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-   -   Toft February 2003 (http://www.healthboards.com/boards/thyroid-disorders/105230-toft-february-2003-a.html)

Sky_Eagle1 09-03-2003 02:29 AM

Toft February 2003
 
If anyone wants to read about this reference I have posted occasionally in here, here's the information you need:

Toft, A. D, Beckett, G. J (2003, Feb) Thyroid function tests and hypothyroidism. Measurement of serum TSH alone may not always reflect thyroid status. BMJ 2003 326: p. 295-296 [url="http://bmj.com/cgi/content/full/326/7384/295"]http://bmj.com/cgi/content/full/326/7384/295[/url]

Of course, Toft has his nose firmly and proverbially implanted in TSH's posterior (this was the guy that said any consideration of T3 is hogwash back in 1999), but you'll see some admissions TSH isn't the be-all to end-all, and some other good statements.

If anything it'll be a good start for some discussion in this thread - this is what we have to go against to get well is lame brained idiots like Dr. Toft.

[This message has been edited by Sky_Eagle1 (edited 09-03-2003).]

CheriP 09-03-2003 07:25 AM

Thank you for posting. I found the article very interesting. I'm also interested in the tone in which people write, usually indicating to me the underlying mood or "come from" that the author has. It's amazing how one's ego can get in the way of so many things.

Once again,
Thanks for the info.

midwest1 09-03-2003 07:50 AM

Sky Eagle,
How do you interpret Toft's statement --
"Of course, we are perhaps naive in thinking that patients with autoimmune thyroid disease who continue to complain of non-specific symptoms despite restoration to normal of TSH and T4 concentrations can be improved by tinkering with the dose and form of thyroid hormone used for treatment. It is just possible that these symptoms arise from the chronic inflammatory basis of the underlying thyroid disease, but that story is largely unwritten."

??? Is he saying nobody has done research to know whether replacement of either or both T4 and T3 helps Hashi's? (Yikes. I feel doomed... :( )



CheriP 09-03-2003 08:38 AM

I know your question was directed at SkyEagle, but I wanted to give my interpretation.

He's basically saying that tinkering with the dose and form of thyroid hormone may not eliminate all the non-specific symptoms experienced by auto-immune thyroid diseased patients. His premise is that these symptoms COULD be caused by the underlying chronic inflammatory nature of the disease, which he acknowledges has not been written too much about. Nor, does he offer what alternatives a patient is left with if this in fact the case. It almost seems as if he is saying, too bad, so sad.

Judging from his tone in the editorial, both condescending to his medical counterparts and the patients themselves, I suspect that this is not a doctor that I would want treating me. While he seems intelligent and knowledgable about the science of the subject, he doesn't seem open to explore possibilities...which may include "tinkering" with various formulations or dosages, or considering application of other options which may present themselves in the future, in order to decrease the non-specific symptoms of the patient.

It is my belief that there is more to being a doctor than simply striving to treat the patient medically. I firmly contend that they have a responsibility to make every attempt to assist the patient in achieving a state of well-being.

I changed pediatricians several months ago because my son's doctor only wanted to talk to me about medical issues, and not help me with other issues relating to a new baby, i.e. the infant's sleep patterns, feeding patterns, etc., all of which had to do with trying to achieve a state of well-being for the baby as well as the household. I feel the medical and well-being go hand in hand. Our new pediatrician answers my questions and discusses wellness issues with me too. I feel as though we are "partnering" in care of the baby.

That is the relationship I think we all desire from our practitioners in treating our thyroid issues.

[This message has been edited by CheriPatrice (edited 09-03-2003).]

midwest1 09-03-2003 12:49 PM

[quote]Originally posted by CheriPatrice:[b]It almost seems as if he is saying, too bad, so sad.[/b][/quote]
That's what I was afraid he said... ! Thanks for that gloomy confirmation, CheriPatrice.

I know exactly what you mean about wanting a partner in health. I'm not paranoid enough to believe that doctors really conspire to keep their patients ill out of cruelty; but they have all the human frailties as the rest of us. Whatever keeps them from making correct diagnoses and providing proper treatments is going to continue, I think, and maybe even get worse. The list of "whatevers" is long; could be ego, ignorance, fear, money, pride, control... or a combination of any of them.

I've met a lot of doctors in my time. I can count on one hand the number who I admired and felt in good hands with. Want to hear some horror stories?... The internist who told my dad he was depressed and needed to snap out of it, when he actually had terminal metastatic brain cancer. The pulmonologist who performed a bronchoscopy in his office on my good friend without the backup of a crash cart or even a tank of oxygen... She died right there from an anaphalactic shock reaction to the local anesthetic, and she was a barely 23 year-old newlywed. The cardiologist who delivered the unexpected news to me that my husband needed cardiac bypass surgery in the same nonchalant manner as someone would comment on the day's weather.
There have been others, too many to name.
Gee whiz, I wish they would get a clue.

Sky_Eagle1 09-03-2003 07:12 PM

Cheri interpreted it correctly basically...

Be sure you read all the comments associated with this article too...they are VERY interesting too.


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