This article in The Lancet looks at "healthy" levels of TSH (NB not on treatment). It proposes a narrower range expression for health for both FT4 and TSH. But it is devising these recommendations from a statistical viewpoint. Low TSH is related to greater chance of cardiac problems. And high FT4 is unliked. I mention this, because I fear that, if it comes into use, patients on treatment will be shoehorned into its approved smaller ranges from the incorrect point of view that relationships between TSH, FT4 and FT3 in treatment are the same as health. The block thinking from statistics is sharply illuminated, as opposed to personal presentation and any realisation that thyroid health and disease have different ranges.
The optimal healthy ranges of thyroid function defined by the risk of cardiovascular disease and mortality: systematic review and individual participant data meta-analysis
ConclusionThere was a J-shaped association of FT4 with cardiovascular disease and mortality. Low concentrations of TSH were associated with a higher risk of all-cause mortality and cardiovascular disease mortality. The 20–40th percentiles of FT4 and the 60–80th percentiles of TSH could represent the optimal healthy ranges of thyroid function based on the risk of cardiovascular disease and mortality, with more than 5% increase of 10-year composite risk identified for FT4 greater than the 85th percentile in women and men older than 70 years. We propose a feasible approach to establish the optimal healthy ranges of thyroid function, allowing for better identification of individuals with a higher risk of thyroid-related outcomes.
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Perhaps they should be made hypothyroid by having carbimazole for a while! Until these so-called “experts” realise just how debilitating and life-changing this condition is they will continue to come up with all these stupid, STUPID little pet theories that have absolutely no scientific basis in fact whatsoever! They make me want to throw up!
Such a disturbing philosophical position about how to draw conclusion.
It seems to me Tania Smith has debunked loads of this style of work. A study that starts off as observational (often or sometimes a decent piece of work), that then gets twisted out of context to be treated as prescriptive. Then they never find any actual evidence the prescriptive stance is effective, as they think they don't need to.
It’s happening with pedigree dogs, but it lessens the gene pool further which is probably the real underlying problem with their health issues.
We are a bit more than a just a thyroid gland, but we pay for it big time if it goes wrong, and get lousy treatment which is getting worse thanks to pseudoscientific rubbish like this article.
Scraping around for any value in the study, I see a tiny glimmer of light. If this is taken up, it requires archiving healthy TSH and FT4 levels in all and especially women so that the perceived problems coud be rectified on treatment for later thyroid loss. This of course is only a glimmer. The field has to admit that patients under therapy are not simply sick patients made well always (equivalently to health) with T4 only, and that FT3 has to be measured both archively and on treatment with both T4 and combination. But getting a thyroid function archive in health is what we have always advocated. If you don't know your start point, how can you run the race back to something like normality.
Starting in childhood, done as a standard test, would at very least have something to assess against in our teens and adult years. Sadly, they seem not to give... x2 proverbially. 'Research' for its own sake [I'm someone fully endorsing education for its own sake] - which excludes the plight of patients - smacks of one upmanship and pay cheques.
I have been proactive with regards to my son who has coeliac disease ( another autoimmune condition) . He does a comprehensive thyroid blood test every year ( he feels really well at the moment ), we now have about 6 years worth of annual blood tests ( which have been virtually the same throughout, i.e. very little fluctuation of levels) with thyroid hormone level and vitamin/ mineral levels, it will be easy to prove if there is a significant deterioration in hormone levels going forward. He has always had negative antibody results which may or may not be due to being strictly gluten free as my antibodies went very low after initiating a gf diet.
I wish I had had the opportunity to compare hormone levels before I had my children to those prior to diagnosis, which were scraping the bottom of the range for years, I was constantly told by GP's they were completely normal despite having every hypo symptom in the book.
The archive is, as you say, a positive suggestion from this study. I was diagnosed at age 64 (at the same time as an Hba1c test diagnosed T2 diabetes, diabetes and hypothyroidism seem to influence each other). My mother, in the 1950’s often observed that both myself and my father were cold blooded - we had a normal temperature around 1 deg C (she said 1.5 deg F!) so in the last 10 years I’ve sometimes pondered that both of us were already low thyroid, 50 or 60 years before my diagnosis. I can see an archive going back to the 2012 first test, but earlier than that it is “no test, no entry“!
🤦♀️ This makes me wanta puke🤮... I've been on my thyroid journey since around 2014 when some endo wrote a report on my 2 blood tests... "This lady appears to have 2 short suppressed TSH with episodes of thyroiditis" recommend she as regular thyroid function blood tests because of the thyroiditis episodes.First I never saw this report till 2020 when I requestedy records 😠 gp did absolutely NOTHING.. No further bloods.. NOTHING I went on to develop graves thyrotoxicosis, lost my thyroid in 2019 😠
But when the powers that be eventually noticed I was severely hyper in thyroid storm, I was given all kinds of information about my thyroid.
1, did I know my thyroid is known as the second heart?
2, did I know just how important the thyroid is to my health?
3, the thyroid does so much work in the body.
4, the thyroid is the body's thermostat.
Wow so much info from my ward doctor when I was in thyroid storm, he really seemed to care 🤗
Now let's go to.. AFTER my thyroidectomy... All the above went out the window, I honestly felt I was being treated for a mild cold😠 Here take these (T4) you'll never look back.... What a joke!
Since that time my gp/endo have tried me on T4, (didn't absorb it due to gut issues) 2020 put on T3 for which I'm still having gut issues 🤦♀️
I came to the conclusion early on, we don't matter, they don't care, we are a nuisance, just get on with it, I have other patients far worse than you!!
I'd been taken of my T3 because my TSH was 0.05...put back on T4 which plummeted my T3 level making me soooo unwell gut wise/hypo🤮... I told my gp to get me back on T3 asap, and only due to the dire T3 level did he agree.
I had a bit of a hissy fit with an endo in 2021 saying to her.. "you wouldn't treat a diabetic patient this way" so why do we as thyroid suffers get treated at such a low standerd ?
She snapped back saying.. "do you realise diabetic patients are far more ill that thyroid suffers, they have far more symptoms and are likely to suffer more, we treat diabetic patients the same as thyroid patients.
Hence to say she no longer wanted me as a patient... Suits me👍
They throw all these levels at us.. Not bothering to actually look at us or even asking us how we feel... (my experience) We're treated like robots.. Here.. this is your oil change T4, T3 now off you trot 🐎 bet if the horse had any thyroid issues it would get better treatment than we do.. 😁
I don’t understand how this study can draw conclusions about their stated reference levels of thyroid test results when they exclude anyone with (overt) thyroid diseases and anyone with diagnosed cardiovascular problems. It would have been more useful to produce 4 subsets of the potential cohorts: 1. Everyone, 2. No thyroid, no cardiovascular, 3. No cardiovascular (but include thyroid diseases), 4. No thyroid (but include cardiovascular). If there was no difference between these 4 groups, then drawing conclusions about the thyroid cohort from group 2 (no thyroid no cardio) might be OK.
It reminds me of another area of study, mostly funded by Big Pharma with Big financial interests in prescribing statins. Here they do the opposite - they include patients on statins in setting LDL and other cholesterol level targets - so if statins are so good and enough people are on them, then the target levels are being set by including those on this cholesterol reducing medication. Lowering cholesterol is associated with reduction in cardiovascular disease although Big Pharma is selective about which trial results to publish to support this.
The studies that use the Cochrane Central Register are using other trialist’s work. This is a cheap way of doing a study. It assumes that combining data from many trials will on average eliminate any bias or design shortcomings in one or more of the constituent trials. However due to their criteria for candidate studies and an unwillingness of some of the candidate studies to participate, they end up basing their conclusions on , 26 out of 3935 studies - that is 0.66% of them. That seems rather low to me!
You would have thought that you couldn’t make it up, but sadly the application of logic in designing trials seems to be sadly missing. Now if there was a drug that could improve the logic of trial designers……..!! I bet medical and government officials would ban it…..😂
Add to this the gender bias which despite mandating for sex equality rutinely excludes women or allows for a paltry 20-30% represenation of them in the clinical trials even when a lot of meds are used mainly by women and you have a really full fluffy picture of how well research works 😁
especially relevant for hypothyroid sufferers who are predominantly female according to most sources. As a bloke you have my sympathy and I hope things change.
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Thyroid Hormone and Heart Disease
