December 2019 – Page 2 – Thyroid Patients Canada

Relational Stability, part 3: Shifting TSH-T4-T3 relationships

December 16th, 2019thyroidpatientsca2 Comments

Why are some people extremely hypothyroid while their TSH is above reference range, while others have no symptoms and are completely healthy? How important is the Free T3 test when diagnosing true “euthyroid” status within the TSH reference range? Is it true that a normal TSH alone, or a normal TSH and normal FT4 test together, can assure us that the FT3 will also be at a healthy level within thyroid therapy? Could I take my TSH, FT4 and FT3 test results from when I had a healthy thyroid gland, and use them as treatment targets after thyroid disease or …

Relational Stability, Part 2: Normality of TSH and thyroid hormones

December 15th, 2019thyroidpatientsca2 Comments

Does the statistically-defined “normal” TSH reference range for the healthy population describe the TSH range for a healthy individual? Does having a TSH within the normal laboratory range always mean you, as an individual are biologically euthyroid? Does falling outside statistical TSH normality really mean that you are hypothyroid or thyrotoxic? This is part 2 of my paraphrase of Hoermann et al’s landmark article on the “relational stability” between TSH and the thyroid hormones T4 and T3. This section explains why thyroid science and clinical practice has overemphasized TSH testing and has isolated the three hormones TSH, T4 and T3 …

Relational stability among thyroid hormones and TSH, part 1

December 14th, 2019thyroidpatientsca3 Comments

In a series of posts, I’m sharing my plainer-English paraphrase of a very important article in thyroid science. My hope is that the public, doctors, and educated thyroid patients can better understand and appreciate its insights. This article by Dr. Rudolf Hoermann and colleagues Midgley, Larisch, and Dietrich explains the complex interrelationships between TSH, T4 and T3 hormones. Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2016). Relational Stability in the Expression of Normality, Variation, and Control of Thyroid Function. Frontiers in Endocrinology, 7. https://doi.org/10.3389/fendo.2016.00142 I often cite and comment on articles by Hoermann and colleagues …

What can prevent T3 from getting into thyroid receptors?

December 11th, 2019thyroidpatientsca2 Comments

This is part 2 of a post which began with the question “How do we get enough T3 into our thyroid hormone receptors?” In this post, I discuss the factors that can prevent T3 from getting into receptors. There are two factors that usually operate together: 1) the “variable rate” of T4 conversion in cells, and 2) a lowered supply of Free T3 entering cells. Abbreviations: TH = Thyroid hormone TR = Thyroid receptor D1, D2, D3 = Three types of deiodinases that convert thyroid hormones within our cells. The diagram Here is a model of a D2-expressing cell, a …

How do we get enough T3 into thyroid hormone receptors?

December 11th, 2019thyroidpatientsca4 Comments

In thyroid disease and therapy, even when TSH is normalized, we can still be genuinely hypothyroid if we do not have enough T3 getting into our thyroid hormone receptors in cells throughout the body. Most people know there’s two ways we get T3 into our cells’ nuclei: From circulating Free T3, and From circulating Free T4 hormone that is converted into T3 at a variable rate. However, most doctors are not taught about our cells’ and tissues’ high priority for and dependence upon circulating T3, nor are they taught about the largest factor that can reduce T4’s local variable conversion …