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Lumifer comments on Thyroid Hormones, Chronic Fatigue and Fibromyalgia: A Hypothesis and a Proposed Experiment - Less Wrong Discussion

3 Post author: johnlawrenceaspden 20 February 2016 11:20PM

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Comment author: Lumifer 07 March 2016 10:21:40PM 1 point [-]

for forty years they've been arguing about what blood levels of TSH fine people have, and the latest answer is "such a narrow range that huge numbers of people who aren't ill are outside of the range".

Rephrased a bit, this says "Healthy people have such a narrow range of TSH that huge numbers of healthy people are outside of this range". I trust you see the problem.

the real problem is that they never checked whether it worked or not

What do you mean by "worked"? As you yourself point out, it's just one variable in a complicated system with feedback loops. If you mean "necessary and sufficient to give a clinical diagnosis", then no, it never "worked". Doesn't mean the number is not useful.

Comment author: johnlawrenceaspden 08 March 2016 10:52:40PM *  0 points [-]

Absolutely I see the problem! Thank you for phrasing it more elegantly than I did. And absolutely TSH is a useful number. It's a very fine measure of the hormone thought to control the T4->T3 conversion rate, as well as the thyroid output.

Now can you tell me (a) What the AACB did wrong in their report, or (b) why, when someone goes to their doctor with many of the symptoms of hypothyroidism, they do this test, and they find the number to be within a very broad range, and then they say "your problems can't be anything to do with thyroid hormones".

Especially in the context of diabetes, another endocrine disorder, where we know that you can have normal levels of hormones, but for some reason they aren't working, and you have high blood-sugar that is killing you anyway? No one in their right mind would tell a type-2 diabetic that they weren't diabetic because they had a normal amount of insulin.

Comment author: Lumifer 09 March 2016 03:32:55PM 1 point [-]

What the AACB did wrong in their report

I don't know, haven't looked at it. I suspect that the underlying issue is that for one variable in a complicated process the concept of unconditional "normal range" might be too simplistic.

why

For the usual reasons :-/ Find a better doctor.

Comment author: johnlawrenceaspden 09 March 2016 05:16:50PM 0 points [-]

Except that all the better doctors have been struck off! Who takes hypothyroidism to a chiropractor?

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