"The simplicity and economy of the Lawson Kinemometer makes it a utilitarian device for use in the clinic....... " (The case for Euthyroid Hypometabolism, Marshall Goldberg MD, American Journal of Medical Science October 1960 tpauk.com/downloads/EUTHROI... )
It's a shame there isn't still a KINEMOMETER in the 21st Century GP's toolkit .
When i was diagnosed in 2003 my GP had a go at assessing the speed of mine by eye, which was interesting, and led him to order further tests that led to diagnosis.. but obviously not very accurate by eye .
Typing " Lawson kinemometer tracing " into 'a search engine' produces some interesting stuff about tendon reflex testing in hypo / hyper / euthyroidism ..... eg. this one :
pmj.bmj.com/content/postgra...
POSTGRAD. MED. J., (1965), 41, 518 A CRITICAL EVALUATION OF THE TENDON
REFLEX MEASUREMENT AS AN INDEX OF THYROID FUNCTION
A. M. ROBSON, M.D. Ncle., M.R.C.P. Luccock Research Fellow
R. HALL, M.D., B.Sc., Durh., M.R.C.P. Wellcome Senior Research Fellow in Clinical Science
and Honorary Lecturer in Medicine
G. A. SMART, M.D., B.Sc., Durh., F.R.C.P. Professor of Medicine The Department of Medicine, University of Newcastle upon Tyne
"It is now accepted that the tendon reflex is prolonged in patients with hypothyroidism.
Chaney (1924) was the first worker to record the Achilles tendon reflex and prove what had
previously been detected clinically. Since then several systems have been devised for recording the ankle jerk....."
"Despite its limitations, the technique can be helpful in the diagnosis of hypothyroidism and it is especially
useful in assessing 'the effect of treatment and in regulating the dosage of thyroid replacement therapy
given to hypothyroid patients."
Interesting to see comment in print re. it's utility/ accuracy for assessing dose , rather than just for diagnosis.
( *note the dose sizes of levo they were using at this time ... "don't feel better on 300mcg .. ok, have 400mcg" ..... feel better ? great~ carry on )
They found some link to hypEthyroidism too ( speeded up, as opposed to slowed down) , but not in everyone.... hence their "...despite it's limitations" comment ........ but i strongly suspect this speeding up when hyper would have held true for me , because when was overmedicated with thyroid hormone , i was literally 'jumping' in response to unexpected noises in the street.
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"The delayed relaxation of the tendon-jerk in myxoedema was first described by Ord (1884), and in 1924 Chaney, using a pneumatic recording system, measured the tendon-reflex time in myxoedema and showed that it returned to normal with treatment. In 1929 Mussio Fournier demonstrated rapid tendon reflexes in thyrotoxicosis. Various techniques have since been devised for timing the ankle-jerk...... "
".....Though previous authors (Lambert et al., 1951; Fogel et al., 1962) have reported that return of the reflex speed to normal during treatment of hyperthyroidism or hypothyroidism correlates well with the clinical state of the patient, we have not been able to confirm this. Indeed, in our series, in both thyrotoxic and myxoedematous patients, the VP measurements returned to normal values within a few days of starting treatment and long before any subjective or objective clinical improvement. Furthermore, during treatment of myxoedema or thyrotoxicosis the tendon-jerk time became abnormal some days before clinical evidence of overdosage or underdosage appeared. Hence it is of great value in the regulation of treatment." bmj.com/content/bmj/1/5491/...
(Value of Ankle-jerk Timing in the Assessment of Thyroid Function, British Medical Journal, 1966, 1, 830-833 )
A Little Bit of History re Thyroid Hormone replacement
Paper about the relationship of iron deficiency and thyroid function
TSH Suppression Benefits and Adverse Effects
