I'm afraid that this will be another arrow in the TSH doctors' quiver. What will most likely be overlooked is the reference to "potential negative consequences of thyroid hormone excess". Neither the word "potential" nor the the words "thyroid hormone excess" are likely to be acknowledged. Just thought I'll share so that everybody might be prepared for another reason to treat the TSH and not the patient (beside bone and heart trouble reasons).
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buddy99
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I can't see the entire paper. It seems they are suggesting that elevated thyroid levels as a result of hyperthyroidism are the same thing or can be equated to a lowered TSH (indicating 'overtreatment' or thyrotoxicosis ) from too much T4 hormone being administered. It didn't explain what is cognitive disorder or how that was defined and measured (but probably does in the full paper?)
Am I right in saying none of the cohort had a diagnosis of 'cognitive disorders' 6 months prior, but after they looked for it for the purposes of the test they were diagnosed with it.
In this cohort study among patients 65 years and older, a low TSH level from either endogenous or exogenous thyrotoxicosis was associated with higher risk of incident cognitive disorder. Iatrogenic thyrotoxicosis is a common result of thyroid hormone therapy.
Yet again we see TSH being touted as the significant marker!
And a "fear" of thyroid hormones!
Surely they should be looking at the active thyroid hormone FT3....and the patients symptoms which are frequently overlooked
Surely cellular T3 level needs to be be excessive before thyrotoxiosis develops?
Ah....but we cannot use lab tests to measure cellular T3.
We must rely on clinical evaluation.....can they do that without the crutch of "guidelines"!
FT3 measures the T3 in the serum which if the system functions correctly will reflect the level of T3 reaching the nuclei of the cells where it becomes active and attaches to T3 receptors .....so high serum FT3 in a correctly functioning system would mean high cellular T3.
And, high cellular T3 will ultimately result in thyrotoxicosis
However, if some form of resistance exists and the serum T3 does not adequately reach the T3 receptors in the nuclei then there may not be enough cellular T3 to cause thyrotoxicosis....despite there being a high serum level/ FT3 and suppressed TSH
So....we come back to the importance of treating the patient and their signs and symptoms rather than depending solely on a list of numbers, as the diagnostic tool.
By sidelining the symptoms there is a danger of wrong diagnosis if TSH is the focus
Are these patients being wrongly diagnosed as being at risk of developing dementia!
I declare a personal interest here!
On the basis of this study, as someone aged 78 with a form of Thyroid Hormone Resistance, who needs a supraphysiological dose of T3-only to function, with consequent suppressed TSH, should I now anticipate an increased risk of cognitive disorders....and dementia.
I doubt it, because my cellular level of T3 is not causing any symptoms of overmedication.
I'm clearly no expert but this abstract doesn't offer much confidence in the actual study.....
But, it may just add another arrow in the TSH doctors' quiver....if they fail to see beyond TSH.
My point exactly! Hurrah, say the doctors (without reading the whole paper), now we have even more reason to keep patients as hypo as possible. Grrrrrrr!
For many years my TSH has been around 0.005, my T4 several points above the range, BUT my T3 within range, at the higher end. Luckily my GP and a consultant have agreed to continue my current medication dose, 175mcg daily and I am metabolically well. (no sign of bone problems after scan). if my thyroxine dose is reduced (I've tried it) I begin to feel unwell after about ten days. I am now having problems with low ferritin. I am sure I need an iron infusion but specialists are only looking at figures. My iron level is 18 and I cannot absorb though my stomach. I am extremely annoyed that decisions have been reached without so much as a consultation. This is the difference between treating the patient and just looking at numbers. I CAN LOOK AT NUMBERS and I'm not a doctor.
They were more clued up about clinical evaluation 60 years ago before reliance on tests and numbers crept in
An old medic friend of mine used to repeat, " Listen to your body, it will tell you if something is wrong".
I am extremely annoyed that decisions have been reached without so much as a consultation.
This should not happen...they should consider Autonomy
Autonomy in medical law states that patients should have the right to be allowed to make their own choices over what medical treatment they should receive. I'm not a lawyer....a GP told me this when I started to self medicate with T3!
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