Ok, so the “hormone resistance” hypothesis is really something more like: the rate of some key reaction involving T3/T4 is being slowed down by some unknown factor; since we don’t know what the factor is, we can’t fix it directly, but we can increase the reaction rate by increasing the concentration of T3/T4 in the bloodstream to above normal levels, to compensate for the damping effect of the unknown factor.
This hypothesis makes an obvious testable prediction: that when people with CFS/etc. who are treated with thyroid extract feel better, the T3/T4 levels in their bloodstream should be above normal. Or, conversely, if their bloodstream T3/T4 levels are within the normal range, they should not feel better, even though they are being treated with thyroid extract. I don’t know if any existing data has this information.
Absolutely, hormone levels would have to be higher than they were, in order to make any difference.
Whether that means ‘out of the normal range’ for any particular hormone, I don’t know. Nobody seems to have the faintest idea what ‘normal range’ means for these things. But if there are serious cases of resistance, the level of the thing resisted should have to be way high in order to make any difference.
And it should probably cause TSH suppression. In my own case, I had TSH 2.51 when I first started complaining of symptoms, it was 4.06 when they came back, and with a tiny bit of thyroid which was nevertheless enough to get rid of all manifestations of CFS and cause some hyper symptoms it was 2.31, so looks like it pushed TSH down, but still not even as far as some people say is optimal.
And all of that could be noise in the test. Circadian cycle means TSH results can vary by a factor of two depending on when the blood is drawn. Go figure!
What would be ideal would be to figure out the cause of the ‘hormone resistance’, and fix it, rather than trying to overwhelm it.
It might even be a bad idea to fix it, if it’s performing some vital immune defence function.
Whether that means ‘out of the normal range’ for any particular hormone, I don’t know. Nobody seems to have the faintest idea what ‘normal range’ means for these things.
Yes, a better way to put it would be that the bloodstream levels of T3/T4 should be significantly higher when the person is treated and feels better than they were before treatment.
it should probably cause TSH suppression
That would be expected, yes.
What would be ideal would be to figure out the cause of the ‘hormone resistance’, and fix it, rather than trying to overwhelm it.
Yes, agreed. See below.
It might even be a bad idea to fix it, if it’s performing some vital immune defence function.
If this is true, it might also be a bad idea to overwhelm it. The “immune defense” hypothesis says that, if a person is feeling symptoms of CFS/etc., it’s because some pathogen is trying to attack their cells, so the immune defense kicks in, but as a side effect it also depresses normal cell metabolism. If thyroid therapy increases normal cell metabolism by overwhelming the immune defense, it might also increase the ability of the pathogen to infect cells. The only real fix in this case would be to find the pathogen and eliminate it.
Agreed. All I’m really saying is “For God’s sake, people, there’s enough evidence here to have a look, surely?”
We do have Broda Barnes’ word that taking desiccated thyroid long-term isn’t that bad for people. He really does seem to have put people on thyroid at the slightest excuse, and he reckoned that his patient records showed them being healthier than the general population, especially for things like heart disease. Which is kind of weird given that his patients were the sort of people who went to see a doctor and got put on lifetime medication.
Maybe only the really healthy could survive his methods and everyone else scurried back to more conventional doctors who would sensibly tell them it was all their fault for fancying their parents? Increasingly I think that psychiatry has the same advantage as homeopathy, in that it can’t possibly have any effect so they’re not going to hurt people.
I don’t know how seriously to take Barnes. Originally I thought he must have been a bit of a lunatic, until I ended up coming up with the idea above, which pretty much makes his observations as predictions. Then I read his book, and it said exactly what I thought it would say.
I disagree with his ‘origin story’, that the strange widespread hypothyroidism of modern times is because people aren’t dying of infections any more. (He thought that hypothyroid children were prone to infections and so they’d have all died of tuberculosis before they became adults. I think that a ‘genetic proneness to infection’ would have bred out very quickly.)
But again, if he was handing out thyroid meds to people who already had enough of the stuff naturally, that should have hurt them, not made them less prone to illness.
He might have been a fraud, but it seems a weird thing to do..… Even if he was just disregarding his patients’ complaints because he had given them thyroid and so they were damned well better, whatever they thought, he should have noticed them dying of heart attacks.
But I don’t really trust anyone medical any more. And Barnes was an endocrinologist.
Ok, so the “hormone resistance” hypothesis is really something more like: the rate of some key reaction involving T3/T4 is being slowed down by some unknown factor; since we don’t know what the factor is, we can’t fix it directly, but we can increase the reaction rate by increasing the concentration of T3/T4 in the bloodstream to above normal levels, to compensate for the damping effect of the unknown factor.
This hypothesis makes an obvious testable prediction: that when people with CFS/etc. who are treated with thyroid extract feel better, the T3/T4 levels in their bloodstream should be above normal. Or, conversely, if their bloodstream T3/T4 levels are within the normal range, they should not feel better, even though they are being treated with thyroid extract. I don’t know if any existing data has this information.
Absolutely, hormone levels would have to be higher than they were, in order to make any difference.
Whether that means ‘out of the normal range’ for any particular hormone, I don’t know. Nobody seems to have the faintest idea what ‘normal range’ means for these things. But if there are serious cases of resistance, the level of the thing resisted should have to be way high in order to make any difference.
And it should probably cause TSH suppression. In my own case, I had TSH 2.51 when I first started complaining of symptoms, it was 4.06 when they came back, and with a tiny bit of thyroid which was nevertheless enough to get rid of all manifestations of CFS and cause some hyper symptoms it was 2.31, so looks like it pushed TSH down, but still not even as far as some people say is optimal.
And all of that could be noise in the test. Circadian cycle means TSH results can vary by a factor of two depending on when the blood is drawn. Go figure!
What would be ideal would be to figure out the cause of the ‘hormone resistance’, and fix it, rather than trying to overwhelm it.
It might even be a bad idea to fix it, if it’s performing some vital immune defence function.
Yes, a better way to put it would be that the bloodstream levels of T3/T4 should be significantly higher when the person is treated and feels better than they were before treatment.
That would be expected, yes.
Yes, agreed. See below.
If this is true, it might also be a bad idea to overwhelm it. The “immune defense” hypothesis says that, if a person is feeling symptoms of CFS/etc., it’s because some pathogen is trying to attack their cells, so the immune defense kicks in, but as a side effect it also depresses normal cell metabolism. If thyroid therapy increases normal cell metabolism by overwhelming the immune defense, it might also increase the ability of the pathogen to infect cells. The only real fix in this case would be to find the pathogen and eliminate it.
Agreed. All I’m really saying is “For God’s sake, people, there’s enough evidence here to have a look, surely?”
We do have Broda Barnes’ word that taking desiccated thyroid long-term isn’t that bad for people. He really does seem to have put people on thyroid at the slightest excuse, and he reckoned that his patient records showed them being healthier than the general population, especially for things like heart disease. Which is kind of weird given that his patients were the sort of people who went to see a doctor and got put on lifetime medication.
Maybe only the really healthy could survive his methods and everyone else scurried back to more conventional doctors who would sensibly tell them it was all their fault for fancying their parents? Increasingly I think that psychiatry has the same advantage as homeopathy, in that it can’t possibly have any effect so they’re not going to hurt people.
I don’t know how seriously to take Barnes. Originally I thought he must have been a bit of a lunatic, until I ended up coming up with the idea above, which pretty much makes his observations as predictions. Then I read his book, and it said exactly what I thought it would say.
I disagree with his ‘origin story’, that the strange widespread hypothyroidism of modern times is because people aren’t dying of infections any more. (He thought that hypothyroid children were prone to infections and so they’d have all died of tuberculosis before they became adults. I think that a ‘genetic proneness to infection’ would have bred out very quickly.)
But again, if he was handing out thyroid meds to people who already had enough of the stuff naturally, that should have hurt them, not made them less prone to illness.
He might have been a fraud, but it seems a weird thing to do..… Even if he was just disregarding his patients’ complaints because he had given them thyroid and so they were damned well better, whatever they thought, he should have noticed them dying of heart attacks.
But I don’t really trust anyone medical any more. And Barnes was an endocrinologist.