How Physicians Define 'Normal' For the Thyroid Gland

Thyroid disease is on the rise, not due to increased numbers of patients with any different thyroid levels than they ever had, but due to physicians treating more of the mildly elevated TSH patients.
And the mild elevation is determined by a mere formula stating that normal means everyone except the top 2.5% or the bottom 2.5%, this is what a statistician would term the "95% confidence level" . For patients and their physicians the trouble with numbers, when it comes to the thyroid, is that it is not linked to symptoms such as depression or fatigue.Nor is treatment of mild elevation linked to weight changes. It has been shown that treating patients with mildly elevated thyroid can prevent that patient from ever having overt hypothyroidism. In her editorial in JAMA, Dr. Ann Cappola, one of the associate editors, points out that too many patients are being prescribed thyroid when their numbers are only slightly off, and that there is no clear benefit for this type of treatment. Over treatment with too much thyroid medication, however, is not safe. Women have special considerations with thyroid management, especially if they are pregnant. And women who have been treated with too much thyroid replacement have been reported to have abnormal heart rhythms and bone fractures. The point is ultimately to work with your physician to achieve levels that correlate with optimal health. You want medicine, not math, to determine your personal thyroid management.


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