There was some discussion in one of the other threads about the reliability of information provided by sites such as www.stopthethyroidmadness.com. I’d like to continue the discussion here, in an appropriate thread. I’d also like to use this thread as a resource for thyroid information, such as useful studies, press releases, etc.
A little backstory for those who aren’t aware: many people make the claim that hypothyroidism symptoms are very similar to hypogonadism symptoms, or that the symptoms cover a very wide spectrum of negative effects, and that the tests that are regularly run (i.e. TSH and fT4) are insufficient for diagnosing hypothyroidism on their own. However, most medical professionals consider the TSH+fT4 panel to be sufficient.
There is also a lot of confusion and controversy about the proper range for the TSH test. Specifically, a lot of medical professionals and labs use the 0.3-4.5 or 0.3-5.0 range for diagnosing hypothyroidism (above 5 → probable hypothyroidism). However, some medical professionals, and many individuals who believe that they have hypothyroidism (and who have benefited from treatment), believe that the upper limit should be 3.0, 2.5, or even as low as 1.0 for individuals that are expressing symptoms. Here are two useful links from medical professionals who argue in favor of a lowered upper limit:
TysonKilpatrick posted a rebuttal of many of STTM’s (www.stopthethyroidmadness.com) hypothyroidism claims in another thread. I have copied it here:
[quote]Purechance and Akaji,
In the interest of full disclosure, I have not vetted all of the information on STTM and so will not damn the entire site since that would be unfair. Before I give a few specific examples that I pulled from the first page I came to when I visited the site let me take a second to make a few general statements about medical information in general and some situations in which skepticism should be the default:
The site is moderated/written by a person/group with an agenda i.e. revenge against tendentious and intellectually lazy western medicine (like STTM’s stated raison d’etre)
The site is maintained by people with no medical background. This is a classic case of a wiki expert who knows just enough to be dangerous and make some valid points while not understanding the complexity of the system.
The site promotes one malady as the “real reason” for just about all that ails you. They take non-specific symptoms i.e. fatigue, brain fog, depression, weight gain, etc., which can be caused by about 1000 other disease states and blame them all on one underlying problem. I think everyone on the this board with TRT experience can vouch for the inaccuracy of this position. If hypothyroid isn’t your thing try looking up heavy metal toxicity, vaccine fearmongers, qui-gong practitioners, etc. They all sound almost exactly the same.
They move the goal posts constantly. So if your numbers are out of whack there’s your problem, if they are perfect you still have a problem and the stupid doctors are missing the details somewhere. The pet issue (hypothyroid) is always to blame for unimproving symptoms regardless of the evidence to the contrary.
Now, do these things make the information incorrect and negate every point the site makes? Of course not. Some of what I’ve seen on the STTM site is valid, for instance. This makes it all the more insidious for the lay person because there is enough correct information that it obfuscates the incorrect/oversimplified material and confuses the reader.
For a few particulars, and again this is just what I pulled from the first page I saw and I’m extrapolating to the rest of the site so grain of salt…
The claim that the TSH test alone is ALWAYS inadequate. This is simply false. The TSH level has been validated so many times as an excellent marker for thyroid function that it hardly bears argument. Remember that there are a HUGE number of extremely intelligent people who do this for a living i.e. practicing specialist, that vet the literature constantly looking for new ways to help their patients, that to conclude that the consensus of medical science is so naive as to have missed this cornerstone of diagnosis is quite a bold statement. The few doctors the author quotes are in the minority and they still use the test. Are there situations which make a TSH level ALONE inadequate? Absolutely…that’s why we run more tests. The thyroid is not that complicated in the scheme of things and there are a select number of places that things can possibly go wrong so if a person is symptomatic despite a “normal” TSH, no physician would withhold further testing because the lab said the person was “fine”. That’s a strawman.
Another example surrounds the sites interpretation of adrenal labs. The author really muffed this one and it is a great example of a person reading a text/wiki and then posting information without really understanding it. DHEA is not the mother of all hormones/steroids and is therefore not the end all marker for adrenal/steroidal function as is the claim. The ACTH stim (cort stim test) does not require fasting, can be done at anytime of day, does not require a doubling of cortisol for a normal reading, etc. etc. I could go on but I really don’t have time right now. If there are any specific questions I would be glad to field them.
And I don’t call these sites malpractice since they aren’t run by practitioners, just to clarify.[/quote]
This was my response, which lead in to this thread being created (per VTBalla’s request, as this discussion was on his personal thread):
[quote]Thank you for the response, Tyson. I appreciate the info.
Regarding the TSH test - what is your opinion on the controversy re: the correct lab ranges? E.g. there’s the AACE 2003 report stating that 0.3-3.0 should be the range, and the NACB 2002 report stating that 0.3-2.5 is likely to be the range in the future; there are also studies saying that a TSH over 2.0 indicates a significantly higher risk of hypothyroidism developing later in life. On the other side of the issue, many boards, groups, studies, etc. are claiming a TSH of 4.5 or 5.0 should be the high range, and some even say that a TSH below 10.0 should never be treated… it’s a very confusing situation to me. [/quote]
We can use this thread for generalized thyroid and hypothyroid questions, theories, etc.