Re: Doc appt. did not go well - Elaine

[Guest guest]

Thanks Elaine -

I really needed some authoritative confirmation on that whole " TSH

fluctuates a lot in a given day " statement. When he said it, I really didn't

believe that could be true. I definitely didn't misunderstand what he said.

He clearly said that it could change from .5 to 4.0 in a given day. I know

it's supposed to surge a bit a night, but not the kind of changes he was

talking about! Changes of .3 -.5 sound way more reasonable. I don't know how

people would function if their levels fluctuated like he was talking about

each day.

I looked into 's syndrome last year, but I didn't think it applied to

me because my Free T3 levels have been middle range, so I figured I was

making enough of that. But their website said sometimes it doesn't show in

labs, so maybe there's still something to that theory. Maybe at least if I

try one of the doctors from that site, I'll get someone who understands the

relationship of FT4, FT3, TSH and autoimmune thyroid disease better.

Do you know of any studies or any other evidence that I could use as a case

for having replacement T4 for low end but normal FT4 lab results? And is it

really true that there are no studies showing that antibodies interfere with

the pituitary and TSH readings in autoimmune thyroid disease? Just from what

I've read, I found that statement hard to believe also.

How can there be such misinformation among doctors? <rhetorical question of

course>

Thanks again for your much needed input! I feel better at least knowing that

I'm not a nut and am being sold a pack of untruths.

Re: Doc appt. did not go well

> Hi ,

> I think your doctor is confused about TSH, but labs are to blame for that.

> When we began doing the TSH test, we recommended it for thyroid function

> screening but had no idea how it doesn't quite work this way in autoimmune

> thyroid disease.

>

> It's also not true at all that a TSH level will fluctuate from 0.4 to

> whatever he said in a given day. During the waking hours TSH only

fluctuates

> by about 0.3-0.5 mu/L.

> You're correct in that FT4 and FT3 measure your actual thyroid function.

TSH

> reflects it and in people who don't have autoimmune thyroid disease or

have

> stable levels on meds, TSH can be helpful.

> I'm not a fan of Dr. 's, but I believe his philosophy, and that of

Dr.

> Broda , are correct. Symptoms are much more important than labs.

There

> are many things that can interfere with lab results, depending on the

> reagent. We use monoclonal antibodies to different animals like goats and

> mice. On occasion we have people with antibodies to these animals who have

> labs that make no sense. And there's no way to know how often this

happens.

> We generally only pursue it when we're doing drug levels and they're so

> obviously wrong.

> Jody mentioned that a web site listing doctors who follow Dr. 's

> philosophy. I think I'd find a doctor more up on things. take care, elaine

>

>

>

[Guest guest]

Hi ,

Devin was asking about the pituitary/TSH receptor connection last week, and

in one of the posts he included the URL for Brokken's study. Dr. Utiger wrote

an article about this that was on the Thyroid Foundation of America web site

a while back. TSH receptors on pituitary thyrotroph cells recognize TSH

receptor antibodies, both stimulating and blocking ones, as if they were TSH.

Thinking we have enough TSH circulating in our blood, the pituitary slows

down TSH production.

I'm not thinking you have 's Syndrome, but I think the doctors who

follow his philosophy are more likely to understand that labs can be

misleading, and they're more willing to prescribe low dose thyroid

replacement hormone. Zoey and B had labs similar to yours when their

doctors recognized they needed replacement hormone. Hope this helps, Elaine