In a message dated 6/4/2004 3:25:35 PM US Eastern Standard Time,
[log in to unmask] writes:
Since my Dr. only orders the most common
test TSH for my thyroid, I thought about getting myself tested, and wondered
which of these should I look into? >>>>
In my humble opinion (IMHO), you should save your money and find a better
doctor to care for you and your thyroid problems.

1. The lab is a purely a peripheral event to the patient. Like the shadow of
a tree, the labs tell us some things, but loses more information than it
delivers. History (how the patient has been doing) is 85% of any diagnosis, the
exam 10%, and the labs are worth (at most) 5%.

These are not my crazy ideas, I learned them at Wayne State University School
of Medicine. (Where the motto, we used to joke, was "If you can't be
brilliant, try hard not to be stupid.")

Treating any lab slip, instead of your patient, is stupid. The labs only know
what healthy is by what the clinician tells them.

The range is not a "healthy range," but a "normal" one. That is, a
statistical range that covers 95.5% of the scores on that test, at that lab.
It says NOTHING about healthy. Hypothyroidism was diagnosed and treated
(probably better than it is today) for close to 100 years before the clinical labs
could say anything relevant about thyroid.

The lab's "normal range" is most closely comparable to a weight range of
75-260 pounds (34-118 Kg): The range covers about 95.5% of the adult population;
but that is NOT a good reason to say that it is appropriate for any given
person. It is only a guide to tell how common or uncommon that weight is.

A man 6 foot tall (2 meters, about) may weigh 75 pounds, but is not likely to
be healthy. Likewise, TSH is even listed in text books as not being well
correlated to the thyroid function.

Diagnosis based solely on the lab work is almost the "Standard of Practice,"
but so were blood letting, leeches, and cauterizing the stumps of amputees in
boiling oil. That does not mean that it is a good way to do things.

And 2. If you do get labs done, normal or not, where will you find someone to
treat you based on that information? You're much better off starting with a
doctor who will treat you correctly.

A prayer that you get what you need to get well.

Doc Don

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