= 27d567bc2d48d9f40e9ccc20ea370b15)
Lumifer comments on The Thyroid Madness : Core Argument, Evidence, Probabilities and Predictions - Less Wrong Discussion
You are viewing a comment permalink. View the original post to see all comments and the full post content.
= 783df68a0f980790206b9ea87794c5b6)
Loading…= b715d02e85f7b3b4ae65ca3d3e450868)
Subscribe to RSS Feed
Powered by Reddit
= f037147d6e6c911a85753b9abdedda8d)
You are viewing a comment permalink. View the original post to see all comments and the full post content.
Comments (132)
No worries about sounding harsh! I declared Crocker's Rules, so I'm explicitly asking you to optimise for communication and not worry about offending me. And I very much appreciate you taking the time to tell me things I don't know.
That's exactly what I'm saying! The action of T3 seems to be to control ATP recycling in the mitochondria. Sarah Myhill's beautiful paper to my mind proves almost beyond doubt that that's the problem in CFS. This is what I mean by 'every time I look for disconfirming evidence, I find new reasons to believe'.
I know that I sound like a crank. That's because I am a crank. I am a member of several at-risk groups for Arrogant Overconfidence Disorder, which I strongly suspect to be related to hypothyroidism in some way. Others have suggested that I am under a certain amount of 'stress'.
CFS/FMS and hypothyroidism are much more similar than most diseases, to the point where out of a fabulous number of possibilities I was trying to fit to what was wrong with me, hypothyroidism looked instantly like what I had, despite the fact that I'd not only had the test for it, but the test was bang in the middle of the normal range. And I think the CDC agree. One of the diagnostic criteria is explicitly that hypothyroidism have been ruled out (haven't checked this, just a memory).
But also, doesn't the fact that all diseases look similar strike you as suspicious? As I understand it that was the whole reason for the 'stress' theory in the first place.
Let me think about the logic for a while, I'll get back to you.
OK, logic looks fine. I really need to know if that bit's wrong. It means my mind is broken.
If they're not differently caused then they have the same cause. And if that's true, then in one case the TSH test is picking it up, and in the other it's not. So the test is not doing what it's supposed to.
Suppose diabetes was diagnosed by insulin levels instead of blood glucose. And there were two sets of patients, who had roughly the same symptoms, but one lot weren't treated because the insulin test showed that their problems weren't diabetes.
Would you not say that the insulin test was broken?
We should be looking for the 'blood glucose' for hypothyroidism. And as a very lot of people have been claiming since 1940, that's 'slow metabolism'.
I really hate arguing by analogy. But it seems people don't understand unless I do, and I'm now arguing to persuade. Not of the truth of the hypotheses, but of their plausibility.
The sciences I trained for would leap on this. Medical Science has left it uninvestigated (to say the least) since 1970. Whether I'm right or not, that's careless.
And if I'm right.... Jesus Christ.
Well, what's the test for speed of metabolism? Usually it's measured by the consumption of oxygen (VO2, high-level athletes do that a lot) and that's not a particularly expensive or difficult test. I am sure there is data on the distribution of VO2 in normal population. Do you think this test would be adequate for your purposes?
I think it most definitely would. Broda Barnes didn't like it, but only because the test is stressful and so tends to give false negatives (you're looking for the resting rate). But as long as it's done carefully, it should be fine.
The resting VO2 will need to be post-processed to be a diagnostic indicator. A brief look indicates that it is a function of sex (higher in men), age (higher in younger people), and weight. Might be a function of physical fitness (or at least lean body mass) as well.
Yes, sorry, thank you. The important quantity would be metabolic rate divided by the best prediction from the known relevant variables, as you say. It was once a test for hypothyroidism, so whatever the last word pre-blood test was should be good enough.
As I say, Broda Barnes found this test wanting and preferred waking axillary temperature (for females, on the correct days; for males, anytime), but it should be plenty good enough to establish that there's something funny going on. The problem is to draw the attention of medical science to it at all. I trust them to sort out the details.
You are digging into this problem and I suspect there's enough published data on RMR (resting metabolic rate) in healthy and not-so-healthy people to collate some interesting evidence.
Agree, we should be able to refute it or strongly support it from the published literature. My initial attempts at that look like refutation. How can fibromyalgia in Turkish women be associated with HIGHER body temperature if my hypotheses are true?
And I wonder if there are enough Less Wrong readers with friends with these diseases to make a survey of some sort?
That's not how you find patients a lot of patients. It makes more sense to seek online communitites where people with the illnesses congregate.
There's the patientslikeme forum: https://www.patientslikeme.com/forum/fibromyalgia/topics
http://www.fibromyalgiaforums.org/
http://www.healingwell.com/community/?f=24
Oh, and I predict that the resting VO2 would be normally distributed, but with a skew towards low values, and the size of that skew should be directly related to the size of the problem.
And that low VO2 should correlate strongly with cholesterol, fatigue, blah, blah, blah.
And I've got no idea whether that's true. It's a prediction.
Well... Technically speaking, that's impossible because normal distribution is defined on the negative infinity to positive infinity range. So there should be some kind of a bounded bell-shaped distribution, might be a truncated normal but I have no idea whether to expect heavy or light tails.
A paper reports that for the sample size of 535 people they have the mean of 241 ml/min with the standard deviation of 56.6. They have some graphs and eyeballing them the observed minimum is around 100 and the observed maximum is about 450 -- that indicates a bit of a right-hand skew. But their population is not normal, their sample is basically cardiac patients.
You can go chase the references in that paper. At least one looks promising.