Hypothyroidism. Interesting abstract

[AlexanderDenmark]

Thyroxine should be tried in clinically hypothyroid but biochemically euthyroid patients (Skinner GRB, Thomas R, Taylor M, Sellarajah M, Bolt S, Krett S, et al. BMJ 1997; 314: 1764)
We wish to question present medical practice, which considers abnormal serum concentrations of free thyroxine and thyroid stimulating hormone–those outside the 95% reference interval–to indicate hypothyroidism but incorrectly considers "normal" free thyroxine and thyroid stimulating hormone concentrations to negate this diagnosis. It is unusual for doctors to start thyroxine replacement in clinically hypothyroid but biochemically euthyroid patients.
The free thyroxine and thyroid stimulating hormone concentrations in 80 patients considered to be hypothyroid on established criteria indicated that only five patients had free thyroxine concentrations (just) below the reference interval of 10-19 pmol/l (values of 9.4, 9.8, 9.8, 9.9, and 9.9 pmol/l) and only four patients had thyroid stimulating hormone values above the reference interval of 0.5-5.5 mU/l (values of 5.6, 8.4, 11.8, and 30.1 mU/l); moreover in these 80 patients the mean (SE) concentration of free thyroxine was 12.9 (0.2) pmol/l and the mean concentration of thyroid stimulating hormone was 2.2 (0.4) mU/l; both of these values lie well within the normal reference intervals. While we accept that there will be subjective variation in the evaluation of clinical diagnostic criteria and that the long term response to thyroid replacement is a prerequisite of our proposition, exclusion of hypothyroidism on the grounds of hormone concentrations measured in the laboratory seems wrong.
We contend that an incremental three month trial of thyroxine treatment in clinically hypothyroid but biochemically euthyroid patients is a safe and reasonable strategy. The dangers of osteoporosis and cardiac catastrophe–particularly during a three month trial–are sometimes quoted, but these worries are unfounded and condemn many patients to years of hypothyroidism with its pathological complications and poor quality of life. We urge that the question of clinical hypothyroidism in biochemically euthyroid patients should be subjected to a formal clinical trial.

Goes to show that hypothyroidism is probably horribly undiagnosed and undertreated. I think it might account for a large percentage people who are depressed and have "psychosomatic" ilnesses.

[marianco]

Originally Posted by AlexanderDenmark

Thyroxine should be tried in clinically hypothyroid but biochemically euthyroid patients (Skinner GRB, Thomas R, Taylor M, Sellarajah M, Bolt S, Krett S, et al. BMJ 1997; 314: 1764)
We wish to question present medical practice, which considers abnormal serum concentrations of free thyroxine and thyroid stimulating hormone–those outside the 95% reference interval–to indicate hypothyroidism but incorrectly considers "normal" free thyroxine and thyroid stimulating hormone concentrations to negate this diagnosis. It is unusual for doctors to start thyroxine replacement in clinically hypothyroid but biochemically euthyroid patients.
The free thyroxine and thyroid stimulating hormone concentrations in 80 patients considered to be hypothyroid on established criteria indicated that only five patients had free thyroxine concentrations (just) below the reference interval of 10-19 pmol/l (values of 9.4, 9.8, 9.8, 9.9, and 9.9 pmol/l) and only four patients had thyroid stimulating hormone values above the reference interval of 0.5-5.5 mU/l (values of 5.6, 8.4, 11.8, and 30.1 mU/l); moreover in these 80 patients the mean (SE) concentration of free thyroxine was 12.9 (0.2) pmol/l and the mean concentration of thyroid stimulating hormone was 2.2 (0.4) mU/l; both of these values lie well within the normal reference intervals. While we accept that there will be subjective variation in the evaluation of clinical diagnostic criteria and that the long term response to thyroid replacement is a prerequisite of our proposition, exclusion of hypothyroidism on the grounds of hormone concentrations measured in the laboratory seems wrong.
We contend that an incremental three month trial of thyroxine treatment in clinically hypothyroid but biochemically euthyroid patients is a safe and reasonable strategy. The dangers of osteoporosis and cardiac catastrophe–particularly during a three month trial–are sometimes quoted, but these worries are unfounded and condemn many patients to years of hypothyroidism with its pathological complications and poor quality of life. We urge that the question of clinical hypothyroidism in biochemically euthyroid patients should be subjected to a formal clinical trial.

Goes to show that hypothyroidism is probably horribly undiagnosed and undertreated. I think it might account for a large percentage people who are depressed and have "psychosomatic" ilnesses.

From my point of view, the mental illnesses all have a physical basis - a physical pathophysiology. For mood disorders (including anxiety disorders), suboptimal thyroid signaling due to various other causes is present in nearly all patients.

Synthroid is relatively safer than using Armour Thyroid. It is more easily tolerated in patients with adrenal fatigue. Not all patients improve on Synthyroid, however. For example, they may have problems converting T4 to T3. In these patients, having an option like Armour Thyroid or T3 is highly useful.

[AlexanderDenmark]

Tibetan medicine the other way around asserts that most chronic health problems have some kind mental component or basis. From what I can understand from your posts, you say that the body is the mind and the mind is the body.

I understand the buddha dharma's explaination of this that body is not the mind and the mind is not the body. The two are interdependent. The subtle difference is of great importance. Because if the body is the mind and the mind is the body. It means that you can't be mentally well if you are psycially ill. Which is something I don't quite agree with. I'd say that one is much more likely to well if one is psycically healthy, but it isn't garaunteed.

Of course Buddhism isn't an established science as such, but I do find that most of the teachings on mind and body issues still ring true after 2500 years.