In a message dated 1/14/2005 12:01:01 PM US Eastern Standard Time,
[log in to unmask] writes:
While the TSH blood test is the most sensitive and accurate diagnostic tool
for thyroid disease, >>>
I strongly feel that statement, and the countless variations of the same
lie, are causing limitless suffering among people in every part of the world.
There a many reasons why TSH will not go up in someone who has Hypothyroidism.
Not the least of these is damage to the pituitary, but even central nervous
system dysfunction or damage can affect the ability of the brain to increase
the output of TSH in severe hypothyroidism.
From (almost) Classic Doc Don:
<< Then why, why, why do so many Dr's rely on the TSH so heavily? I just
don't
understand it. >>
My theories are 1. It is easy, quick, and requires no thought or patient
listening. Rather than listening to a patient's story, getting a good
picture
of their distress and thinking; many feel that a litmus test is answer.
2. It works sometimes...sort of. At extremes (in Dr. David Derry's words):
"When your Graves is so bad that your eyeballs are hanging on your cheeks,
it
will probably go down. And, when you are an hour or so from Myxedema Coma,
it may well
go up."
3. I'm not sure who said it, but "No matter how complex, subtle, intricate a
problem; there is a simple, straight foreword, easy, and wrong answer."
4. The practice of Medicine has very little to do with Science. Remember,
this is the same group who brought you cauterizing stumps of amputees in
boiling oil (frying) from before Hippocrates until they, by chance, ran out
of boiling oil
during the American Civil War, and found that the soldiers who didn't get
their stumps fried, did a lot better.
Medicine is based on tradition, greed, and prejudice. Have you ever wondered
how we can condemn countries for human rights violations regarding female
circumcision while countless male infants were mutilated shortly after birth
with a routine circumcision? Many today will admit that its biggest
advantage was a fast $200 for the Pediatrician involved.
Radical Mastectomies for breast cancer (essentially removial of the front of
the woman's chest wall) was know to be no better than the much more limited
surgery, for years before the general practice changed.
In Langer's book, "Solved: The Riddle of Illness," he said that the American
College of Physicians rated over 50 tests to be of no proven value,
obsolete,
or unreliable. Many of those tests are, no doubt, still big money makers for
labs.
It is truly shameless how your doc is given advertising about labs, drugs
and
so forth, and then believes it. If I ever started a Medical School, one
admission criteria would be at least a B+ in Distrust of Medical Advertising.
Doc Don
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