TSH hormone – Thyroid Patients Canada

Four types of unstable thyroid function in the elderly

August 11th, 2022thyroidpatientsca1 Comment

Diagnostic concepts like “subclinical hypothyroidism” have become cognitive barriers to understanding the adaptations and dysfunctions of the aging hypothalamus-pituitary-thyroid (HPT) axis. Thyroid diagnostic categories are usually based on whether TSH and FT4 are in range, above range, or below range, in relation to an age-blind reference range. These are convenient biochemical stereotypes. These stereotypes have convinced many people that “thyroid function” is easily discerned by judging these two hormone levels by their separate reference intervals. Fortunately, leading thyroid scientists are breaking down stereotypes. They are trying to show physicians that thresholds of dysfunction and health risk are not necessarily located …

Age bias may hide hypothyroidism under a normal TSH

July 22nd, 2022thyroidpatientsca2 Comments

Scientists have been explaining that TSH responds to thyroid hormones differently in childhood, early adulthood, late adulthood and very advanced age. This poses a problem for regions that have implemented TSH-only screening for thyroid dysfunction. The effect of age on TSH is one of many factors that can make this screening test less accurate (Ling et al, 2018). Thyroid scientists have known about the age-distortions of TSH for at least 20 years (Hollowell et al, 2002). People have been advocating for age-specific reference intervals for a long time (Surks & Hollowell, 2007). Many advocates emphasize the older population’s need for …

Visual bias: The pituitary gland in HPT axis diagrams

July 14th, 2020thyroidpatientsca4 Comments

Too many diagrams focus on the “HPT axis,” in which the Hypothalamus, the Pituitary, and Thyroid gland are the biggest icons. Take for example this diagram from Ortiga-Carvalho’s chapter in a physiology textbook. The huge, super-ballsy pituitary. Seriously? In diagrams like these (this is not the only such pictorial), the truly pea-sized TSH-secreting pituitary gets blown out of proportion. It’s now a masculine, two-lobed blob that dangles over the thyroid like a master commanding his passive, smaller-sized servant. Pituitaries don’t normally get this large in relationship to the thyroid gland, so this is as physiologically incorrect a diagram as one …

7 ways to raise TSH without reducing thyroid dose

January 21st, 2020thyroidpatientsca9 Comments

You’ve just come to your doctor for your annual check-up. Either you feel fine and you want to get a renewal of your current thyroid prescription, or you feel rather hypothyroid and you’re hoping to get an increased dose. But your doctor has been trained to say this: “Your TSH is below reference (or too low in reference). I’m going to have to reduce your thyroid medication.” The current therapy guidelines say so. Your heart sinks. You predict months or a year of increased brain fog and fatigue. But have hope! There could be a way to escape from perpetual …

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 …