Talk:Hypothyroidism

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[edit] Subclinical Hypothyroidism

Ah - the section labeled "Subclinical hypothyroidism" is a bit confusing to me. Could someone detail what the meta-analysis found no benefit of?

76.190.30.87 (talk) 03:21, 19 December 2007 (UTC)Dave


Is Wilson's syndrome an important topic to discuss?

[1]

No. Why on earth are you posting this here and not on Wilson's disease? JFW | T@lk 03:52, 23 Jan 2005 (UTC)
Our querent has apparently happened on a web site that sells drugs for something they've termed "Wilson's Thyroid Syndrome" (which seems to be named after "E. Denis Wilson, MD", who owns the web page. Unfortunately, as you and I know, that's not the accepted name for anything, and is likely to be confused with both "Wilson's disease" (to which there is not even a purported relation) and with hypothyroidism...from reading the website, it isn't even what would normally be called "sick euthyroid syndrome" or "subclinical hypothyroidism" - it's a disease "discovered" by Dr. Wilson, who says that "most doctors" don't "know about" it "yet", and who says it must be treated according to his "naturopathic" doctrines...and with his medicines only. [2] So I'd agree that the answer is, no, it's not a syndrome that is established in the medical literature, and we therefore needn't be discussing it. - Nunh-huh 04:09, 23 Jan 2005 (UTC)

[edit] Fluoride poisoning?

The analogy of fluoride poisoning with hypothyroidism is weak. The external link goes to an advocacy group: Parents of Fluoride Poisoned Children. The 'scientific evidence' provided by the website is very poor. Here is one example: PFPC claims a link between fluoride poisoning and multiple sclerosis. PFPC refers to the paper 'Neurotoxicity of sodium fluoride in rats' by PJ Mullenix in 'Neurotoxicology & Teratology' Journal. Mullenix's paper is valid and rigorous. However Mullenix makes no comparison to any specific human disease. MS was not mentioned at all.

This link was added by anonymous user 24.202.242.119 After reviewing the user's edits, it is apparent that he/she has a preoccupation with fluoride. Axl 17:47, 24 Jan 2005 (UTC)

[edit] Myxoedema

I can't find the definition or the peculiar signs which define the mixoedema in this article. The redirection is obviously wrong, but during those days of cleaning, I'm not going to write something which will be "mercilesssly deleted".


NEW COMMENT

  • Someone undo the redirection from "Myxoedema" please*

Or at least teach me how to do it.

Myxoedema refers to the skin and tissue disorder usually due to hypothyroidism. It is NOT one and the same as Hypothyroidism. I can do up a page on it if someone would just unlink it or teach me how to do it thanks.

--Mkmk


Hi Mkmk!

To answer your question: you can edit the Myxoedema page by typing "Myxoedema" into the search box (which currently redirects you here). Then look for the text under the title "Hypothyroidism" and under the phrase "from wikipedia, the free encyclopedia" -- which says "(redirected from Myxoedema)". Click on the word 'myxoedema' (it's a link to the actual myxoedema page, it should not redirect you back to this page). You can then edit that page like you would any other page, and get rid of the #REDIRECT tag you'll find when you edit it for the first time. By the way, you can sign your name and the date and time with four tildes. J Lorraine 13:10, 9 February 2006 (UTC)

thanks! --Mkmk

Quote from American Thyroid Association Hypothyroidism Booklet "myxedema: severe hypothyroidism; the brain, heart, lungs, kidneys, and other organs slow to the point that they cannot keep up critical functions like maintaining temperature, heart rate, blood pressure, and breathing myxedema coma: often-fatal unconsciousness resulting from severe hypothyroidism "

Is Myxedema Severe Hypothyroidism or just a result?

[edit] Primary and secondary

Does anyone think it's worth mentioning primary and secondary hypothyroidism? Primary being due to gland dysfunction and secondary due to decreased drive from TSH? Evilhypnotist 20:29, 21 February 2006 (UTC)

Primary hypothyroidism results from the thyroid gland itself not making sufficient thyroid hormone when it is stimulated by thyroid-stimulating hormone (TSH), from the pituitary.

Secondary hypothyroidism results from insufficient TSH from the pituitary.

Tertiary is further back the stimulation highway and involves too little stimulation of the pituitary by the hypothalamus.

Both secondary and tertiary forms of hypothyroidism are termed "central" hypothyroidism. In either of these cases, "it's all in your head"--literally! regards, good2Bherewithyou

[edit] Sources

Maybe I'm missing them, but I'm not seeing many(or any) sources cited on this article; at least the sources I do see contain very little in terms of all of the total content on the article. Smeggysmeg 01:33, 9 March 2006 (UTC)

"Stop the Thyroid madness" does not have the appearance of a WP:RS WP:EL compliant source. I removed it. Midgley 11:46, 23 June 2006 (UTC)

[edit] Subclinical hypothyroidism

Subclinical hypothyroidism gives a modest increase in cardiovascular risk[3]. JFW | T@lk 17:40, 9 July 2006 (UTC)

[edit] Actually

The most common cause of hypothyroidism is Atrophic (autoimmune) hypothyroidism and not Hashimoto's thyroiditis. While both are associated with thyorid microsomal antibodies, they are not the same.

The article should probably mention iodine deficiency and dyshormonogenesis as a cause too.

Wow that's interesting. I've heard of the possible difference between atrophic and goitrous autoimmune hypothyroidism, but I didn't know the atrophic version is more common. Do you know where I could find a reference? I appear to suffer from the atrophic version. --GrimRC 86.4.58.252 17:00, 24 October 2006 (UTC)

I am new at this but here goes... (Endocrinology: An Integrated Approach was the text I used...)

The most common causes of hypothyroidism is autoimmunity. T-cell mediated actions destroy thyroid gland and disrupt certain, or all, function. Hashimoto's disease is one characterized means of autoimmune thyroid disruption.

Secondary hypothyroidism often results from damage to the hypothalamic-pituitary axis, which interfers with thyroid hormone production or action.

Thyroid hormone is normally released by follicles within the thyroid gland. The formation of hormone is dependant upon the addition of four iodine molecules. The follicles sequester about ninety days worth of iodine for this purpose, but long-term iodine deficiency, beyond follicle stores, is life-threatening.

The World Health Organization (WHO) recognized that ~30% of the world's population was at risk for such iodine deficiency. Efforts to include iodized salt into populations at risk have had great success.

[edit] Fluoride and Herbal remedies

I removed the unsourced claim that consuming fluoride causes hypothyroidism. I can't find any claims to this effect other than from anti-fluoride conspiracy theorists. A website devoted to denouncing fluoride is a biased source. If fluoride really causes hypothyroidism, how come this isn't mentioned in the 25 page booklet published by the American Thyroid Association? They don't use the word fluoride once.

Also, while iodine deficiency is apparently a leading cause of hypothyroidism in developing countries, in developed countries where iodized salt is readily available this isn't a problem. In fact, the American Thyroid Association notes that taking excess iodine can actually make the codition worse.

I also edited the "Possible Cures" section, which I renamed "Treatment". Previously it appeared to be spam for a particular herbal remedy. The American Thyroid Association (which represents professional thyroid researchers and physicians) states that herbal remedies are ineffective. -- Tim314 16:35, 3 January 2007 (UTC)

REPLY, Change it to say that there is controversy about this claim or that this is only claimed by anti-flouride groups. Do that at least, don't remove it completely. Would you like me to delete the other stuff saying that it is from a biased source which is the government? Anyway I'm putting it back in. IF YOU WANT TO CHANGE IT, CHANGE IT SO SAY THAT THE AMERICAN THYROID ASSOCIATION DOESN'T BACK THE CLAIM! DO NOT REMOVE THE VIEW POINT COMPLETELY. AntiLiberal2 04:05, 5 January 2007 (UTC)

If there is a source for the claims about fluoride and hypothyroidism, please give it. Rosemary Amey 23:55, 9 January 2007 (UTC)
It doesn't do any good. The person above deleted it because they said that all studies that support it are from biased sources. If source that has a study about this they say that it's biased and ignore it, because they say that it's an "antifluoride" or a "conspiracy site" and refuse to accept it. Anyway I'm going to say that certian sources like antifluoride groups claim that fluoride is the main cause of this. You can't argue with that. AntiLiberal2 04:49, 12 January 2007 (UTC)
I don't think the claims about fluoride causing hypothyroidism are notable enough to be included in this article. See WP:N. If we start including every fringe theory, then we would have to add urine therapy, homeopathy, accupuncture, etc etc to this page, which I think would be ridiculous. Also, please see WP:RS for what constitutes a reliable source. Rosemary Amey 05:22, 12 January 2007 (UTC)
The problem is that it's true, really it should be the main point in the article, but I'm being nice. French doctors did prescribe Sodium Fluoride to treat over active thyroid. People today are exposed to fluoride levels higher than the doctors prescribed. It's so simple, how can you not get this? AntiLiberal2 00:34, 13 January 2007 (UTC)
If it's true, I would certainly want to know about it, as I suffer from hypothyroidism myself, but you still have not given a reference! Rosemary Amey 00:36, 13 January 2007 (UTC)
What about all the other stuff that doesn't have a source? Somebody just put it there as if it's common knowledge? Anyway, there are quite a few people with string anti-fluoride beliefs and it is worth mentioning on wikipedia! AntiLiberal2 01:03, 13 January 2007 (UTC)
The fact that there are other unsourced statements in the article means the article needs improvement. It isn't license for adding unproven allegations. Is there a scientific paper (not an advocacy group) that even mentions fluoride in connection with hypothyroidism?0nullbinary0 (talk) 06:44, 28 February 2008 (UTC)

[edit] Request for comment: fluoride and hypothyroidism

This is a dispute about whether claims that fluoride causes hypothyroidism should be included in the hypothyroidism article. 02:14, 13 January 2007 (UTC)

Statements by editors previously involved in dispute

  • Although some anti-fluoride activists claim that fluoride causes hypothyroidism, this is a fringe theory which is not notable enough to merit inclusion on this page. No one has given a reliable source for the anti-fluoride claims. Rosemary Amey 02:14, 13 January 2007 (UTC)
  • So basically only sources that are from the government or the established medical system are qualified for wikipedia? I see that you searched PubMed. Had you searched google for the same thing you would have found maybe even hundreds of papers and possible many studies that support the claim that I presented. AntiLiberal2 04:07, 13 January 2007 (UTC)

Comments

  • I'ld be a bit kinder and state trivial un-notable theory, as the provided link to campaigning site does in itself cite real research. The problem is one of over interpretation of the research results and linking ideas not then supported by external 3rd party research. One of the links itself cited numerous studies showing no effect of fluoride on thyroid function where iodine levels are normal, but possibly some effect in Himalyas when iodine deficiency was occuring. This though does not support hypothyroidism occuring in the UK where all salt has been supplemented for many years with iodine, thus laergely preventing iodine-deficiency, yet we still see cases of hypothyroidism
    A search of PubMed for "hypothyroide fluroride" keywords gives 22 hits, of which just 4 seem direct research suspecting such a link, and the last of these was printed 21 years ago - hardly a topic of current interest:
    • Bachinskiĭ P, Gutsalenko O, Naryzhniuk N, Sidora V, Shliakhta A (1985). "[Action of the body fluorine of healthy persons and thyroidopathy patients on the function of hypophyseal-thyroid the system]". Probl Endokrinol (Mosk) 31 (6): 25-9. PMID 4088985. 
    • Börner W, Eichner R, Henschler D, Moll E, Ruppert G (1980). "[Pharmacokinetics of fluorides in thyroid dysfunctions. The plasma fluoride concentration after oral administration of 40 mg of NaF in delayed and nondelayed form depending on the thyroid function]". Fortschr Med 98 (28): 1083-6. PMID 7419155. 
    • Hillman D, Bolenbaugh D, Convey E (1979). "Hypothyroidism and anemia related to fluoride in dairy cattle". J Dairy Sci 62 (3): 416-23. PMID 447892. 
    • Strubelt O, Bargfeld D (1973). "[Toxicology of drinking water fluoridation]". Dtsch Med Wochenschr 98 (15): 778-83. PMID 4266645. 
    I did see in the search though one paper that for endemic "Chronic fluoride toxicity in the form of osteo-dental fluorosis was observed in cattle, buffaloes, sheep and goats from 21 villages of Banswara, Dungarpur and Udaipur districts of Southern Rajasthan where the mean fluoride concentration in drinking water varied from 1.5 to 4.0 ppm" found "None of the fluorotic hibited any apparent evidence of hypothyroidism, stunted growth or low milk production" - Choubisa S (1999). "Some observations on endemic fluorosis in domestic animals in Southern Rajasthan (India)". Vet Res Commun 23 (7): 457-65. PMID 10598076. 
    I think if fluoride and thyroid must be mentioned, then perhaps as part of arguements in Water fluoridation controversy, but this is really a trivial viewpoint (thus not requiring mention under WP:NPOV) as far as human clinical hypothyroidism is concerned (no biomedical research paper in last 21 years).
    Remember as Wikipedia:Fringe theories content guidence states: "The discussion of a non-mainstream theory, positively or negatively, by other non-mainstream groups or individuals is not a criterion for notability, even if the latter group or individual is itself notable enough for a Wikipedia article. If a non-mainstream theory is so unnotable that mainstream sources have not bothered to comment on it, disparage it, or discuss it, it is not notable enough for Wikipedia.". Surely teh absence of any PubMed abstracted paper in last 21 years counts as "not bothered to comment on it, disparage it, or discuss it" ? David Ruben Talk 03:26, 13 January 2007 (UTC)
  • You're saying that a study that is 22 years old is no longer any good??? Fluoride is still fluoride, and people are still people. Has there been a change in human beings or chemical properties in the last 22 years? AntiLiberal2 22:56, 13 January 2007 (UTC)
  • No, the study was the study, but the 2 dacades of no further research indicates not "a topic of current interest" and thus not seeming to be a concept thought worthy of ongoing research. David Ruben Talk 04:20, 14 January 2007 (UTC)
  • That is not how science works. Whether something is a "topic of current interest" is irrelevant to its merit. It may be that the study in question has been debunked, and that is why there is no current interest in the topic, but if this result has been reached, surely somebody must have published it, right?0nullbinary0 (talk) 06:51, 28 February 2008 (UTC)
  • No - a trivial minority fringe theory will tend to just be ignored (why should anyone waste their time having to debunk every claim made). To go back to wikipedia guidelines, as stated above, "If a non-mainstream theory is so unnotable that mainstream sources have not bothered to comment on it, disparage it, or discuss it, it is not notable enough for Wikipedia.". Remember this is a talk page for discussing the edit of the article, not to discuss the topic itself. Now if the theory had entered mainstream acceptance and so need nolonger any new research papers on the topic as per Randroide's point immediately below, then there would still be current sources to cite from, namely standard textbooks on endocrinology. So unless it can be shown that this idea is prevalent in current standard textbooks on the subject, or mainstream reviews (eg MedlinePlus, eMedicine etc) then it is not a mainstream view, but a minority one. Next the failure to find it even reasonably well mentioned-in-passing if only to merely disparage it, strikes me as a reasonable criteria for considering this a trivial minority viewpoint, and thus under WP:NPOV inappropriate to mention at all in the encyclopaedia.David Ruben Talk 12:05, 28 February 2008 (UTC)
  • A 20yo study could be as good (or better, or worse) than a current year study. If there is no new evidence showing that those studies were flawed, the age of those studies is totally irrelevant. Just an example: Pasteur#Germ_theory. That experiment was made in the 19th century, but it is still cited.Randroide 09:36, 28 January 2007 (UTC)


  • comment -The studies should be mentioned, but it should be clear how old they are and they should not be given undue importance. futurebird 19:10, 31 January 2007 (UTC)

[edit] Hypothyriodism and Iraq War Vets.......

Durring My first trip To Iraq during the invasion with the us army myself and other soldiers found our selves in a predicament, we were working out every day after missions as well as dieting but were becoming grossly over wieght. after reading this i have one question. can this have to groups of men that were exposed to depleted uranium? or maby some other chem or substance? I am asking this because this condition usualy effects women. but out of about 120 men almost 25 of us now have it. and it has ruined my life and the va will do nothing for me. please contact me via email.....cherplace@aol.com —Preceding unsigned comment added by 67.131.224.6 (talk • contribs) 03:37, 12 November 2007

A quick search on PubMed gives no hit for "uranium hypothyroid", whilst "hypothyroidism gulf" came up with just one (?relevant) link of PMID 12888300. Seems therefore lack of information, and certainly insufficent for commenting generally within the article, but I hope it is of interest. David Ruben Talk 10:31, 12 November 2007 (UTC)

[edit] Treatment section is biased

Regarding the T3/T4 meta-analysis, please do not provide unreferenced facts and your own personal commentary. You mention the poor design of the studies in the analysis--this is clearly an opinion, not an unbiased fact. Please edit. It's acceptable that you mention that patients were all assigned the same dose, but saying that the studies were poorly designed is an opinion.

I haven't read the studies, but just offhand: if you're comparing T3 and T3 + T4, regardless whether or not the doses were tailored to the patient, I believe you can reasonably gauge whether or not T3 has an additive therapeutic effect. These were controlled trials, no?

Your tidbit about most clinicians finding that patients need higher doses of T3 needs to be referenced, otherwise, delete.


What drug company are you with? —Preceding unsigned comment added by 67.81.40.233 (talk) 03:41, 3 December 2007 (UTC)

[edit] Treatment using T3/T4 or T3-only medicines

I added a comment regarding treatment using T3/T4 or T3-only as opposed to the mainstream view of treating using T4-only medicine. This is relevant because a "mainstream source" - i.e. the American Thyroid Association, has addressed this issue in their guidelines, and said that there is not "enough" evidence to change the current treatment, although there's certainly a new interest in this type of treatment (the ATA said so). That is their opinion, and I believe the encyclopedia acticle deserves a review of other opinions. (different eyes gave different opinions to current "evidence", we cannot ignore the different opinions on the evidence and give just the opinion of ATA). Mathityahu (talk) 21:21, 23 April 2008 (UTC)

[edit] Organization problem when new content was added

I am very sorry, but I keep trying to add a section to the Treatment Controversy. I think that this section is important in balancing the Treatment Controversy portion of the article, but for some reason, everything goes out of alignment when I try to add my content. Adding the information somehow messes up the portion of the article on Subclinical Hypothyroidism. I do not understand this because I included two equal signs around the phrase Subclinical Hypothyroidism. When I try to correct the organization problem, strange things happen. I might try editing it half a dozen times, and it remains a mess! Sometimes, the references disappear. Other times, the text about Subclinical Hypothyroidism appears below the references. I have tried adding the information on two different occasions, and the same thing happens every time: the content from Treatment Controversy somehow becomes merged (in an unreadable way) with the content from Subclinical Hypothyroidism, without any separation between the two portions of the article. Right now, I have the article the way I think it should be, except for the fact that the references have disappeared! Could anyone possibly help me to reorganize this and include some of this information? Here is what I wished to write on the Treatment Controversy portion:

Levothyroxine is the standard treatment for hypothyroidism, but both the American Association of Clinical Endocrinologists (AACE) and the American Thyroid Association (ATA) have said that some patients may fare better on a combination of T4 and T3.[1][2] T3 can clear up symptoms in patients who still show symptoms on T4 treatment. Some patients report that they feel so much better when they switch treatments. T3 treatment may be necessary for patients who have trouble converting T4 to T3. The journal Thyroid Science states, “[T]oday's conventional thyroid hormone therapy, T4-replacement, has been documented to be ineffective and harmful to many patients.”[3] Some studies have shown that a combination of T4 and T3 is more effective.[4][5]

More often than not, however, L-T4 is the more appropriate treatment option. T3 is ten times more active than T4, but almost all hypothyroid people can convert T4 to T3; their thyroid glands simply are not producing enough T4 and T3. The ATA has explained that T3 treatment can cause T3 levels to fluctuate in the bloodstream, from very high to low, producing symptoms of hyperthyroidism. T4 has a much longer half-life than T3. T3 levels are more stable during L-T4 treatment.[6] One source of controversy is the fact that the ATA has received funding from Knoll, producer of Synthyroid.[7] However, Arnold Stern, M.D., Ph.D, in an endocrinology course from New York University, also says that T4 has a longer half-life: seven days versus twenty-four hours for T3, and T4 is used both for replacement therapy and TSH suppression while T3 is used chiefly for TSH suppression.[8]

The "more often than not" statement has to be referenced. Besides, I don't think the moderators in wikipedia would agree to cite a certain MD's opinion. However I think you can cite his article if it shows more favourable results to T4 therapy compared to T3+T4 therapy in a clinical research article published in a peer-reviewed journal.Mathityahu (talk) 08:48, 6 June 2008 (UTC)
Besides, a statement such as "some patients report that they feel so much better when they switch treatments" is clearly an opinion and IMO does not belong to wikipedia. Mathityahu (talk) 08:55, 6 June 2008 (UTC)
Thank you, Mathityahu, for repairing this page for me. This page had no references last night. However, there are still two minor problems with the article that I need someone to help me with. First, the same content for Subclinical Hypothyroidism appears twice in the article, in two different places. Yesterday, when I was attempting to correct the organization problems, I tried moving the section on Subclinical Hypothyroidism, placing it between the sections on Diagnostic Testing and Treatment. Second, the Table of Content shows that Subclinical Hypothyroidism (5.2) is part of the Treatment section (5); it should be a separate section (6). I really do not have a preference about whether the section comes after Diagnostic Testing or Treatment. I also wonder: if someone else were to add content to Treatment Controversy, would the article end up a mess again? I wish that I knew how to format this article to correct these problems, but all that I know is that you use two equal signs for the name of a new section and three equal signs for a subsection. Can someone please help me? —Preceding unsigned comment added by 69.34.87.191 (talk) 00:42, 7 June 2008 (UTC)
I removed one of them subclinical hypothyroidism paragraphs. IMO, subclinical hypothyroidism should be a part of treatment as it is now. If some else adds content to treatment controversy and makes it well-referenced and well-edited, there won't be a mess again. I am not much of an expert on editing either, I guess you can read the help, and also create a user for yourself. Mathityahu (talk) 09:45, 7 June 2008 (UTC)

Thank you so much, Mathityahu! —Preceding unsigned comment added by 69.34.86.215 (talk) 22:52, 7 June 2008 (UTC)

[edit] Removal of Thyroid Science

WP:NPOV describes how equal weight should not be given to minority view points. Thyroid Science, as far as I can tell, is a website with a very specific agenda ("Today's conventional thyroid hormone therapy, T4-replacement, has been documented to be ineffective and harmful to many patients. Resistance to abandoning T4-replacement, or limiting its use to particular appropriate cases, is strong."[4]) which is hardly compatable with scientific open mindedness of their byline "A journal dedicated to truth in thyroid science and clinical practice". Furthermore again as far as I cen tell it allows self-publishing ("Thyroid Science is an open-access electronic journal"[5]).

To describe Thyroid Science as a "medical journal" seems misleading and imply that articles are as rigorously peer-reviewed and credentials of authors checked, something this website goes out of its way to reject "In that we are dedicated to such truth, we consider Thyroid Science a stark contrast to most major medical journals today—especially endocrinology journals. In my judgment, most such journals have been co-opted by corporations and are used as cloaked advertising media. We conceived Thyroid Science as an alternative to those publications, offering it as a medium of expression for those who do not want their views censored"[6] - but seems material accepted not for being of a rigorous researcher and study design, but for "such truth" as fits their preset ideas (that conventional T4 replacement is wrong as set out in the previously mentioned author guideline link). Hence long quote of this journal is of WP:UNDUE nature compared to the conventional mainstream majority view. The controversy section provides references to 2 papers from peer-reviewed journals which suitably verify this minority viewpoint.

Finally the AACE view seemed to be dismissed by stating that "recent publications have also challenged the status quo", yet used sources older than that given for the AACE ! I removed the "recent" description (I could have used "older" but so nearly contempory as to be splitting hairs) but placed views into order that they have been expressed. David Ruben Talk 00:22, 8 June 2008 (UTC)

Hello. By similar criteria, I believe the misguided opinion of the NAACE should be removed as well, as they are funded by Abbott Laboratories, makers of Synthroid (T4), and although presented as a "non-profit" organization, is guided by commercial interests. Mathityahu (talk) 05:22, 8 June 2008 (UTC)
Please reference above statement. While you are at it, does Forest Pharmaceuticals (maker of Armour Thyroid, a competitor of Synthroid) also "fund" NAACE. —Preceding unsigned comment added by 24.170.49.91 (talk) 03:16, 14 June 2008 (UTC)
Hello. Abbott Laboratories funds many of of the activities of AACE in meetings in conferences and in many of their presentations AACE thanks Abbott. They also give an "unrestricted educational grant" to AACE to send free copies of their "educational thyroid brochures" as can be seen on the order page: http://www.aace.com/pub/bookstore/edumaterials.php . For a reference, I cannot cite a medical journal as this is not a scientific "conclusion" of any article, but it is well known and I don't think it should be referenced in that way. This issue has received much attention throughout the internet, here is an example of a letter sent to AACE's president and his reply regarding this issue http://thyroid.about.com/library/hotze/bllawletter.htm . Forest Pharmaceuticals of course do not fund the AACE. Mathityahu (talk) 09:49, 14 June 2008 (UTC)
Wikipedia is not a soapbox[7] and to dismiss views of the majority (endocrologists) just because of a perceived conflict of interest due to Pharma support and thus some conspiracy is not helpful Mathityahu. One might likewise look at Coronary artery disease (CAD) and the advocacy and guidelines recomending use of statins to reduce colesterol levels. Yes there are cholesterol-CAD deniers (see Lipid hypothesis#The cholesterol controversy of atherogenesis), who in part claim all guidelines purely the drug companies pushing of their products, but the majority view is not this and the CAD article does not add caveats of Pharma funding.
That all said, there are some intersting issues to do with T3 administration, such as why it seems to cause such swings in circulating thyroid hormone levels across the day. Likewise what is the best TSH range to seek is interesting - as an example an article finding low tissue T3 levels when treatment with T4 is given to reach TSH targets... concluding that slightly higher T4 levels perhaps should be given to give low-normal TSH values and higher tissue T3 levels - Alevizaki M, Mantzou E, Cimponeriu AT, Alevizaki CC, Koutras DA (September 2005). "TSH may not be a good marker for adequate thyroid hormone replacement therapy". Wien. Klin. Wochenschr. 117 (18): 636–40. doi:10.1007/s00508-005-0421-0. PMID 16416346. . David Ruben Talk 01:41, 15 June 2008 (UTC)