from suggestibility or are unaffected by thyroid hormone doses - most likely a range of woefully inadequate wrong doses - it makes for pretty grim reading. Why can’t they just accept what we say is the case and conclude it’s science that’s got it all wrong and work to improve the design of their experiments to actually reflect reality. They seem determined to invent a non existent reasearchland into which we are pigeoned holed, seen as a bunch of fantasists completely divorced from our own bodies or minds incapable of telling the truth - it’s a nonsense.
Oh dear we’ve a very long way to go in this never ending battle for the right to decent treatment. As for the claim of the unrealistic expectations of patients . I’d say it’s more a case of a lack of ambition on the part of health providers to get the best treatment possible for their patients that’s a big part of the problem.
I was told I simply had to put with feeling ill for the rest of my life on t 4 monotherapy because it was the only option by the endocrinology thyroid nurse I had the misfortune to see. It was complete and utter rubbish. I feel very well indeed on NDT. It is possible to restore health after very protracted and untreated thyroid disorder. We should never give up hope to be well again despite what these medical researchers and practitioners spout to the contrary. I stared death in the eyes with this awful affliction but I was still able to recover and have a good quality of life. I could be particularly tough and resilient or plain lucky, but I doubt it. I just needed the right treatment the rest came back naturally.
I’m not saying it’s the only illness causing every single health problem of course, but it’s an illness that wreaks absolute havoc in the body and every effort should be made to optimise appropriate thyroid therapy before blaming other things on persistent symptoms. I suppose they have to discuss the range of possible culprits but I found a lot of it a very disappointing read. I fear I’ll have pegged it before any real and meaningful change is achieved. I might have 20 -30 years if I’m very lucky.
Thanks for your great efforts in our behalf, it feels like an uphill struggle at times and hard to see any change in attitude or approach in endocrinology toward those with thyroid disorder.
Thyroid brain fog giving me a hard time
Terrible fatigue and brain fog
Brain fog in the morning 
