"Rethinking Hypothyroidism" - Antonio Bianco

[wiseoldwoman]

Hello everyone. Hope it is ok to post this about an author...? Book is same title. I could not find his name flagged on this forum so maybe he is not well regarded? just that I found his talk on youtube one of the most informative and clear explanations of this miserable condition - haven't got to the end of it but I learnt a lot just in the first 10 minutes, as someone who has been trying (fighting?!) for over 10 years to discover what my symptoms mean and GPs telling me it is : nervous exhaustion/age/chronic fatigue/fibromyalgia et al. Anyway, hope this is useful. Never Give In!!

youtube.com/watch?v=_6T2lSI...(Not working as expected?)

[DippyDame]

You will find more re Bianco on RHS of page....under "Related Posts"

His focus is on TSH, not FT3 and FT4 which are the important labs ....so diagnoses are not necessarily accurate!

These may be of interest...

healthrising.org/blog/2019/...

frontiersin.org/articles/10...

[wiseoldwoman in reply to DippyDame]

Hi, thank you for those excellent links. I had not realised his adherence to 'normal' TSH as it does not seem to be mentioned until the Q&A (approx 38 minutes in-yes, I have now listened to it all!) wherein he says 1.5-2.5... totally agree with you however, it is positive that he seems to be an advocate of T3 (in some patients!) Was bit concerned at his position on T3 'causing' AF but on the whole I found his explanations about how the thyroid hormones and d-enzymes function to be informative/helpful - for me anyway 🙄also interesting were his comments about changing attitudes in US about combination therapy and T3 etc - UK seems to adopt most US concepts so maybe will filter through to here🤷‍♀️ all the best to you.

[RedApple Administrator]

This link is to a forum search for Bianco. He and his book are mentioned quite a lot here healthunlocked.com/thyroidu...

[wiseoldwoman in reply to RedApple]

Thank you so much, as above reply to DippyDame and very useful to read the comments of others. This youtube seems to have been from 1 month ago with the thyroid trust so I do not know if it is that recent or not. As I do not need to say, this is so complex as we are all individuals with different lives/ages etc and while treatment is obviously 'available'.. one size fits all doesn't cut it.

[jimh111]

Bianco is the leading expert on deiodinase. He is giving a talk in London on Saturday 18th November. It's scheduled to take place in Covent Garden but the venue might change.

He adopts a conservative approach but I suspect he is more open than he appears in public. I don't think anyone has contributed more to our understanding of deiodinase and our need for T3. Here is his website deiodinase.org/ .

[wiseoldwoman in reply to jimh111]

Yes, it is interesting that he seems very cautious despite seeming to have researched decades back yet refrains from really questioning the mainstream approach.... e.g. range of TSH. Best case scenario is this is a form of peer pressure (who is brave enough to withstand the slings and arrows of 'colleagues'?!)but ...?? Totally agree about his enzymes explanation, illuminating indeed. Thank you.

[Blissful in reply to jimh111]

Great link

I found this confusing - does e.g. the NHS use the “direct FT3 method”?

However, measuring serum FT3 levels is labor intensive and requires equipment not readily available in most clinical reference laboratories. The majority of all commercially available assays utilize an alternative approach to analyze FT3 concentrations directly in the presence of proteins (unfractionated samples of serum). This “direct FT3 method” is subject to interference and lack specificity. It is not clear that using a direct FT3 assay offers any clinical advantage over measuring serum TT3 levels.

[jimh111 in reply to Blissful]

Immunoassays are used as they are cheap and simple. This is beyond my knowledge, I'm not sure what the quote about. Is this quote from the Bianco talk?

[Blissful in reply to jimh111]

It's from page 2 of the link you posted

deiodinase.org/

[jimh111 in reply to Blissful]

Here is a paper that discusses the various methods chemistry-europe.onlinelibr... . Note I haven’t read it.

People can pick up antibodies that confuse immunoassays which usually use mouse antibodies. I don’t know the details but the idea is if you live or work with certain animals you get antibodies that mess up the immunoassay. However, in this excellent presentation youtube.com/watch?v=Z0Z-zYF...(Not working as expected?) the chap in charge of the lab at Addenbrooke’s says that assay interference is quite rare.

[Regenallotment]

He has been interviewed by Dr Eric Balcavage on his Thyroid Answers podcast too. Great episode he asks some very insightful questions. Particularly about people who don’t present with ‘normal’ blood work.

Here is the link via Apple Podcasts podcasts.apple.com/gb/podca...

[wiseoldwoman in reply to Regenallotment]

Thank you - will have a look - tomorrow:cognitive function now gone for the day!

[Regenallotment in reply to wiseoldwoman]

I know the feeling 🤗

[Marymary7]

Thanks. I listened to the end. I didn’t get it when he was asked in the last question I think, ‘what if you have no TPO antibodies but you have thyroglobulin antibodies’ he said then you have Graves which is overactive not under active thyroid?

[wiseoldwoman in reply to Marymary7]

Hopefully one of the very knowledgeable folk on here can explain...

[helvella Administrator Thyroid UK in reply to Marymary7]

I don't accept that as a definition of Graves.

People frequently have times at which they are hyperthyroid due to Graves. But either after taking an anti-thyroid medicine for a while, or spontaneously, go into remission and have within-range thyroid hormone levels. (I'm ignoring the low levels while actually taking anti-thyroid medicines.)

It doesn't seem at all right for people in remission to be told they don't have Graves because they are not currently overactive.

That seems to be the implication of that saying "Graves which is overactive..."

Also, the main problem we see with Graves is what used to be called "a long-acting thyroid stimulator (LATS)" which is now seen to be TSH receptor stimulating antibodies. Not thyroglobulin antibodies.

(I do not know how often thyroglobulin antibodies are found in people with Graves. Must try to find out!)

[tattybogle in reply to Marymary7]

in reply to an earlier question (1.05:30) he said . "TPO ab are more typical in hashimoto's , while TGab are typically more positive in graves , but both can be present in any ...."

His reply to that last Q does not mean that a ptient with raised TGab without TPOab definitely has a Graves diagnosis.... he is just saying that having positive TGab without TPOab is more likely to be present in graves patient than hashimoto's patient.

Most hashimoto's patients will have positive TPOab , but not all (there are studies where they found clear physical evidence of autoimmune thyroid destruction , but no evidence of raised TPOab, so from this we know it's possible that a few patients without evidence of raised TPOab may have hashimoto's) .

TPOab nay be raised in both hashimoto's and graves patients, it is very common for graves patients to have rasied TPOab , but their levels tend to not be so high as you find in hashimoto's patients

TGab may also be raised in both hashimoto's and graves patients .. bianco is saying it's more common that they are raised in graves .

[Marymary7 in reply to tattybogle]

Thanks for replying. I was confused as in my first private test yrs ago my TPO ab was 12.9 and Thyroglobulin ab was 507 and I have Hashimoto’s.