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From: mikes on 13 Apr 2008 18:19
I remember that diurnal variations of TSH have been already discussed
in this group.
I've just met an interesting plot, which shows change of TSH from 1.0
to 4.5 during 24 hours (!):

http://www.psycheducation.org/thyroid/studies.htm

(to the importance of the same time of TSH tests).


From: AJBP2009 on 13 Apr 2008 20:59
On Apr 13, 5:19 pm, mikes <prt2...(a)yahoo.com> wrote:
> I remember that diurnal variations of TSH have been already discussed
> in this group.
> I've just met an interesting plot, which shows change of TSH from 1.0
> to 4.5 during 24 hours (!):

That was very interesting. The graph is something I've been looking
for actually. Thank you so much for sharing!

Angela
From: Herman Family on 13 Apr 2008 21:42

"mikes" <prt2355(a)yahoo.com> wrote in message
news:ed430614-fc35-4bd8-8edd-3305b3d2c89d(a)p25g2000hsf.googlegroups.com...
>I remember that diurnal variations of TSH have been already
>discussed
> in this group.
> I've just met an interesting plot, which shows change of
> TSH from 1.0
> to 4.5 during 24 hours (!):
>
> http://www.psycheducation.org/thyroid/studies.htm
>
> (to the importance of the same time of TSH tests).
>
>

Nice. I'm going to play devil's advocate on their
conclusions.

1. The first study was done before the change in "normal"
by the AEA. They could have simply been increasing the
overall t3 level on people who were undertreated, as many
were back then.

2. The one with the table shows tsh of 2.2 for t4 only and
1.75 for t4 + t3. The conclusion was that the t3 improved
things better than t4 alone. Because the patients were not
at the same tsh level, they were comparing apples and
oranges. A fair comparison would be to get the tsh levels
of both groups the same.

What they didn't test was simply adding a bit of t4 to the
dosage, rather than adding some t3. If they picked out the
right amounts, they may have found that it improved things
quite nicely also.

These studies bear repeating, with proper controls and
dosages, especially in light of the change in the thyroid
protocols since they were done. This would be especially
interesting because it could lead to lowering the maximum
tsh spec to somewhere around 2, and lower for depression
patients.

Michael


From: Rod on 14 Apr 2008 03:15
mikes wrote:
> I remember that diurnal variations of TSH have been already discussed
> in this group.
> I've just met an interesting plot, which shows change of TSH from 1.0
> to 4.5 during 24 hours (!):
>
> http://www.psycheducation.org/thyroid/studies.htm
>
> (to the importance of the same time of TSH tests).
>
>
Good one.

Wondered about this statement on that page - "probably best to have your
blood drawn between 8:30 am and 4 pm". With that sort of variation, it
surely depends on what you want your doctor to see!

"I am normal" - go at 08:00.
"I am slightly hypo" - go between 20:00 and 00:00.
"I am hypo and want treatment" - go at 04:00.

(No - I don't know an all-night phlebotomist either... :-) )

There has been much discussion of people who appear hypo by symptom but
euthyroid by lab. Inasmuch TSH is able to disclose hypothyrodism, could
this be one reason?

When people ask here about when to take their medicaine in relation to
blood draws, the answer is usually "in the morning, before meds". But
for undiagnosed people, perhaps we should be saying "07:00 or earlier if
they are open" - but what to do if they work ordinary office hours?

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
<www.thyromind.info> <www.thyroiduk.org> <www.altsupportthyroid.org>
From: kgrhoads on 14 Apr 2008 15:39


Herman Family wrote:
> "mikes" <prt2355(a)yahoo.com> wrote in message
> news:ed430614-fc35-4bd8-8edd-3305b3d2c89d(a)p25g2000hsf.googlegroups.com...
....
>
> 2. The one with the table shows tsh of 2.2 for t4 only and
> 1.75 for t4 + t3. The conclusion was that the t3 improved
> things better than t4 alone. Because the patients were not
> at the same tsh level, they were comparing apples and
> oranges. A fair comparison would be to get the tsh levels
> of both groups the same.
>
....
> Michael

I agree that a proper comparison would be better, but
having the same TSH is not necessarily the best.
TSH seems absurdly sensitive not only to dosing levels,
but their times as well. I do not konw what would be a good
way to provide a proper comparison. However I am fairly
sure that just matching TSHs without doing anything
else WILL NOT provide a fair comparison.

I would think that matching TSH, and serum levels of
thyroid hormone, with blood draws carefully timed against
times of dosings, may be enough to provide an apples
to apples comparison. But, .... as far as I can tell
the only sure thing in the thyroid game is our (collective)
ignorance.

I am comfortable with complicated stuff, such as the
(vector) magnetic diffusion equation. But the thyroid
system in mammalian biochemistry is
1) more complicated
2) not at all linear
3) not well understood
It is much messier than just applying del-squared
to a B-field.

The M.D.s seem to treat it much too cavillierly for
my taste. But then I only a ignorant engineer with
a Ph..D. from MIT, I ain't no M.D.
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