Volume 3, Issue 48
December 16, 2010
Blame your thyroid test
I’ve told my patients and readers for years to ignore the results of thyroid blood tests. They are not an accurate way to diagnose thyroid deficiency. Unfortunately, most doctors don’t understand this. So you may need thyroid hormone, but your doctor won’t give it to you because your blood test says you’re in the “reference range.” If this happens to you, you’re not alone.
In fact, a patient came in to see me for the first time the other day. He said. “I need you to give me some thyroid. I’ve been on it for 22 years, but the last doctor I saw was a new one, and he refused to refill my subscription. He said my blood tests showed I didn’t need it. Now I’ve been without it for a month and a half and I feel terrible.”
If you can empathize with this patient, there’s hope. All you need to do is show your doctor the results of a study published a full two decades ago. It shows just how inaccurate these tests are, especially for anyone over the age of 55.
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The Archives of Internal Medicine, a very prestigious medical journal, published this study. So your doctor should pay attention. The researchers looked at 968 men and women over the age of 55. They focused on this group because as we get older, the ability of the brain to regulate hormone production declines. As a result, hormonal blood tests often become increasingly inaccurate.
And that’s exactly what these researchers discovered.
They found that 7.3% had an elevated TSH level. According to accepted wisdom, this means that this 7.3% had hypothyroidism (low thyroid function). But they didn’t stop there. They gave all of these people an injection of protirelin. Protirelin is the hormone that’s made in the hypothalamus part of the brain that stimulates the pituitary gland to make TSH. The result was astounding! Almost every one of these people, 95% to be exact, had an exaggerated response to the protirelin.
This means that these people did not have hypothyroidism at all. They just needed more TSH than the general population. In essence, the study shows that diagnosing a patient as having hypothyroidism simply because their TSH is elevated is wrong 95% of the time! But it just gets worse.
Of the rest of the group, 2.5% had suppressed levels of TSH. Once again, according to conventional wisdom, this would mean that these people had hyperthyroidism (excessive thyroid function). And, once again, that conclusion would be wrong. When the researchers did the protirelin test on these people, they found that 81% of them had a suppressed response to it. Meaning that for these 81%, diagnosing hyperthyroidism from the TSH test would have been wrong.
So let’s get this straight. Conventional medical wisdom would have us believe that the best way to diagnose whether or not a patient has too much or too little thyroid is by ordering a TSH test. If the TSH is too high, then it must mean that the patient has hypothyroidism. And if it is too low, it must mean that the patient has hyperthyroidism. The only problem with this is that either way the test goes it’s wrong more than 80% of the time. At this point, the savvy physician has only one question to ask. “Then what in the world does the test mean when it's 'normal'?” And the answer in all of these cases is very little. In terms of diagnosing whether or not a patient has too much or too little thyroid hormone, the TSH test is a waste of time.
So the next time you hear that some doctor uses the TSH test to verify how well your thyroid is doing, tell him you want a basal metabolic test. That’s what I have been doing on every one of my patients for the past 12 years. And I can tell you that I find very few people over the age of 50 who don’t need some amount of thyroid. And in more than 90% of cases, their TSH test is normal. Now you know why.
If you need a basal metabolic test, please ask your doctor to contact my office at 775-450-6229 (doctors only please). We’ll tell your doctor what he needs to do to help you balance your thyroid.
Finding your Real Cures,
Frank Shallenberger, MD
REF: Bagchi N, Brown TR, Parish RF. Thyroid dysfunction in adults over age 55 years. A study in an urban US community. Arch Intern Med. 1990 Apr;150(4):7857.
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