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Website re: possible inaccuracy of reliance on thyroid hormone testing alone for diagnosis and treatment.

DandyButch profile image
15 Replies

Hi all, just wondering if this article is 'out there'.I found it quite enlightening.

Thyroid function tests—time for a reassessment

ncbi.nlm.nih.gov/pmc/articl...

[ Title of article/paper added by admin to help people decide whether or not to read, and remind those who might have read it! ]

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DandyButch profile image
DandyButch
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15 Replies
greygoose profile image
greygoose

That article was written in 2000. Since then, things seem to have got worse, not better.

DandyButch profile image
DandyButch in reply to greygoose

Very upsetting when research is ignored when it concludes something different to the research used as law.

I do think that race etc could be a significant fact because genetics vary, as per the non conversion from T4 to T3. But, using race is racist. But everyone knows that certain races can be more at risk from certain medical problems, due to their race and genetic history.

Seems if it affects some races, it is significant and researched and promoted.

greygoose profile image
greygoose in reply to DandyButch

Every patient should be treated as an individual, anyway. They shouldn't try to squeeze us all into the same mould. There are so many variables.

DandyButch profile image
DandyButch in reply to greygoose

Then why, oh why, is everyone treated the same, (except male and female), by the NHS using identical parameters for diagnoses and treatment.

greygoose profile image
greygoose in reply to DandyButch

Because doctors see us as all being the same. One doctor even said to me: "you're the same as everyone else, there's nothing different about you except your name - and even that isn't very original"!!! They believe that everyone has a perfectly working pituitary, and that everyone does well on levo mono-therapy. They refuse to recognise our differences - probably because it would make too much work for them!

helvella profile image
helvellaAdministratorThyroid UK

It was published on BMJ and, while the paper itself is inaccessible on the BMJ site, the related replies are accessible and could be of some interest:

Thyroid function tests—time for a reassessment

BMJ 2000; 320 doi: doi.org/10.1136/bmj.320.724... (Published 13 May 2000)

All rapid responses

bmj.com/content/320/7245/13...

humanbean profile image
humanbean in reply to helvella

I was gobsmacked by this paragraph in the reply by Alun Price (his credentials are at the bottom of the references and I see that he is a crony of AW) :

Finally, the danger we perceive in O'Reilly's article is that it may encourage the mistaken belief that hypothyroidism can be diagnosed clinically. At least let us be clear that symptoms and signs are inadequate for diagnostic purposes and thyroxin is not indicated unless hypothyroidism (clinical or subclinical) is confirmed biochemically.

I think a lot of patients nowadays would consider biochemical testing alone to be a terrible way of diagnosing hypothyroidism, and a complete failure in terms of making patients feel well, since it leaves so many of us untreated or under-treated. And modern doctors have made matters even worse by only treating TSH and ignoring Free T3 and Free T4.

I still remember reading an anecdote by someone who was told by a doctor that "We aren't here to make you feel better we are just here to get your blood tests in range."

(Or something like that - it was a long time since I read it.)

DandyButch profile image
DandyButch in reply to humanbean

I thought doctors were there to cure you by finding the cause and treating it so that a patient felt well again. Surely if the patient is still unwell, after treatment, the doctor has missed something. Is it because doctors like to pass the buck and don't take any responsibility any more.

humanbean profile image
humanbean in reply to DandyButch

I always assumed that doctors were supposed to make people feel well, and was horrified when I read that anecdote.

But now that I'm medically described as "elderly", and having had multiple family members and friends die in the last 20 years, i now have a much more realistic expectation of what doctors are likely to do for sick people.

But I am shocked to see how doctors have limited their own profession and their own expectations. It must make their jobs very depressing.

1tuppence profile image
1tuppence in reply to humanbean

You know hb, I've been wondering exactly the same about how medics in GP practices might be feeling now they are more and more disconnected from their patients...excuse me, any patient they might come across via online forms for why an appointment is needed/telephone contact not Face to Face/and no longer (in my local GP practice at least) have any patients who have them as their named doctor.

If I were only in contact via those means I feel sure I'd lose heart , as there is no proper contact.... no knowing the person who needs treatment. Horrid way to work. Soul destroying and soul-less.

FallingInReverse profile image
FallingInReverse in reply to 1tuppence

But 1tup, aren’t we too encountering eachother via similar online circumstances…

There’s something else going on - what happens between a person growing up wanting to be a doctor, studying for years, paying tons for school… just to end up doing more harm than good in that profession.

It’s too fantastic to believe how broken things are, and how the money somehow funnels to all the wrong places like administrators and layers of management instead of the patient and rewarding doctors who can make them well.

Everything is so upside down.

1tuppence profile image
1tuppence in reply to FallingInReverse

Yes, FiR, we do connect via on=line circumstances. But, we have the opportunity to learn about each other over time. We can read various responses to questions, and learn how each of us replies, forming a picture of the individual.

The main difference is no longer having a named GP. Each GP comes to each issue from a place of newness and computer screen. There seems to be no one GP who follows a patient's issue and then thinks "Oh! this needs further investigation as X keeps recurring without being resolved". I speak from experience here. 7 different Drs were involved in reading test results, and none of them were asking why this was happening until I made an appointment for F2F...in the days when it was possible to make an appointment without having to fill in the on-line form and then be triaged and informed 3 or 4 days later whether or not an appointment would be possible.

FallingInReverse profile image
FallingInReverse in reply to 1tuppence

Did not know that 1tupp! What has the world come to huh.

FallingInReverse profile image
FallingInReverse in reply to DandyButch

I almost thought you were being sarcastic…! I’d never thought of it before, but even here in the US in the past ~10 years I’ve experienced doctors become more like plumbers, too many patients jammed into 5-10 min appointments, performing a routine checklist of tasks and typing into a computer screen.

The stories I hear on this forum add a next level of suspicion around actual bad intention. I wake up every day and assume everyone is doing their best… but some of these stories it’s very hard to maintain that belief.

rosael56 profile image
rosael56

Very sad to see this article is 24 years old and yet nothing has changed.

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