Many people are told their thyroid is now treated and their blood tests are normal, yet they still feel unwell. This is a common and frustrating experience. It often reflects the gap between a normal test result and genuine wellbeing.
Long history of misdiagnosis and poor treatment
For decades, thyroid disease has been diagnosed and monitored largely by the TSH test and treated largely with T4 alone. This approach helps many people but leaves a significant minority still symptomatic. Their continuing symptoms have too often been attributed to other causes rather than to under treatment, which has caused real and lasting distress.
Shifting of medical opinion (Toft, Bianco and others)
Medical opinion is slowly changing. Senior endocrinologists, including Anthony Toft and Antonio Bianco, have acknowledged that a proportion of patients do not feel well on T4 alone and may benefit from T3 or combination treatment. Research into the deiodinase enzymes and individual variation in hormone handling supports the view that one treatment does not suit everyone.