Proof positive that "successful" diagnosis and treatment is assumed to occur with "normal" TSH

[diogenes]

This downloadable paper from the Bianco lab shows in sharp focus the unwillingness to demote "normal" TSH from its spurious role as an endpoint to routinely determine satisfactory T4 monotherapy. The community still hangs on to this by its fingernails, whatever the contrary evidence. And of course, satisfaction is statistically recorded rather than individual patient's' experiences.

Levothyroxine Treatment Adequacy and Formulation Changes in Patients With Hypothyroidism: A Retrospective Study of Real-World Data From the United States

June 2023Thyroid: official journal of the American Thyroid AssociationFollow journal

DOI: 10.1089/thy.2022.0382

Antonio C. Bianco, Yanjun Bao, Oscar Antunez Flores, Todd Frieze

[TiggerMe]

Low blow for a Monday morning diogenes 😕

[Musicmonkey]

Rude word. Rude word. Rude word 😡

[tattybogle]

link to paper:

pubmed.ncbi.nlm.nih.gov/373...

So from 2013 -2020 the American GP's have been better at keeping patients TSH within range than they were previously ..

That's nice for them .

( nice for the GP's anyway ...)

[FAB-jellybean]

Gotta love that it's "physician engagement and patient education" that's recommended and not the other way round. 🙄 But then again looking at real world data without asking the pertinent questions explains that statement!

[Hoxo]

I don’t understand Bianco. Why waste time and resources on this nonsense?

[DippyDame]

Most LT4-treated patients maintain normal TSH levels, which is an improvement vs. previous reports.

But how do these patients have to feel to enable that conclusion?

[LAHs]

Well, that's nice and I am glad it gave some medics fun collecting data BUT I have a clear memory when I was being treated for hypothyroidism and my TSH was normal and I felt like I was dying - and I think I was, slowly at first and then it began to accelerate. Why do I say this: because for all of the data, nowhere did it mention how the patients felt. When they had normal TSH were they well and full of energy or did they feel like hell. When they were measuring very low TSH did anyone notice (they certainly didn't record) that the patient felt wonderful. The bottom line is how is the health of the patient. If they feel ill, then something is wrong and further study has to be done on what is causing the illness. For me it was low T3, as simple as that and I researched as to how I could raise it and did it cause any harm to live with low TSH (the answer was no).

[serenfach]

How the patient feels is not important. The figures are the important bit. So you are just a collection of numbers. It also does not matter that most drug testing for ranges was done on young fit males. You are a round peg and the only hole is square so you will be made to fit whether you like it or not.