More controversy about TSH - showing WE are right and the BTA and RCP are WRONG

[Guest guest]

Pass these papers to your GP/Endocrinologist. These are

quite, quite brilliant. Read the FULL TEXT of both.

Luv - Sheila

http://www.thyroidscience.com/hypotheses/rowsemitt.najarian.H.6.11/rowsemitt.najarian.6.11.htm

Thyroid

Science

6(4):H1-16, 2011

TSH is

Not the Answer:

Rationale for a New Paradigm to Evaluate and

Treat Hypothyroidism, Particularly Associated with

Weight Loss

(Full

Text Free in pdf format)

Carol N.

Rowsemitt, PhD, RN, FNP and Najarian, MD

Correspondence: Dr. Carol Rowsemitt, San Obispo, CA,

rosey805@...

Correspondence: Dr. Najarian, Incline Village, NV,

tnajarianmd@...

Abstract. While many endocrinologists continue to debate the appropriate levels

of TSH to use as boundaries for normal limits, we believe using TSH to assess

thyroid function is counterproductive, particularly in those patients

attempting to lose weight. From the published literature and our own clinical

experience, we have come to understand that the set point for metabolism is

adjusted downward in the hypocaloric state. The decrease in metabolism is often

referred to as part of the ¡Èfamine response.¡É This metabolic response has been

documented in several major vertebrate classes demonstrating its widespread

importance in nature. In our current environment, the famine response limits

the patient¡Çs ability to lose weight while consuming a hypocaloric diet and

performing modest levels of exercise. Our own experience with the famine

response is consistent with that found in the literature. Treating to normalize

thyroid hormone levels and eliminate hypothyroid symptoms results in the

suppression of TSH. This is understood as a normal part of treatment once we

accept that the thyroid set point has been lowered. This is not an argument to

use thyroid hormones to increase metabolism above normal to achieve weight

loss. Our goal is to correct the hypothyroid response in a weight loss patient

and return him/her to normal metabolism so that the patient feels normal and is

better able to lose weight and maintain that loss.

Keywords ¡ü Famine response ¡ü Hypocaloric state ¡ü

Hypothyroidism ¡ü Reverse triiodothyronine ¡ü rT3 ¡ü T3 ¡ü TSH ¡ü Triiodothyronine

http://www.thyroidscience.com/cases/najarian.rowsemitt.6.2011/najarian.rowsemitt.6.11.htm

Thyroid

Science 6(6)CR1-7,

2011

Hypothyroidism,

Particularly Associated with Weight Loss:

Evaluation and Treatment based on

Symptoms and Thyroid Hormone Levels

(Full

Text Free

in pdf format)

Najarian, MD and Carol N. Rowsemitt, PhD, RN, FNP

Correspondence: Dr.

Najarian, Incline Village, NV, tnajarianmd@...

Correspondence: Dr. Carol Rowsemitt, San Obispo, CA,

rosey805@...

Abstract. Famine causes adaptive

changes in thyroid function which helped individuals survive during times of

low food availability. These changes in thyroid function and metabolism have

become maladaptive as the induced hypothyroidism associated with intentional

weight loss restricts the success of diet attempts and encourages weight

regain. In our previous paper[1] we described the mechanisms and consequences behind maladaptive

hypothyroidism associated with intentional weight loss. Here we give two

specific patient examples of this syndrome and how the biochemical and

clinical changes were managed for the clinical benefit of our patients. More

broadly, we address the need to understand that there are limitations to our

ability to detect every appropriate variable in any one patient, so that we

do not overestimate the value of any particular lab reading in any one

patient.

Keywords • Famine •

Weight loss • Maladaptive hypothyroidism

Reference: 1. Rowsemitt, C.N. and Najarian,

T.: TSH

is Not the Answer: Rationale for a New Paradigm to Evaluate and Treat

Hypothyroidism, Particularly Associated with Weight Loss. Thyroid

Science, 6(6):H1-16, 2011.