Category: HPT axis

Stop spreading the unscientific myth about the normal T4:T3 ratio!

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Sigh. Just sigh. Even some of our best thyroid patient advocates can unknowingly share misinformation about thyroid therapy. Mary Shomon’s thyroid articles on Verywell.com are usually to be trusted. But yesterday I was saddened to see that an article supposedly authored by Mary Shomon was spreading unscientific myths about “normal” thyroid secretion ratios being 13:1 to 16:1. These statements are misleading. They are not truly representative of the wide range of ratios of thyroid hormone in health, according to science. These 13:1 or 16:1 ratios have NEVER been clinically proven to be the only safe and effective ratios in thyroid …

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LifeLabs BC handout reveals thyroid testing policy failure

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This week (as of October 4, 2019), a thyroid patient from British Columbia posted an image of a piece of paper handed to her at a LifeLabs laboratory. LifeLabs BC was using this paper leaflet to explain to her why “Free T3 and Free T4 will not be tested when the TSH is in reference range.” The paper says this: “Thyroid Protocol Changes. YES: Diagnosis or comments on the requisition include any of the following words or phrases: All other diagnoses and comments do not qualify as special case.” In this post, I’m going to show how the leaflet reveals …

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Individual thyroid ranges are far narrower than lab ranges

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We’ve known since at least 2002 that being within “normal range” is never good enough when it comes to thyroid hormone blood tests. An important set of four articles has taught us that each human being has an optimal range for TSH, Total T4 and Total T3 that is far less the width of the population-wide reference range. Andersen, S., Pedersen, K. M., Bruun, N. H., & Laurberg, P. (2002). Narrow Individual Variations in Serum T4 and T3 in Normal Subjects: A Clue to the Understanding of Subclinical Thyroid Disease. The Journal of Clinical Endocrinology & Metabolism, 87(3) Andersen, S., …

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A Dialogue with Utiger: T3-based thyroid therapy over-suppresses TSH

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Robert Utiger, M.D. (1931-2008) is well known in endocrinology as the father of the TSH test. Despite his trust in the TSH test, in his publications he acknowledged that TSH behaved very unnaturally in response to T3 levels in blood while dosing T3 thyroid medication. What Utiger discovered in the 1970s and 1980s about the TSH reponse to T3-T4 combination dosing matters a lot to thyroid patients’ health and well being today because it provides a model of genuine evidence-based inquiry. Even though Utiger loved his TSH test, he was more than willing to admit that TSH behaved unexpectedly and …

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Overreliance on TSH is a thyroid therapy policy that fails to detect its own failure

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In standard T4 thyroid therapy, TSH normalization is so easy to achieve that it is almost impossible to fail. First, TSH out of range is the judge of an initial DIAGNOSIS. Next, normal TSH becomes the sole TARGET of therapy. Finally, normal TSH becomes the sole JUDGE of therapy success. This is faulty reasoning. There are no checks or balances to verify whether normalizing the TSH is a valid target or the correct judge. It’s a system that is set up to fail at detecting its own failure. A COLLEGE ANALOGY “Whenever I fail on an exam, I know it’s …

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