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Rapid Responses: Rapid Responses published:
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TSH has no clinical correlation
- David Derry (17 October 1999)
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50 years of commercially motivated fraud relating to thyroid
- Raymond Peat (16 November 1999)
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Useful Data
- Dawn Brighton (5 February 2000)
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Re: TSH has no clinical correlation
- Candie Freeman (16 July 2001)
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Thanks for useful thyroid info
- Phyllis Kasper (31 October 2001)
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Personal symptomology count for something
- Nancy L. Adams, Deb Sullivan (15 September 2002)
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This information needs to go to the Pathology Labs.
- Donald F Hughes (5 October 2002)
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David Derry, Practicing Physician Victoria British Columbia Canada
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Dr Weetman's article brings an important point forward in that there is no correlation except at extremes between the signs and symptoms of thyroid problems and the TSH. This is clearly stated by Dr. Anthony Toft of Edinburgh in Werner and Ingbar's The Thyroid 1991. page 294. Hence why are we following a test which has no correlation with clinical presentation? The thyroidologists by consensus have decided that this test is the most useful for following treatment when in fact it is unrelated to how the patient feels. The consequences of this have been horrendous. Six years after their consenusus decision Chronic fatigue and Fibromyalgia appeared. These are both hypothyroid conditions. But because their TSH was normal they have not been treated. The TSH needs to be scrapped and medical students taught again how to clinically recognize low thyroid conditions. |
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Raymond Peat, independent research Eugene, Oregon
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Until the second world war, hypothyroidism was diagnosed on the basis of BMR and a large group of signs and symptoms. In the late 1940s, promotion of the (biologically inappropriate) PBI blood test in the U.S. led to the concept that only 5% of the population were hypothyroid, and that the 40% identified by "obsolete" methods were either normal, or suffered from other problems such as sloth and gluttony. During the same period, thyroxine became available, and in healthy young men it acted "like the thyroid hormone." Older practitioners recognized that it was not metabolically the same as the traditional thyroid substance, especially for women and seriously hypothyroid patients, but marketing, and its influence on medical education, led to the false idea that the standard Armour thyroid USP wasn't properly standardized, and that certain thyroxine products were, despite the fact that both of these ideas were shown to be false. By the 1960s, the PBI test was proven to be irrelevant to the diagnosis of hypothyroidism, but the doctrine of 5% hypothyroidism in the populaton became the basis for establishing the norms for biologically meaningful tests when they were introduced. Meanwhile, the practice of measuring serum iodine, and equating it with "thyroxine the thyroid hormone," led to the practice of examining only the iodine content of the putative glandular material that was offered for sale as thyroid USP. This led to the substitution of materials such as iodinated casein for desiccated thyroid in the products sold as thyroid USP. The US FDA refused to take action, because they held that a material's iodine content was enough to identify it as "thyroid USP." In this culture of misunderstanding and misrepresentation, the mistaken idea of hypothyroidism's low incidence in the population led to the acceptance of dangerously high TSH activity as "normal." Just as excessive FSH has been shown to have a role in ovarian cancer, excessive TSH stimulation produces disorganization in the thyroid gland. |
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Dawn Brighton, R.G.N. Community Nurse Southampton
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I would just like to say what an interesting artical, and easy to read in the B.M.J. I have currently a personal as well as professional interest in this article, and found it to be very informative. I have copied off the info, and will keep it in my Notes. Many Thanks
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Candie Freeman, self employed Platte Valley Excavating & Custom Farm Work
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I've tried to find out when, who & how this "normal" level was decided on for the TSH test. I've gone to several doctors for symptoms I've had for years, since Feb. 94 ,I was in a roll over accident which I believe injured my thyroid, I gained 60 lbs. in 5 1/2 years and the fatique & depression got so bad, which doctors always blamed menopause for my symptoms I'm 48. I can now spot a low thyroid woman 10 feet away or on TV, why can't doctors see this problem in so many of their patients? This TSH test , I had this test 30 years ago and was "normal" which I believe I needed thyroid treatment back then, I sure could have avoided at lot of misserable years. The only time I ever felt like a normal person was when I went to a Dr. Robert Starks in Denver, CO. 20 years ago, now he's retired, but I found the doctor who took over his practice, in Cheyenne WY. even then I have a hard time convincing him that I need just a little more Armour than 240 mgs. / day,because of going so long before treatment, but the depression and fatique are slowly going away,hair is still falling out and a few other symptoms slowly going away, but I've been treated since Jan. 3 01 lost 34 lbs. have 25 more to go, I just thought I'd feel better sooner. I wish for myself and so many other women that something can be done soon about this TSH test, and the normal levels, when a person has almost all the symptoms why don't doctors treat the symptoms? I just don't understand. A 9 news health fair in Denver CO it was found that 13 million people have low thyroid and don't know it, this is figured out by the TSH only, they did on everyone, this isn't even the T3 T4 free T3 freeT4 or the TRH tests so I believe there are millions more that suffer from low thyroid, including people like my son who is bypolar and I know thyroid treatment would help the symptoms he has, depression, fatique,weight etc. Sign me , Frustrated with TSH test, Candie |
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Phyllis Kasper, Psychologist Great Lakes Psychiatric Center
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I'm a psychologist working in a small independent mental health clinic, I have also worked in hospital and medical clinic settings. I believe that many clients who are referred to me for "psychological" problems such as depression or anxiety have overlooked thyroid problems. I worked for 10 years doing basic research in psychoneuroimmunology before doing a clinical internship. I sometimes sendd clients back to the referring doctor for another look. I also do a lot of work with chronic pain using biofeedback and teaching self-hypnosis for pain management. I always ask my fibromyalgia clients to get a thorough check for thyroiid problems and allergies. Proper diagnosis and treatment can make all the difference. On a personal level, I believe that I had undiagnosied hypothyroidism for 25 years. When I was charting my basal temperatures in 1976 to track ovulation, my temperature range was 94.2 to 97.6. The doctor told me this was normal. I've tried levoxyl and now thyroid for about a one year period and am much improved, but still trying to find the right dose. Only my allergist apologized for missing the diagnosis. One family practice doctor told me my health problems were simply due to being lazy and uncooperative. My current family practice doctor is more willing to listen to my opinion and pay attention to symptoms as well as tests. Physician education regarding the thyroid is essential. |
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Nancy L. Adams, self self 81226, Deb Sullivan
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For what it's worth, I was on T-4 only meds beginning in 1985 because of a TSH of 6.25. T-4 brought my TSH down to 2.2, yet for 3 years before treatment, and 17 years during, I had debilitating exercise-induced Dysautonomia. When my TSH (while still on T4 only) rose to a "normal" 3.15 the past year, my dysautonomia became crippling--I couldn't do anything without suffering debilitating consequences. Only when I switched to natural hormones, which raised my T3, did my dysautonomia DISAPPEAR, and I am getting closer to normal as far as energy levels than I've been for over 20 years!!! Measuring my TSH as the only guide for my overall health was foolish in my case. |
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Donald F Hughes, self employed Melbourne Australia 3000
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Thanks for this information, but it really needs to go out to the pathology labs. In practice, that's where a typical GP gets his information on what's normal! I've personally been aware of some of the symptoms of hypothyroidism since childhood because of a family history of it. For as long as I can remember I've had difficulty keeping warm, despite growing up in a sub- tropical climate, so I've long been suspicious about my own thyroid function. Every few years I'd request a thyroid function test, and be told everything was normal. Eventually the problem was recognised at about the age of 50 by an Endocrinologist I was seeing for something else. I was put on synthetic thyroxine, and the difference was nothing short of remarkable. Even so, my body temperature is still low and so is my libido. Based on the information in this article, I suspect I'm still not being adequately treated. Regardless, it's clear to me that this problem should have been diagnosed decades earlier. I have to ask why. Probably the first issue is that GPs apparently believe this problem only affects elderly women. When I was a young man the possibility that I had a thyroid problem was not taken seriously. The other issue is that the ordinary GP who runs these tests isn't a specialist, and can't be expected to know what normal is for each test he orders. He relies on the pathology lab report to tell him this. And what does the lab give him? The very wide range commonly seen in the general population. This does NOT indicate what normal is, but unfortunately the poor GP has nothing better to go on. Back in the 1970s, Chereskin & Ringsdorf published their work on "Predictive Medicine", which opened my eyes to this. It's been 20 years at least since I read it and I can't remember the fine detail, but here's the gist of what they did. They tested several bodily substances of apparently healthy people then followed up with those same people some years later (10?). The original test levels were widely spread, but looking at only those people who were still healthy years later, their early tests had all been VERY close together. |
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