In a message dated 4/3/2004 3:46:25 PM US Eastern Standard Time,
[log in to unmask] writes:

> She said the T4 is the best test to see whether or not one needs
> supplementation.  Is she correct?  >>>

No. The effect of supplementation on the health of the patient is the best
test of whether one needs thyroid. Laboratory work can be helpful in deciding
some matters, but it is ultimately the health of the patient that counts.

The "normal range" doesn't necessarily reflect a range of health, simply it
reflects the middle 95.5% of the population that got that thyroid test done (at
our lab and University of Michigan's lab, at least). The people we usually
get thyroid levels on are usually ill people who we suspect of having a thyroid
problem.

There are countless people who can have "normal" looking TSH, T3, T4 and
whatever else you may wish to test, yet be clinically hypothyroid and would profit
from a trial of the correct thyroid medication.

The History (What has been happening to your patient?) is 85% of any
diagnosis, the Exam (How does the patient look to the, hopefully, trained eye? is
about 10%; and the labs are only worth about 5%. This is what they taught me in
Medical School. I didn't believe it then, I do now. (Too soon we get old, too
late we get smart.)

To say that you don't need thyroid replacement based on your labs alone is as
silly as saying that you are physically fit if you weigh something between 85
and 260 pounds (about 37-118 Kg) without ever seeing you or asking any other
questions.

Doc Don

>
>

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