JarOfPickles I found your write up interesting, but only in a funny way, now I appreciate that you are a GP, and like the women you mentioned I had a T4 on the floor when diagnosed TSH not horrendous but still 52, and no I was not ill not in the slightest, it was found by accident and I ollapsed ended up in hospital being told I could have had heart attack, then they prescribed Levothyroxine, then my life got turned upside down, my hair fell out, I lost my eyebrows, I started dripping of sweat, had anxiety which turned into a full blown panic disorder,my once always laughing personality gone, my memory gone, and my nickname was data base and Maggie thatcher as I had a photo graphic memory,and I never needed more than 5 hours sleep all my life all 39 years.my skin began to itch, dermatitis,i could not stay awake at work, I could not function, then guess what? oh yes then came the "you have CFS/ME I said at th time you are talking rubbish, what would be the chances the week I start Levo I miraculously get CFS, you then say I you had questions you would speak with the Endocrinologist, I find this even funnier, I saw an Endo for 18mths, at every appointment he would say "hello what shall we try today" every up I medication was my idea, to add T3 was my idea, and at the end of 18mths he told me he was only allowed to see a patient for 18mths, I said you have not done anything for me, every change has been my suggestion,now this whole time I have been in range but y in range has been T4 10.4 (range 10.4-21) T3 3.4 (range 3.2-5.9) nowyou keep going on about your patients are not ill they are within range,common sense says that when they put this into place in 1973 (if my memory serves me well), there has to be a top and there has to be a bottom, they took an average fro people not diagnosed with hypothyroidism or hyper,but that does not mean they were all 100% well just because none had been diagnosed, but this is where the real common sense comes into it,
if for argument sake you tell me you are looking for a new car, nd I say there is a scale we work on for our cars, and this is it,
10, excellent in everything
9, slight problems with with speed, but runs well
8, costs a lot on petrol,is juddery,winder wipers are intermittent
7, breaks down regular,struggles to get up hills,leaks petrol
so as you can see on the above scale if you want a great car you will get one at range 10, if maybe you have not got much money you may plum for a 9, but only someone absolutely skint, and has no other choice would go for a 7, but the car sill works, any lower than a 7 would be a car that did not work at all.
now what you are saying is if you have a patient, say who is like me who is right at the bottom of both ranges, you would say I am well because I am within range.do you understand what I am saying. if I am at the bottom of the rang I do have symptoms because my thyroid is working but not well.
The TSH test is not a satisfactory test, and before you say I have got it wrong, I have read an incorrect website, no I have not I have actually met the gentleman and I have read some of his thesis and reports, who came up with the TSH test, (he did work with another guy if I remember) the test is not used as it was intended there have been many irregularities with the consistencies of these, tests and the different variations and procedures with blood used at different facilities, they do not all do the same, they do not all treat the blood correctly as the test was intended,
and you may say you do everything possible, my GP is very honest and tells me that he is a GP not a specialist and as such there are many areas he would not know, and don't take this the wrong way, you study very hard to be a doctor and you normally specialise in one area, and as such you know a little bit about everything but not a lot about most things,as my GP once analogised it, "we are the checkout worker of a super market, he said we know everything we sell, but don't know much about all the items in the aisle. s we sell o much stuff, that's why you pen a bookfor an answer, that's why the tests you send off tell you if in range or not, that's why you enter patients symptoms to get an answer for possible medications.