Research Reviews – Page 2 – Thyroid Patients Canada

Relational Stability, part 4: The new thyroid paradigm

December 16th, 2019thyroidpatientsca3 Comments

This final section of my paraphrase of Hoermann et al’s landmark 2016 article articulates the shift from the limited, older TSH-T4 paradigm to the new paradigm that includes T3 hormone. Interrelational Measures and Emerging New Concepts of Thyroid Homeostasis [Paraphrase begins] TSH can play a useful role in screening patients who do not have any hypothyroid or hyperthyroid symptoms. However, it cannot at the same time assume the second role of being a reliable diagnostic tool (a gold standard) for defining true “euthyroid” status within the TSH range. We should therefore scale back the common practice of clinical interpretation of …

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 …

Discordance in thyroid symptoms reported by patients and their doctors

December 10th, 2019thyroidpatientsca0 Comments

There’s no surprise that patients and doctors would disagree about the incidence rate of hypothyroid symptoms in a given patient. “We have an average of 7.2 symptoms per patient” says the cohort of 262 patients. “No, you have an average of 4.0 symptoms per patient,” says the cohort of 100 doctors about those 262 patients. This is especially unsurprising during standard therapy in contemporary society, now that the TSH test is commonly used to declare a patient “euthyroid” despite any or all chronic symptoms of hypothyroidism. But to what degree do patients and physicians disagree in their reporting on a …