TSH test
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Several fallacies in the TSH-T4 paradigm of thyroid therapy
When you are steeped in a medical paradigm, its fallacies can be as comfortable and taken for granted as an old pair of sneakers. In this post, I’ll take apart several thyroid therapy fallacies, starting with the fallacy “description is not prescription.” I will investigate many of the ways in which patients on T4 monotherapy…
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TSH “can be very misleading” during thyroid therapy, say researchers
How many treated hypothyroid patients’ TSH has fallen below range even when both their thyroid hormones are in normal range and when they have no symptoms or signs of hyperactivity or hypermetabolism? In my observation on thyroid patient forums, the answer is “too many.” It’s common among thyroid patients to resort to such forums for…
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Thyrotoxicosis can occur with high or normal TSH?
Table 17.1 in Braverman & Cooper’s 2013 chapter in Werner & Ingbar’s The Thyroid textbook, 10th edition, lists many causes of thyrotoxicosis. The only time the TSH _hormone_ is listed as a cause of thyrotoxicosis is in the case of “Inappropriate TSH hypersecretion.” If thyrotoxicosis can occur when TSH is inappropriately _high_ or non-suppressed in…
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Thyrotoxicosis vs. Low TSH
Our medical system has invested so much in the TSH test that we’ve given it authority to override medical discernment about thyrotoxicosis. The oft-repeated mantras that “TSH is the most sensitive and specific test” and “the only necessary test” have blinded many doctors to the diverse influences that can suppress or inflate TSH secretion. Many…
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References for Thyrotoxicosis vs. Low TSH series
Posts in this series July 2019 Thyrotoxicosis? Many factors can lower TSH Thyrotoxicosis: Symptoms and signs Thyrotoxicosis vs. Low TSH Thyrotoxicosis can occur with high or normal TSH? TSH “can be very misleading” during thyroid therapy, say researchers How TSH ultrashort feedback works, and antibody interference Pregnancy thyrotoxicosis vs just a low TSH due to…