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Jiro comments on The Thyroid Madness : Core Argument, Evidence, Probabilities and Predictions - Less Wrong Discussion
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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.
No, not in general. It might be for diabetes, but that's fact-specific. Let's try substituting in something else:
Suppose fractured skulls were diagnosed by X-rays. And there were two sets of patients, who had roughly the same symptoms (head pains and bleeding), but one wasn't treated because the X-ray test showed that their problem wasn't a fractured skull. Would I say that the X-ray test is broken? Of course not.
Nicely done, thank you! My brain is broken, and this "informal reasoning" is harder than it looks.
In your case, the X-ray test is doing its job perfectly. And if the posited type 2 hypothyroidism needs different treatment from the type 1 version, which it probably would, then the TSH test will be a great way to tell them apart.
What I don't think you're allowed to do is say 'no problem, can't be anything to do with your car crash' when what you mean is 'your skull is not fractured'.
So the TSH test is a great test for TSH, and probably a good test for circulating thyroid hormones (although it doesn't give the whole picture). But I don't think that means that the TSH test is a good test for 'no thyroid hormone-related problem'.
Do we still disagree? Can I phrase my A&B&C=>(D OR E) thing better? Or do I need to abandon it?
Perhaps: Hypothyroidism (by which I mean any failure of thryoid hormones to act on cells).....
That example only works because fractures are involved in a subset of car crashes and car crashes are involved in a subset of fractures; either one can happen without the other. If that relation doesn't hold true, you would be allowed to say that. For instance, saying "no problem, can't be anything to do with your car crash' when what you mean is 'you weren't anywhere near a car at the time of the crash'.
Agree again, thanks