Thyroid hormone is produced from a tiny gland that curves across the windpipe just below the Adam’s apple; its job is to keep the body’s various functions working at the right pace. Too much and everything goes too fast – you lose weight, can’t sleep and your heart races; too little and your system slows down – fatigue, dry skin and constipation.
Too little (hypothyroidism) is the most common; production can be affected by all sorts of things – an autoimmune response, for example, or other factors such as prolonged stress or intake of certain drugs which can damage your thyroid. Patient groups like Thyroid-UK – set up in 1999 to fight for better treatment for this condition – claim pollutants and even a lack of fruit and vegetables can also reduce your thyroid gland’s output. The official NHS line, which Dr Skinner, author of Diagnosis and Management of Hypothyroidism disregarded, is that if the level of a marker for thyroid levels in your blood is within the ‘normal’ range, then you aren’t hypothyroid and you shouldn’t get a hormone supplement.
Dr Skinner’s approach was to treat the individual patient, not a blood test. “I’d run the regular test and some more besides,” he says. “But if the patient had all the symptoms that you get with low thyroid, then I’d prescribe a low dose supplement and gradually increase it. If their symptoms improved, that was a pretty good sign that their body needed more than the normal range.” In fact, whether you are found to be inside or outside the normal range can depend on where the test is being done.
The difference between the UK and the USA is particularly striking. In the UK, the healthy range for the most commonly used test – known as TSH (thyroid stimulating hormone) – is between 0.5 and 5, although many experts will refuse to treat a patient until the level reaches 10 (the job of TSH is to make the thyroid produce more, so when it is high it means the thyroid is in trouble). Yet four years ago, the American Association of Clinical Endocrinologists recommended that: “Doctors consider treatment for patients who test outside a TSH range of 0.3 to 3&......
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