In a message dated 4/30/2002 1:44:25 PM US Eastern Standard Time,
[log in to unmask] writes:


> With severe weekness C falling asleep at the drop of a hat, I doubt that my
> useable T3 is really that high.  Unless too much can cause extreme
> weekness, shortness of breath, and chest pains? >>>

Did your doc ever ask you how you felt? About 85% of any diagnosis is simply
history (What has been happening to your patient before she came to your
office?), about 10% comes from the exams, and the labs add about 5% of the
diagnostic information.

Thyroid status is a Diagnosis, NOT a blood test. Patients with thyroid
problems were around far longer than the tests that were made to make
identifying them. Physicians (as opposed to docs) were correctly diagnosing
and treating hypothyroidism for about 100 years before the Clinical Lab could
say anything useful about thyroid status.

The use of Clinical Labs instead of Clinical Acumen, is probably the most
common reason that most of us came to this List Serve. Let's face it, if our
docs had done a good job, early in our illness, getting the diagnosis and
treatment right, we would not need to surf the web and discuss problems and
battles trying to get decent treatment for our problems.

I would trust most of my patients to titrate my thyroid meds before I would
trust any other doc in my town. Most of my patients are also better at
diagnosing hypothyroidism than most of the other docs in my town. My patients
tend to be observant, ask questions and listen. Too many docs don't bother.
People often get labs and prescriptions for antidepressants long before
anyone could have an idea of what is wrong.

Simply put, looking at labs without knowing the patient is like trying to
tell if someone is physically fit by only looking at the weight, and never
seeing the patient!

Run, don't walk to a doc who will listen to you, take a good history, and
THINK about the diagnosis. Reading isolated labs is probably less accurate,
and no more relevant to the diagnosis, than reading tea leaves.

Doc Don

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