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- Page navigation anchor for RE: Thyroid Stimulating Hormone Stability in Patients Prescribed Synthetic or Desiccated Thyroid ProductsRE: Thyroid Stimulating Hormone Stability in Patients Prescribed Synthetic or Desiccated Thyroid Products
I am concerned that this study, publicized in Science, and discussed in physician forums online, may be misleading, either accidentally or intentionally.
A large healthcare system such as Kaiser Permanente has thousands of patients taking thyroid preparations prescribed by many types of physicians. In this population are patients with complete absence of endogenous thyroid function, and those with marginal or even questionable need for a thyroid pill. An example of the former group is a 50 year old woman who became hypothyroid from autoimmune thyroiditis, with pretreatment TSH of 60 and a current full replacement dose of 137 mcg. An example of the latter group, whose requirement was more marginal is a 50 year old woman who complained of slow metabolism to her primary doctor, who found a TSH of 6 and prescribed 25 or 50 mcg of levothyroxine. Neither type of patient is rare, but the second woman may well stop taking her thyroid pills in the future and her TSH will have returned to normal; her "TSH stability" will be excellent. I looked in vain for average current dose and pre-treatment TSH in the 25 characteristics carefully matched and reported by these authors. Almost every one of the 25 listed characteristics is less important to TSH stability than the degree of hypothyroidism. Why would the authors not include the current average doses and the pre-treatment TSH levels? It is difficult to imagine an honest motive for concealing a substantial difference...
Show MoreCompeting Interests: None declared.