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Date: | Sat, 2 Aug 1997 19:24:32 -0500 |
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Kevran,
Good points. The TSH is absolutely NOT the only important test in
evaluating thyroid function. For the TSH value to be meaningful the
hypothalamus, the pituitary, and the adrenal glands (called the HPA axis
for short) must all be functioning properly. A problem in any one of
those systems or anywhere along the chain can cause the thyroid to not
be triggered by TSH (which comes from the pituitary).
Unfortunately, many more doctors than not worship the Almighty TSH and
the drug Synthroid. If somebody's results to all of the tests you
mentioned are "normal" the next step is to ask for a TRH stimulation
test. After you argue with the doctor who will insist that this test is
outdated and unnecessary, demand s/he order it or find a doctor who
will. Usually they'll do it if you ask them to humor you!
A normal response to this test is about an 8.5 to 20 point jump in the
TSH at 30 minutes post injection of TRH. (They draw blood for a
baseline TSH, inject TRH IV, and draw samples at 30 and 60 minutes.
Anything less is considered a blunted response and can mean one of two
things. If the person has symptoms of hyperthyroidism and the standard
tests point in that direction then it may well mean hyperthyroidism.
But, and this is the one most doctors conveniently ignore, if the
standard tests are inconclusive (i.e. "normal"), and the patient appears
clinically to be hypothyroid, then a blunted response points to
pituitary or hypothalamic insufficiency. The treatment for this?
Thyroid hormone either in the form of T4 or a combo product such as
Armour. Again your point is well-taken. Don't accept the word of the
office staff OR your doctor that "you're in the normal range." Demand
copies of all your test results.
You also can have resistance to your own thyroid hormone at the cellular
level, and in this case Cytomel (T3) has been used successfully to treat
this form of hypothyroidism. This is the main idea behind the Lowe
protocol. I have more info on this if anyone's interested. Please
request by private e-mail.
Dale
[log in to unmask]
Kevran Day wrote:
>
> I just want to point out that many stories on this list indicate that TSH
> is *not* the most reliable test. If you suspect you have a thryoid
> problem, please get a complete thyroid panel, including free T3, free T4,
> TSH, and the anti-thyroids. <snip>
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