Comments on: Dick Cheney’s physical: An analysis http://www.kevinmd.com/blog/2005/07/dick-cheneys-physical-analysis.html medical blog Mon, 23 Nov 2009 01:35:28 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Venus Envy Training http://www.kevinmd.com/blog/2005/07/dick-cheneys-physical-analysis.html/comment-page-1#comment-90365 Venus Envy Training Wed, 18 Mar 2009 15:18:00 +0000 http://clients.emmense.com/kevinmd/2005/07/dick-cheneys-physical-an-analysis.html#comment-90365 Although I'm not a doctor, my research turned up a still considerable amount of debate and inconclusive research (in the P-R journals) over the diagnosis and treatment of subclinical hypothyroidism. Seems that there are potentially several thyroid-related perturbations that are the RESULT not cause of some of the "symptoms" associated with subclinical hypothyroidism. Not saying everyone who feels crummy shouldn't investigate and pursue diagnosis, but I'm troubled by so much quackery in this field. Although I’m not a doctor, my research turned up a still considerable amount of debate and inconclusive research (in the P-R journals) over the diagnosis and treatment of subclinical hypothyroidism. Seems that there are potentially several thyroid-related perturbations that are the RESULT not cause of some of the “symptoms” associated with subclinical hypothyroidism. Not saying everyone who feels crummy shouldn’t investigate and pursue diagnosis, but I’m troubled by so much quackery in this field.

]]> By: Jeffrey Dach MD http://www.kevinmd.com/blog/2005/07/dick-cheneys-physical-analysis.html/comment-page-1#comment-77458 Jeffrey Dach MD Tue, 10 Jul 2007 12:49:00 +0000 http://clients.emmense.com/kevinmd/2005/07/dick-cheneys-physical-an-analysis.html#comment-77458 "TSH for thyroid disease<br/>Again, inconclusive and not routinely recommended"<br/><br/>We routinely screen for low thyroid with a symptom questionnaire, physical examination findings including delayed reflexes, (Achilles reflex time) and we do a complete thyroid panel including free T3, free T, TSH, and thyroid antibodies.<br/><br/>We occasionally pick up thyroid antibodies in patients with otherwise normal labs, and obvious symptoms of low thyroid.<br/><br/><b>Low Thyroid, <br/>the Missed Diagnosis</b><br/><br/>Mainstream medical practice usually relies on the TSH test to determine when to treat with thyroid hormone (lab range 0.5 – 5.5), however, this has been recently changed to 0.3 to 3.0. And as Dr. Kevin mentions, the TSH may be unreliable, especialy in patients who can't make much TSH.<br/><br/>The TSH may be paradoxically low in a condition called hypothalamic dysfunction. Since the TSH may be below 3.0, no mainstream doctor would give thyroid hormone. However, if the free T3 and free T4 are both low, this indicates a low thyroid condition, in spite of the low TSH. <br/><br/>For more information on low thyroid, see my <a HREF="http://jeffreydach.com/2007/05/05/jeffreydachdrdachthyroid.aspx" REL="nofollow">newsletter</a>.<br/><br/><a HREF="http://www.drdach.com/" REL="nofollow">Jeffrey Dach MD</a> “TSH for thyroid disease
Again, inconclusive and not routinely recommended”

We routinely screen for low thyroid with a symptom questionnaire, physical examination findings including delayed reflexes, (Achilles reflex time) and we do a complete thyroid panel including free T3, free T, TSH, and thyroid antibodies.

We occasionally pick up thyroid antibodies in patients with otherwise normal labs, and obvious symptoms of low thyroid.

Low Thyroid,
the Missed Diagnosis

Mainstream medical practice usually relies on the TSH test to determine when to treat with thyroid hormone (lab range 0.5 – 5.5), however, this has been recently changed to 0.3 to 3.0. And as Dr. Kevin mentions, the TSH may be unreliable, especialy in patients who can’t make much TSH.

The TSH may be paradoxically low in a condition called hypothalamic dysfunction. Since the TSH may be below 3.0, no mainstream doctor would give thyroid hormone. However, if the free T3 and free T4 are both low, this indicates a low thyroid condition, in spite of the low TSH.

For more information on low thyroid, see my newsletter.

Jeffrey Dach MD

]]>