In a message dated 8/27/2006 10:17:57 A.M. US Eastern Standard Time, [log in to unmask] writes: When we are told we have autoimmune hypothyroidism, does this definitely indicate the gland will decline in function more and more until it is totally destroyed? In that case, it would seem best to ramp up the thyroid hormone replacement, and just suppress the remaining endogenous function altogether. Quality of life on full replacement would then be optimized. >>>>> Friends, Holly's attitude toward thyroid replacement makes a lot more sense that what I have heard from the bulk of my colleagues. Basically, we should treat patients, NOT labs. The most common complaint I hear on site such as this are from victims of docs who treat the labs. The presence or absence of antibodies; "Abnormal" or "Normal" TSH, Free T4, or Free T3 does NOT tell us if a given patient needs thyroid replacement. Our DIAGNOSIS dictates the proper treatment of a given patient. A good Clinician will tell you that History (How has your patient been doing before they came to you?) provides 85% of the information for the Diagnosis; the Exam is worth about 10%, and the Laboratory is only worth about 5%. Unfortunately, docs too often make the Labs the final and sole authority in the Diagnosis. Sometimes, making an accurate diagnosis means that a patient must have a careful therapeutic trial of thyroid replacement. There is no Clinical Lab that is able to replace Clinical Acumen. When the doc tries to use the lab instead of thinking, the patient suffers. The so called "normal range" really only represents the middle 95.5% of the sick people we send to the lab to get their thyroid checked. (Two Standard Deviations either side of the mean score.) "Normal" is not a Medical Diagnosis, it is a Statistical one. Doc Don _______________________________________________________________ Control Your Self-Serve Thyroid Account Rules - mailto:[log in to unmask] Subscribe - http://listserv.icors.org/SCRIPTS/WA-ICORS.EXE?SUBED1=thyroid&A=1 Unsubscribe - mailto:[log in to unmask] Our Home Page - http://www.Emissary.Net/thyroid/index.html Thyroid Archives - http://LISTSERV.ICORS.ORG/archives/thyroid.html _______________________________________________________________