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  • Anonymous
      Post count: 93172

      While I can’t make any contradictory remarks concerning the
      overall gist of this article, I did want to ask a question
      that someone might be able to shed some light on. It sounds
      like Dr. Volpe is a firm believer in the TSH test. Okay,
      it is recognized as the most “sensitive” of the thyroid
      hormone tests. However, docs I have talked with have
      told me that it takes a minimum of 6 weeks for changes in
      my TSH to show up in a bloodtest. Wouldn’t this fact make
      TSH as “weak” as tests for Free T4 and T3 then? Isn’t it
      possible that changes in FT4 (at least) levels could be able to
      react to the increased/decreased TSH levels by the time
      the TSH changes show up in a bloodtest result?? Well, anyway,
      I think I’m getting too technical for a Friday afternoon.
      Anyone else heard about the “lag time” for TSH changes
      to show in bloodtests though?

      Sheila H.

        Post count: 93172

        ‘thyrobulletin’ Summer 1998 Volume 19, No.2

        Dr. Volpe Speaks:

        Misinformation on diagnosis and treatment

        There is a great deal of misinformation
        being spread by alternative medicine
        regarding the diagnosis and manage-
        ment of hypothyroidism. In a recent publica-
        tion by a drug firm, the tradition continues as
        they have published an article by the Broda
        Barnes Research Foundation which is essen-
        tially without foundation.

        The article states that determining the
        standard thyroid function tests “fails to do
        what really counts”. This is simply incorrect.
        The authors instead state that a simple basal
        axillary temperature test would determine
        thyroid status. In fact, the temperature range
        for axillary thermometry varies quite widely
        and the use of such a procedure would pro-
        vide a completely erroneous idea as to who
        has thyroid disease.

        We now have extremely sensitive tests
        which measure thyroid stimulating hormone
        (TSH). The results of this test will be elevat-
        ed even before the serum free thyroxine or
        triiodothyronine values decline as patients
        are becoming hypothyroid. Thus, we often
        are able to diagnose what is termed compen-
        sated hypothyroidism while patients have no
        symptoms whatsoever. In such circum-
        stances, the TSH has already risen but the
        levels of thyroxine (T4) or triiodothyronine
        (T3) are still normal at this point.
        Conversely the TSH will fall even before the
        levels of T4 and T3 rise and this is termed
        subclinical hyperthyroidism.

        It is thus clear that the TSH is the most
        sensitive test of thyroid function. Indeed, if it
        is normal, one simply cannot make a diagno-
        sis of primary hypothyroidism or for that
        matter hyperthyroidism.

        Of course, there are some people who
        feel that one can have thyroid function
        abnormalities even with completely normal
        thyroid function tests. However, there is no
        objective evidence for this whatsoever, and
        the consensus amongst thyroidologists,
        including members of the American Thyroid
        Association, is that patients who have vari-
        ous symptoms but normal thyroid function
        including a normal TSH simply do not have
        thyroid dysfunction.

        Another point raised by The Broda
        Barnes Research Foundation is the measure-
        ment of a 24 hour urine test for T4 and T3.
        No endocrinologist in the academic world
        would use such a test when we have
        available the very sensitive TSH determina-
        tions. Once again, there is no credence in
        such a test and it is never even mentioned at
        national and international thyroid meetings.

        Finally, there is no evidence that natural
        preparations have any advantage whatsoever
        over synthetic thyroxine. There is no evi-
        dence that they (i.e. synthetic thyroxine
        preparations) are “very poor replacement
        therapy” and there is no evidence that natural
        desiccated thyroid hormone has proven to be
        much more “bio-equivalent in the body” as
        stated in the article in the drug brochure.
        These represent merely empiric statements
        without any scientific support and should be
        given no credibility.

        —-end of article—

        Message 1 of 0


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