I always know that when I get an email from Dr. John C. Lowe, it’s going to contain excellent information. And he didn’t let me down.
Dr. Lowe is Editor-in-Chief of Thyroid Science, an “open-access journal for truth in thyroid science and and thyroid clinical practice”. And in the recent issue, there is a remarkable and precise TSH (Thyroid Stimulating Hormone) hypothesis by none other than a brilliant UK electrical and electronics engineer, Mr. Peter Warmingham. In fact, his hypothesis about the TSH lab result when treating one’s hypothyroidism exactly corresponds to the successful experience of thyroid patients all over the world.
To quote Dr. Lowe in his introduction about Warmingham’s paper (FYI: “exogenous” refers to the thyroid hormone you give yourself; “endogenous” refers to what happens naturally in your body):
Mr. Warmingham’s hypothesis is straightforward: When a hypothyroid patient (whose circulating pool of thyroid hormone is too low) begins taking exogenous thyroid hormone, a negative feedback system reduces the pituitary gland’s output of TSH. This decreases the thyroid gland’s output of endogenous thyroid hormone, and despite the patient’s exogenous thyroid hormone’s contribution to his or her total circulating thyroid pool, that pool does not increase–not until the TSH is suppressed and the thyroid gland is contributing no more thyroid hormone to the total circulating pool. At that point, adding more exogenous thyroid hormone will finally increase the circulating pool of thyroid hormone. The increase must occur for thyroid hormone therapy to be effective. The patient’s suppressed TSH, then, does not indicate that the patient is over-treated with thyroid hormone; instead, it indicates that the patient’s low total thyroid hormone pool will finally rise to potentially adequate levels.
In other words, when your doctor says no to an increase in your desiccated thyroid simply because your TSH lab result is, or would become, below the so-called normal range (and in the presence of continuing symptoms or a low temperature), he will usually end up keeping you hypothyroid! i.e. making an ink spot on a piece of paper more important than clinical presentation is just one reason why the current thyroid patient revolution represented by Stop the Thyroid Madness exists!
You can read Warmington’s entire paper here on Dr. Lowe’s site. For further information on the fallacy of the TSH lab test, go here or read Chapter 4, aka Thyroid Stimulating Hooey, in your copy of the STTM book for more detail.
P.S. Dr. Lowe is probably right on when he says he expects criticism to flow for the fact that Warmington is not an Endocrinologist and “how in the world can anybody but an Endo make a logical hypothesis about the TSH lab test”. Read more on Lowe’s thoughts about this here. But enlightened thyroid patients around the world are collectively shouting “GOD BLESS AN ELECTRICAL ENGINEER!”
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14 Responses to “God bless an electrical engineer: why the TSH lab test needs to be suppressed!”
I have a question about the issue of TSH suppression. I have been perusing studies and not finding much to support the acceptance of TSH as a healthy choice. All the stories I see of patient experience are well and good, but my doctor will not accept those as supportive of my desire to have her pay less attention to TSH. She has always in the past sought to suppress, but after having a patient exhibit severe bone loss on suppressive dose, my doc changed her tune.
She is basing her thinking on studies like the article I will link below, which dominate the literature as far as I can tell. Studies showing TSH does have an active role in bone preservation. We are burying our heads in the sand if we ignore these, we need a good science-based answer. Anyone?
TSH and Bone Loss
LI SUN1, TERRY F. DAVIES1, HARRY C. BLAIR2, ETSUKO ABE1 andMONE ZAIDI1
Article first published online: 30 MAY 2006
Marilyn, no one is burying their heads in the sand. Promise. Note that the article you sent is about a low TSH in conjunction with hyperthyroidism, aka Graves. The low TSH that hyPOthyroid patients on an optimal dose of NDT is different. It falls because our exogenous supplementation of thyroid hormones takes over the job of the real TSH. Also, a large body of patients with the low TSH from an optimal dose report that all tests show their bone density has improved!! We’ve seen many women who had a diagnosis of Osteopenia find that it’s reversed. That is huge information when it comes from so many. And finally, you need to read the insightful studies which reveal how faulty much “science” can be based on who did the study, who paid for it, and what the parameters were…or were not.
Thank you for responding so quickly, Janie. I did not mean to say we are ignoring information, but most discussion I see in patient communities does not refer to studies on this issue.
I used my lnked study as an example of the armload my doctor is using, I have only found a couple showing suppressed TSH not to be an issue. I know I am probably needing a new doc, I feel so betrayed since she helped me recover so well with NDT and was happy with my TSH suppressed. She also decided to treat by symptoms when my numbers were still “normal”. I am hoping to change her, there is no one else in own who will do this right. 🙁
So this only happens when you have a thyroid? Mine is completely removed but I just started on 3.5 grains of thyroid brand ndt 3 days ago, after being on synthroid for 6 years, every muscle and joint hurts in my body…… 1 st day on everything felt a bit better and I could walk without brutally sore knees but now after 3 days I’m hurting worse than before…….. Wondering if I’m maybe to low or if something else is going on…….
Mark, patients have learned repeatedly to NEVER start on NDT with a high dose like that. We start much lower, raise by 1/2 grain every two weeks to find the right amount. Read this: https://stopthethyroidmadness.com/natural-thyroid-101
I think I am just going to give up. I quit ambien finally, weaning off xanax slowly (it is very bad w/d) and when I am done I am weaning off nature throid. Don’t feel well on or off stuff so I am just going to let nature take it’s course. What is meant to be will be. If I am meant to die so be it. Sick of lies, frauds, and the drug industry.
Our daughter has below-range iron saturation (10%) and low in range ferritin (18). She has had TSH over 5. She takes Armour 30mg and iron 50mg elemental daily. However, her symptoms of fatigue, exercise intolerance, heavy legs, etc, have not improved. Instead of shutting down her thyroid for life, should the iron be taken care of first before any increase in the thyroid dosage to see if that will correct her thyroid? She eats red meat and has a good diet, and we do not know why she is low on the saturation or ferritin. Thank you for any advice.
(Here are great patient groups which can help: https://stopthethyroidmadness.com/talk-to-others)
The TSH and Synthroid crap is the biggest medical scam of this entire centry – not to mention future centries that will be greatly affected because Medical Schools allow funding by the very Pharma Companies pushing their drug – T4 – Synthroid.
I feel reassured this will continue because what’s the first newstory this morning? ELI LILLY is pushing Cymbalta on the FDA. Great – they already increased the use of Cymbalta this year alone by a huge percentage of patients and now want to harm others as surely others will be harmed by the very fact all of the listed known side effects in the same article by the very drug they are pushing for the sake of MORE BILLIONS $$$$. God Bless America. The FDA should be ashamed. They were created to PROTECT the population.
32 y/o Female RN (only learned of T4 in my nursing school b/c NT was “too hard to regulate”, s/p Total Thyroidectomy at age 2 years for a BENIGN goiter. After the Armour catastrophe and finding relief for 1 too short year – back on Synthcrap with total hypo symptoms ruining my life again and NOW battling MRSA FOR 2 months. I see the infectious disease doctor Monday. Can you say STOP IT ALREADY. Sad when a nurse starts to despise the very medical society I wanted to work in. Ridiculous. Exhausted & in tears.
This article points out an interesting point of discussion related to all exogenous hormone replacement therapies as e.g. used in anti-aging (thyroid hormone, cortisone, testosterone,…). This article is actually saying that in order to benefit from an exogenous hormone treatment you need to increase the dose of exogenous hormone up to the point that the endogenous production of hormone is shut down. I would think that shutting down your body’s own production of cortisone, testosterone or thyroid hormone is not what you want?
Does the TSH level only respond to an increased serum level of T4 or also to an increased serum level of T3 (as this article says)? If it would only respond to T4, this would mean that taking exogenous T3 will not shut down the thyroid.
(From Janie: you can choose not to shut down your thyroid, but you’ll also choose to have continuing symptoms. As far as the use of cortisol, it only temporarily shuts down the adrenals, as many have been able to get off cortisol slowly with the adrenals kicking back in…as long as all other issues which stress the adrenals are treated (low ferritin, low thyroid, low B12, high RT3, etc)
I only just read this! Better late than never, I suppose…
The answer is pituitary TSH level responds to both T4 and T3. The body balances T4 and T3 as required.
T4 is the “storage” form and T3 is the “active” form used by the body.
The feedback loop (simplified version) goes like this:
Pituitary produces more/less TSH >> Thyroid produces T4 and puts in bloodstream >> Thyroid (20%) & Liver (80%) converts T4 to T3 as required >> Blood circulates through body and Pituitary >> Pituitary says: Not enough T4/T3 ? Too much T4/T3 ? >> And back to the beginning…
I believe you will not actually shut down the thyroid production of T4 by supplying it from “outside” (exogenous), because your body, being quite smart, generally prefers it’s own T4 (endogenous). Hence your TSH may go down but not stop completely.
You will notice in the feedback loop that T4 has to be converted to T3 in order to be used by the body. So enough/ excess T4 may not see any improvement by just adding T4. This is where “selenoproteins (aka selenoenzymes) come in, because it is these which the body uses to convert T4 to T3 (mainly in the Liver (80%) and also Thyroid (20%) – SEE ELSEWHERE ON THIS MOST MAGNIFICENT WEBSITE, e.g. https://stopthethyroidmadness.com/selenium/
In POINT 2 I should have added that your Thyroid also needs/ uses selenoproteins to produce T4….
… so you may find that adding selenium may reduce your requirement for external (exogenous) T4.
If you decide to experiment I would suggest 100 micrograms (which is half the usually accepted “minimum” required for results). Please read about selenium on this website first !!
Thank you Me and John for your support.
I have probably just about said it all in my hypothesis paper, but when you take measurements, you need to properly understand that measurement if you are going to make any proper sense of it. Put that way, it might sound rather obvious, but I’m not convinced that most endo’s actually do. The bottom line is that the TSH measurement just does what it says on the tin – no more, no less – it measures how weakly or strongly the thyroid is being stimulated. That may or may not be related to the serum T3/T4 levels. If you want to know the serum T3/T4 levels then why not measure them directly. It’s no more difficult than measuring the TSH level, is it?.
I have found this article by Dr. Raymond Peat, to be an excellent concise history of the evolution of the medical establishment’s diagnosis and “treatment” of Thyroid disfunction. He also covers the exaggerated significance paid by by the Medical establishment to TSH as an indicator .
Thanks for your work!
How can anyone know more than a endocrinologist (insert sarcasm). I can dig up a few hundred that I know personally. I’m not sure if there is a specialty in the medical field that is causing more harm to suffering sick people then these useless “doctors”. If I were Mr. Warmington, I would welcome any criticism from the endo community as a red flag that I am right on track with my hypothesis. Good for you Mr. Warmington.