User talk:Paleohack

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Hello, Paleohack, and welcome to Wikipedia! Thank you for your contributions. I hope you like the place and decide to stay. Unfortunately, your edit to Hypopituitarism does not conform to Wikipedia's Neutral Point of View policy (NPOV). Wikipedia articles should refer only to facts and interpretations that have been stated in print or on reputable websites or other forms of media.

There's a page about the NPOV policy that has tips on how to effectively write about disparate points of view without compromising the NPOV status of the article as a whole. If you are stuck, and looking for help, please come to the New contributors' help page, where experienced Wikipedians can answer any queries you have! Or, you can just type {{Help me}} on your user page, and someone will show up shortly to answer your questions. Here are a few other good links for newcomers:

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September 2012

Your recent editing history at Hypopituitarism shows that you are currently engaged in an edit war. Being involved in an edit war can result in you being blocked from editing—especially if you violate the three-revert rule, which states that an editor must not perform more than three reverts on a single page within a 24-hour period. Undoing another editor's work—whether in whole or in part, whether involving the same or different material each time—counts as a revert. Also keep in mind that while violating the three-revert rule often leads to a block, you can still be blocked for edit warring—even if you don't violate the three-revert rule—should your behavior indicate that you intend to continue reverting repeatedly.

To avoid being blocked, instead of reverting please consider using the article's talk page to work toward making a version that represents consensus among editors. See BRD for how this is done. You can post a request for help at a relevant noticeboard or seek dispute resolution. In some cases, you may wish to request temporary page protection.

Welcome to Wikipedia. I notice that you added some content to Hypopituitarism that appears to be a minority or fringe viewpoint. Unfortunately, this edit appears to give undue weight to this minority viewpoint, and has been reverted. To maintain a neutral point of view, an idea that is not broadly supported by scholarship in its field must not be given undue weight in an article about a mainstream idea. Feel free to use the article's talk page to discuss this, and take a look at the welcome page to learn more about contributing to this encyclopedia. Thank you.Novangelis (talk) 16:49, 6 September 2012 (UTC)[reply]

Hello, Paleohack. You have new messages at Novangelis's talk page.
You can remove this notice at any time by removing the {{Talkback}} or {{Tb}} template.

who is user Novangelis and why is he/she getting personal when all I wanted was to edit a small section of an article to make it show the right info?

Please read the thread below, user Novangelis has questioned my edit in the 'hypopituitarism' article. All I did was to add Natural Desiccated Thyroid Hormones and Liothyronine to the treatment listed for hypothyroidism. I did NOT take out levothyroxine, I did NOT mention whether one is better or more indicated than another! I did NOT state any 'personal' points of view AT ALL, yet this 'Novangelis' asks me to provide 'proof/references' that NDT and liothyronine is treatment provided for hypothyroidism, why? the original author did not have to provide ANY reference/proof that levothyroxine is the only treatment (and it is not the only treatment). I provided some links and then he gives me the reply below that I used 'meaningless' references and then goes onto say I do not agree with the treatment 'advocated' by 'reputable organisations'. How does Novangelis know what I agree or disagree with? I NEVER stated anywhere what I disagree/agree with, I merely asked for all 3 hypothyroidism treatments to be stated that is all, I never asked for anyone to write or say which one is best or should be given!!! These medications are available and used widely by many endocrinologists on this planet, so why hide them like they don't exist??? thank you

Novangelis, like all of us, is a volunteer editor. There are a lot of policies etc to follow here, and they can be a bit daunting at first. Take a look at WP:MEDRS for starters and try to discuss your proposed additions on the talk page of the article. Thanks. Dbrodbeck (talk) 18:55, 6 September 2012 (UTC)[reply]

thank you for your message re: hypopituatarism

Hi there, thank you for sending me a message to tell me I should reference any entry with reputable sources and also to tell me I was trying to edit a 'minor viewpoint' and giving it too much weight.

Unfortunately I disagree with the minor viewpoint and 'giving it too much weight'. There is more than one accepted treatment worldwide for hypothyroidism, the three main prescription treatments are: levothyroxine, natural desiccated thyroid hormones (NDT) and liothyronine (or a combination of levothyroxine, liothyronine or NDT and liothyronine or levothyroxine and NDT).

Whilst I understand that the article is about hypopituitarism and should not digress into other subjects as to 'keep to the point', it would be totally inaccurate to mention levothyroxine only as a form of treatment for hypothyroidism as many sufferers worldwide are treated and optimised with NDT and/or liothyronine either with levothyroxine or not. These people would continue to suffer for the rest of their lives and worsen if treated with levothyroxine only. These other 2 forms of treatment are equally important and must be mentioned. Saying that hypothyroidism is treated with levothyroxine and not mentioning the other 2 medications is giving out wrong information.

Also I would like to ask: why was I prompted to give references for NDT and liothyronine yet there had to be no reference for 'levothyroxine'? how is that right?

Many thanks for patiently taking the above in consideration

Paleohack

ps if I need to provide references in this message please let me know and I will, I am just sending a 'talk' message but I have provided some references on the hypopituitarism article, did not want to 'flood it' so have only put a few. Many thanks — Preceding unsigned comment added by Paleohack (talk • contribs) 17:06, 6 September 2012 (UTC)[reply]

You didn't provide references, you provided meaningless links. Something someone said on the internet is not a source. "Thyroid Science" is not a medical journal listed on PubMed. Countering the latest review articles (which were hard to miss) from high-quality journals with a bunch of WP:FRINGE websites and an article that has nothing to do with human treatment is not balance; it is inappropriate pseudobalance. While you may disagree with reputable endocrinologists' organizations about appropriate therapeutics, Wikipedia has no interest in your opinions.Novangelis (talk) 17:37, 6 September 2012 (UTC)[reply]

Dear Novangelis is these below 'enough' references for you? Now please can you take my above comments more seriously? we are not here to argue what treatment an hypothyroid patient is supposed to be put on, I was 'merely' explaining why I edited the hypopituitarism article so that it was showing a more accurate picture for hypothyroid sufferers (whether they are 'thyroid-less', with or without cancer, Hashimotos etc) Please feel free to add these references to the hypopituitarism article. I did say I did not want to swamp it with references. Many thanks for your continued politeness and patience and I am sure you will be fair at the end.

REFERENCES: 1. Saravanan P, Chau F, Roberts N, Vedhara K, Greenwood R, Dayan CM 2002 Psychological well-being in patients on ‗adequate‘ doses of L-thyroxine: results of a large, controlled community-based questionnaire study. Clin Endocrinol (Oxf) 57:577–585 2. 'Understanding Thyroid Hormone Action and the Effects of Thyroid Hormone Replacement – Just the Beginning Not the End'. P Saravanan, C M Dayan, Integrative Neuroscience and Endocrinology, University of Bristol: http://www.hotthyroidology.com/editorial_135.html 3. Po.AL, Kendall MJ. Causality assessment of adverse effects: when is re-challenge ethically acceptable? Drug Saf. 2001;24(11):793-9 4. Turner S‘.Thyroid Patient Advocacy‘ sponsored a registry of counterexamples, numbering just under 2000 (July. 2012). http://www.tpa-uk.org.uk/register_of_counterexamples.php 5. The SIGN Guide to the AGREE guideline appraisal instrument. http://www.sign.ac.uk/methodology/agreeguide/index.html. 6. Bolitho v City and Hackney Hea lth Authority [1997] 4 All ER 771. 7. Popper KR, Conjectures and Refutations, 1963, pgs 33-39 excerpted on the internet at www.stephenjaygould.org/ctrl/popper_falsification.html and reprinted Routledge Classics, 2003, pgs 43-51 8. Escobar-Morreale HF, del Rey FE, Obregon MJ, de Escobar GM. Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues of the thyroidectomized rat. Endocrinology. 1996 Jun;137(6):2490-502 9. Joffe R, Blank DW, Post RM, Uhde TW. Decreased triiodothyronines in depression: A preliminary report. BIOLOGICAL PSYCHI 1985; 20: 922-925. 10. Cooke RG, Joffe RT, Levitt AJ. T3 augmentation of antidepressant treatment in T4-replaced thyroid patients. J CLIN PSYCHI 1992; 53, 1 (Jan): 16-18. 11. Gelenberg AJ. T3 + T4 = success. BIOLOGICAL THERAPIES IN PSYCHI NEWS-LTR 1992; 15, 4 (April): 14. 12. Dommisse J. T3 is at least as important as T4 in all hypothyroid patients.J Clin Psychiatry. 1993 Jul;54(7):277-9. 13. Whybrow PC (1994): The therapeutic use of triiodothyronine and high dose thyroxine in psychiatric disorder. Acta Medica Austriaca 21:47-5 14. CHOPRA IJ: Euthyroid sick syndrome: is it a misnomer? J Clin Endocrinol Metab 82: 329-334, 1997. 15. Sjöberg S, Eriksson M, Werner S, Bjellerup P, Nordin C. L-thyroxine treatment in primary hypothyroidism does not increase the content of free triiodothyronine in cerebrospinal fluid: a pilot study.Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. stefan.sjoberg@ki.se. Scand J Clin Lab Invest. 2011 Feb;71(1):63-7. 16. Leslie J. De Groot. Dangerous Dogmas in Medicine: The Nonthyroidal Illness Syndrome. The Journal of Clinical Endocrinology & Metabolism January 1, 1999 vol. 84 no. 1 151-164 17. Chester Ridgway et.al. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 2000;160:526-534. 18. O‘Reilly DS. Thyroid function tests-time for a reassessment. BMJ. 2000;320:13324. 19. Gullo D, Latina A, Frasca F, Le Moli R, Pellegriti G, et al. (2011) Levothyroxine Monotherapy Cannot Guarantee Euthyroidism in All Athyreotic Patients. PLoS ONE 6(8): e22552. doi:10.1371/journal.pone.0022552 20. Turner S. Thyroid Patient Advocacy. TPA Hypothyroid Patient Survey: http://www.tpa-uk.org.uk/tpauk_survey.pdf 21. Devlin WF, Watanabe H. Thyroxin-triiodothyronine concentrations in thryoid powders. J Pharm Sci. 1966 Apr;55(4):390-3 22. Alley RA, Danowski TS, Robbins T JL, Weir TF, Sabeh G, and Moses CL. Indices during administration of T4 and T3 to euthyroid adults. Metabolism. 1968;17(2):97-104 23. Escobar-Morreale HF, Obregon MJ, Escobar del Rey F, Morreale de Escobar G. Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studied in thyroidectomized rats. J Clin Invest. 1995 Dec;96(6):2828-38 24. Asper SP Jr, Selenkow HA, and Plamondon CA. A comparaison of the metabolic activities of 3,5,3‘-triiodothyronine and lthyroxine in myxedema. Bull John Hopkins Hosp. 1953; 93: 164 25. Blackburn CM, McConahey WM, Keating FR Jr, Albert A. Calorigenic effects of single intravenous doses of ltriiodothyronine and l-thyroxine in myxedematous persons. J Clin Invest. 1954 Jun;33(6):819-24 26. Gross J, Pitt-Rivers R. Physiological activity of 3:5:3'-L-triiodothyronine. Lancet. 1952 Mar 22;1(12):593-4 27. Gross J, Pitt-Rivers R. 3:5:3'-triiodothyronine. 2. Physiological activity. Biochem J. 1953 Mar;53(4):652-7 28. Burroughs V, Shenkman L. Thyroid function in the elderly. Am J Med Sci. 1982, 283 (1): 8-17 29. Carter JN, Eastman CJ, Corcoran JM, and Lazarus L. Inhibition of conversion of thyroxine to triiodothyronine in patients with severe chronic illness. Clin Endocrinol. 1976; 5: 587-94 30. Tulp OL and McKee TD Sr. Triiodothyronine neogenesis in lean and obese LA/N-cp rats. Biochem Biophys Res Communications. 1986; 140 (1): 134-42 31. Katzeff HI, Selgrad C. Impaired peripheral thyroid hormone metabolism in genetic obesity. Endocrinology. 1993; 132 (3): 989-95 32. Croxson MS and Ibbertson HK. Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endocrinol Metab. 1977; 44: 167-73 33. Harns ARC, Fang SH, Vagenakis AG, and Braverman LE. Effect of starvation, nutriment replacement, and hypothyroidism on in vitro hepatic T4 to T3 conversion in the rat. Metabolism. 1978;27(11):1680-90 34. Opstad PK, Falch D, Öktedalen O, Fonnum F, and Wergeland R. The thyroid function in young men during prolonged physical exercise and the effect of energy and sleep deprivation. Clin Endocrinol. 1984; 20: 657-69 35. Walfish PG. Triiodothyronine and thyroxine interrelationships in health and disease. Can Med Ass. J 1976, 115: 338-4 36. Feyes D, Hennemann G and Visser TJ. Inhibition of iodothyronine deiodinase by phenolphtalein dyes. Fed Eur Biomed Sci. 1982; 137(1):40-4 37. Bahn AK, Mills JL, Snyder PJ, Gann PH, Houten L, Bialik O, Hollmann L, and Utiger RD. Hypothyroidism in workers exposed to polybrominated biphenyls. N Engl J Med. 1980; 302: 31-3 38. Ikeda T, Ito Y, Murakami I, Mokuda O, Tominaga M and Mashiba H. Conversion of T4 to T3 in perfused liver of rats with carbontetrachloride-induced liver injury. Acta Endocrinol. 1986;112: 89-92 39. Paier, B; Hagmüller, K; Noli, MI; Gonzalez Pondal, M; Stiegler, C; Zaninovich, AA. Changes induced by cadmium administration on thyroxine deiodination and sulfhydryl groups in rat liver. J Endocrinol. 1993; 138(2):219-22 40. arregärd L, Lindstedt G, Schütz A, Sällsten G. Endocrine function in mercury exposed chloralkali workers. Occup Envir Med. 1994; 51: 536-40 41. Burger AG, Lambert M, Cullen M. Interférence de substances médicamenteuses dans la conversion de T4 en T3 et rT3 chez l‘homme. Ann Endocrinol (Paris). 1981,42:461-9 42. Grussendorf M, Hüfner M. Induction of the thyroxine to triiodothyronine converting enzyme in rat liver by thyroid hormones and analogs. Clin Chim Acta. 1977;80:61-6hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 43. Erickson VJ, Cavalieri RR, Rosenberg LL. Thyroxine-5‘-diodinase of rat thyroid, but not that of liver, is dependent on thyrotropin. Endocrinology. 1982;111:434-40 44. Rezvani I, DiGeorge AM, Dowshen SA, Bourdony CJ. Action of human growth hormone on extrathyroidal conversion of thyroxine to triiodothyronine in children with hypopituitarism. Pediatr Res. 1981;15:6-9 45. Schröder-Van der elst JP, Van der heide D. Effects of streptozocin-induced diabetes and food restriction on quantities and source of T4 and T3 in rat tissues. Diabetes. 1992;41:147-52 46. Gavin LA, Mahon FA, Moeller M. The mechanism of impaired T3 production from T4 in diabetes. Diabetes. 1981;30:694-9 47. Hoover PA, Vaughan MK, Little JC, Reiter RJ. N-methyl-D-aspartate does not prevent effects of melatonin on the reproductive and thyroid axes of male Syrian hamsters. J Endocrinology. 1992;133:51-8 48. Chanoine J-P, Safran M, Farwell AP, Tranter P, Ekenbarger DM, Dubord S, Alex s, Arthur JR, Beckett GJ, Braverman LE, Leonard JL. Selenium deficiency and type II 5‘-deiodinase regulation in the euthyroid and hypothyroid rat: evidence of a direct effect of thyroxine. Endocrinology. 1992;130:479-84 49. Arthur JR, Nicol F, Beckett GJ. Selenium deficiency, thyroid hormone metabolism, and thyroid hormone deiodinases. Am J Clin Nutr Suppl. 1993; 57:236S-9S 50. Beard J, Tobin B, and Green W. Evidence for thyroid hormone deficiency in iron-deficient anemic rats. J Nutr. 1989;772-8 51. Fujimoto S, Indo Y, Higashi A, Matsuda I, Kashiwabara N, and Nakashima I. Conversion of thyroxine into triiodothyronine in zinc deficient rat liver. J Pediatr Gastroenterol Nutr. 1986;5:799-805 52. Olin KI, Walter RM, and Keen CL. Copper deficiency affects selenoglutathione peroxidase and selenodeiodinase activities and antioxidant defense in weanling rats. Am J Clin Nutr 1994;59:654-8 53. Westgren U, Ahren B, Burger A, Ingemansson S, Melander A. Effects of dexamethasone, desoxycorticosterone, and ACTH on serum concentrations ot thyroxine, 3,5,3‘-triiodothyronine and 3,3‘,5‘-triiodothyronine. Acta Med Scand. 1977;202 (1-2): 89-92 54. Heyma P, Larkins RG. Glucocorticoids decrease the conversion of thyroxine into 3,5,3‘-triiodothyronine by isolated rat renal tubules. Clin Science. 1982; 62: 215-20 55. Scammell JG, Shiverick KT, Fregly MJ. Effect of chronic treatment with estrogen and thyroxine, alone and combined, on the rate of deiodination of l-thyroxine to 3,5,3‘-triiodothyronine in vitro. Pharmacology. 1986;33: 52-7 56. Aizawa T, Yamada T. Effects of thyroid hormones, antithyroid drugs and iodide on in vitro conversion of thyroxine to triiodothyronine. Clin Exp Pharmacol Physiol. 1981; 8: 215-25 57. Voss C, Schrober HC, Hartmann N. Einfluss von Lithium auf die in vitro-Deioderung von l-Thyroxin in der Ratten leber. Acta Biol Med Germ. 1977; 36:1061-5 58. Hays MT. Absorption of oral thyroxine in man. J Clin Endocrinol Metab. 1968; 28 (6):749-56 59. Surks MI, Schodlow AR, Stock Jm, Oppenheimer JH. Determination of iodothyronine absorption and conversion of Lthyroxine using turnover rate techniques. J Clin Invest. 1973; 52:809-11 60. Hubbard WK. FDA notice regarding levothyroxine sodium. Federal register. 1997; 62(157): 1-10 61. Peran S, Garriga MJ, Morreale de Escobar G, Asuncion M, Peran M. Increase in plasma thyrotropin levels in hypothyroid patients during treatment due to a defect in the commercial preparation . J Clin Endocrinol Metab. 1997;82(10):3192-5 62. Selivonenko VG, Zaika IV. The function of the thyroid and thyrotropic function in patients with chronic ischemic heart disease and rhythm disorders. Lik Sprava. 1998 Jan-Feb;(1):81-3 63. Inama G, Furlanello F, Fiorentini F, Braito G, Vergara G, Casana P. Arrhythmogenic implications of non-iatrogenic thyroid dysfunction. G Ital Cardiol. 1989 Apr;19(4):303-10 (Hypothyroidism in patients with hyperkinetic ventricular arrhythmias (25%), atrial fibrillation (37.5%) and atrio-ventricular block (37.5%)) 64. Vanin LN, Smetnev AS, Sokolov SF, Kotova GA, Masenko VP. Thyroid function in patients with ventricular arrhythmia. Kardiologiia. 1989 Feb;29(2):64-7 (Hyperthyroidism was diagnosed in 4.8% of 21 patients with persistent ventricular arrhythmias, and latent hypothyroidism was diagnosed in 38.1%) 65. Nesher G, Zion MM. Recurrent ventricular tachycardia in hypothyroidism--report of a case and review of the literature. Cardiology. 1988;75(4):301-6 66. Fredlund BO, Olsson SB. Long QT interval and ventricular tachycardia of "torsade de pointe" type in hypothyroidism. Acta Med Scand. 1983;213(3):231-5 67. Miura S, Iitaka M, Suzuki S, Fukasawa N, Kitahama S, Kawakami Y, Sakatsume Y, Yamanaka K, Kawasaki S, Kinoshita S, Katayama S, Shibosawa T, Ishii J. Decrease in serum levels of thyroid hormone in patients with coronary heart disease. Endocr J. 1996 Dec;43(6):657-6 68. Cerillo AG, Bevilacqua S, Storti S, Mariani M, Kallushi E, Ripoli A, Clerico A, Glauber M. Free triiodothyronine: a novel predictor of postoperative atrial fibrillation. Eur J Cardiothorac Surg. 2003 Oct;24(4):487-92 69. Telkova IL, Tepliakov AT. Changes of thyroid hormone levels in the progression of coronary artery disease. Arteriosclerosis. Klin Med (Mosk). 2004;82(4):29-34 70. Pavlou HN, Kliridis PA, Panagiotopoulos AA, Goritsas CP, Vassilakos PJ. Euthyroid sick syndrome in acute ischemic syndromes. Angiology. 2002 Nov-Dec;53(6):699-707 71. Pimenov LT, Leshchinskii LA. Thyroid hormone changes (iodothyroninemia) in patients with acute myocardial infarction, and their clinical significance. Kardiologiia. 1984 Oct;24(10):74-7 72. Satar S, Seydaoglu G, Avci A, Sebe A, Karcioglu O, Topal M. Prognostic value of thyroid hormone levels in acute myocardial infarction: just an epiphenomenon? Am Heart Hosp J. 2005 Fall;3(4):227-33 73. Zoncu S, Pigliaru F, Putzu C, Pisano L, Vargiu S, Deidda M, Mariotti S, Mercuro G. Cardiac function in borderline hypothyroidism: a study by pulsed wave tissue Doppler imaging. Eur J Endocrinol. 2005 Apr;152(4):527-33 (namely ―impairment of systolic ejection, a delay in diastolic relaxation and a decrease in the compliance to the ventricular filling. Several significant correlations were found between the parameters and serum-free T(3) and T(4) and TSH concentrations. Data strongly support the concept of a continuum spectrum of a slight thyroid failure in autoimmune thyroiditis‖) 74. Khaleeli AA, Memon N. Factors affecting resolution of pericardial effusions in primary hypothyroidism: a clinical, biochemical and echocardiographic study. Postgrad Med J. 1982 Aug;58(682):473-6 75. Reza MJ, Abbasi AS. Congestive cardiomyopathy in hypothyroidism. West J Med. 1975 Sep;123(3):228-30 76. Rays J, Wajngarten M, Gebara OC, Nussbacher A, Telles RM, Pierri H, Rosano G, Serro-Azul JB. Long-term prognostic value of triiodothyronine concentration in elderly patients with heart failure. Am J Geriatr Cardiol. 2003 Sep-Oct;12(5):293-7 (―Lower serum T3 in cardiac failure: the odds ratio for events was 9.8 (95% confidence interval,2.2-43, p=0.004) for patients in the lowest tertile of triiodothyronine, that is, lower than 80 ng/dL, compared with patients with levels above 80 ng/dL‖) 77. Pingitore A, Landi P, Taddei MC, Ripoli A, L'Abbate A, Iervasi G. Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med. 2005 Feb;118(2):132-6 78. Klein I, Ojama K. In: Werner & Ingbar‘s The Thyroid, ed. Braverman LE & Utiger RD, Lippincott-Raven Publishers, Philadelphia, 1996, 62: 799-804hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 79. Hamilton MA, Stevenson LW, Luu M, Walden JA. Altered thyroid hormone metabolism in advanced heart failure. J Am Coll Cardiol. 1990 Jul;16(1):91-5 80. Kozdag G, Ural D, Vural A, Agacdiken A, Kahraman G, Sahin T, Ural E, Komsuoglu B. Relation between free triiodothyronine/free thyroxine ratio, echocardiographic parameters and mortality in dilated cardiomyopathy. Eur J Heart Fail. 2005 Jan;7(1):113-8 81. Wortsman J, Premachandra BN, Chopra IJ, Murphy JE. Hypothyroxinemia in cardiac arrest. Arch Intern Med. 1987 Feb;147(2):245-8 82. Iervasi G, Pingitore A, Landi P, Raciti M, Ripoli A, Scarlattini M, L'Abbate A, Donato L. Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation. 2003 Feb 11;107(5):708-13 83. Corrective thyroid therapy is safe in hypothyroid patients with common benign cardiac arrhythmias at the condition that thyroid treatment is started at low doses and then gradually and prudently increased to the adequate dose. The treatment does not trigger an increase in arrhythmia frequency except in rare patients with baseline atrial premature beats. It is, however, associated with an increase in basal, average and maximal heart rates 84. Polikar R, Feld GK, Dittrich HC, Smith J, Nicod P. Effect of thyroid replacement therapy on the frequency of benign atrial and ventricular arrhythmias. J Am Coll Cardiol. 1989 Oct;14(4):999-1002 85. Yamauchi K, Takasu N, Ichikawa K, Yamada T, Aizawa T. Effects of long-term treatment with thyroxine on pituitary TSH secretion and heart action in patients with hypothyroidism. Acta Endocrinol (Copenh). 1984 Oct;107(2):218-24 (―T4 doses should be adjusted to maintain normal ET/PEP (systolic time intervals) rather than normal serum TSH levels‖) 86. Barnes BO. Prophylaxis of ischaemic heart-disease by thyroid therapy. Lancet. 1959 Aug 22;2:149-52 87. Holland FW 2nd, Brown PS Jr, Clark RE. Acute severe postischemic myocardial depression reversed by triiodothyronine. Ann Thorac Surg. 1992 Aug;54(2):301-5 88. Israel M. An effective therapeutic approach to the control of atherosclerosis illustrating harmlessness of prolonged use of thyroid hormone in coronary disease. Am J Dig Dis. 1955 June;161-8 89. Yokoyama Y, Novitzky D, Deal MT, Snow TR. Facilitated recovery of cardiac performance by triiodothyronine following a transient ischemic insult. Cardiology. 1992;81(1):34-45 90. Perk M, O‘Neill BJ; The effect of thyroid therapy on angiographic artery disease progression. Can J Card. 1997;13(3):273-6 91. Zondek H. Myxedema Heart. Munch Med Wochenschr. 1918, 65: 1180-3 92. Novitzky D, Fontanet H, Snyder M, Coblio N, Smith D, Parsonnet V. Impact of triiodothyronine on the survival of high-risk patients undergoing open heart surgery. Cardiology. 1996 Nov-Dec;87(6):509-15. 93. Novitzky D, Cooper DK, Chaffin JS, Greer AE, DeBault LE, Zuhdi N. Improved cardiac allograft function following triiodothyronine therapy to both donor and recipient. Transplantation. 1990 Feb;49(2):311-6 94. Yao J, Eghbali M. Decreased collagen mRNA and regression of cardiac fibrosis in the ventricular myocardium of the tight skin mouse following thyroid hormone treatment. Cardiovasc Res. 1992 Jun;26(6):603-7 95. Facktor MA, Mayor GH, Nachreiner RF, D'Alecy LG. Thyroid hormone loss and replacement during resuscitation from cardiac arrest in dogs. Resuscitation. 1993 Oct;26(2):141-6 96. Shigematsu H, Shatney CH. The effect of triiodothyronine (T3) and reverse triiodothyronine (rT3) on canine hemorrhagic shock. Nippon Geka Gakkai Zasshi. 1988 Oct;89(10):1587-93. 97. Joint Committee on Higher Medical Training, ―Higher Medical Training Curriculum for Endocrinology and Diabetes Mellitus,‖ 2003 98. WHO Handbook for Guideline Development - http://www.who.int/hiv/topics/mtct/grc_handbook_mar2010_1.pdf 99. Kavanagh BP(2009) The GRADE system for Rating Clinical Guidelines. PLoS Med 6(9): e10000094,doi:10.137/journal.pmed.10000094 100. UK Guidelines for the Use of Thyroid Function Tests (July 2006) http://www.british-thyroid-association.org/info-forpatients/Docs/TFT_guideline_final_version_July_2006.pdf 101. Amerling R, Winchester JF, Ronco C, ―Guidelines have done more harm than good,‖Blood Purification 2008;26;73-76. 102. Guirguis-Blake J, Calonge N, Miller T, Siu A, Teutsch S, Whitlock E., ―Current processes of the U.S. Preventive Services Task Force: refining evidence-based recommendation development‖. Ann. Intern. Med 2007; 147(2):117–22. 103. Barton MB, Miller T, Wolff T, et al. ―How to read the new recommendation statement: methods update from the U.S. Preventive Services Task Force,‖ Ann. Intern. Med 2007;147(2):123–7. 104. Pritchard EK, ―The Linguistic Etiologies of Thyroxine-Resistant Hypothyroidism,‖ Thyroid Science www.thyroidscience.com – click on ―debate.‖ 105. Gossel, TA, Endocrinology Continuing Education accredited by the Accreditation Council for Continuing Medical Education (ACCME), 2005 106. Baskin, HJ, MD, Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism, Am Assoc Clin Endocrinol, 2002, Rev 2006 107. Levy EG, Ridgway EC, Wartofsky L, Algorithms for Diagnosis and Management of Thyroid Disorders, www.thyroidtoday.com 2004. 108. Patients with Hyperthyroidism and Hypothyroidism,‖ and ―Guidelines for Detection of Thyroid Dysfunction.‖The American Thyroid Association provides links to several hypothyroidism related guidelines www.thyroid.org 109. Vanderpump MPJ, Ahlquist JAO, Franklyn JA, et al., Consensus Statement for Good Practice and Audit Measures in the Management of Hypothyroidism and Hyperthyroidism, BMJ, August 1996 110. Garber JR, Hennessey JV, Lieberman JA, Morris CM, Talbert RI, Managing the Challenges of Hypothyroidism, Supplement to J of Fam Pract, 2006, www.jponline.com 111. Kaplan MM, Clinical Perspectives in the Diagnosis of Thyroid Disease, Clin Chem, 1999, 45:8(B) 1377-1383 112. The Royal College of Physicians http://www.rcplondon.ac.uk/sites/default/files/the-diagnosis-and-management-of-primaryhypothyroidism-revised-statement-14-june-2011_2.pdf 113. Goldberg M, The Case For Euthyroid Hypometabolism, Am J Med Sc October, 1960 pgs 479-493 114. Goldberg M, Diagnosis of Euthyroid Hypometabolism, Am J Obst & Gynec, 81(5): 1053-1058, 1961 115. Baisier, WV, Hertoghe, J., B, Eekhaut, W., Thyroid Insufficiency? Is Thyroxine the Only Valuable Drug?, Journal of Nutritional and Environmental Medicine, Vol. 11, No. 3, September 2001, pages 159-166 116. Braverman LE, Ingbar SH, Keinwem S, Conversion of Thyroxine (T4) to Triiodothyronine (T3) in Athyreotic Human Subjects, The J Clin Invest, 1970 117. BRUCE H. COHEN, MD, DEBORAH R. GOLD, MD. What we know so far.Cleveland Clinic Journal of Medicine Volume 68.No 7; July 2001 118. Dillman E, Gale C, Green W, et al. Hypothermia in iron deficiency due to altered triiodithyroidine metabolism. Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381. 119. Smith SM, Johnson PE, Lukaski HC. In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of dietary fat. Life Sci 1993;53(8):603-9.hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 120. Zimmermann MB, Köhrle J. The Impact of Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry and Relevance to Public Health. Thyroid 2002;12(10): 867-78. 121. Beard J, tobin B, Green W. Evidence for Thyroid Hormone Deficiency in Iron-Deficient Anemic Rats. J. Nutr. 1989;119:772- 778. 122. Jabbar A, Yawar A, Waseem S, Islam N, Ul Haque N, Zuberi L, Khan A, Akhter J. Vitamin B12 deficiency common in primary hypothyroidism. Department of Medicine, Aga Khan University, Karachi, Pakistan. 2008 May;58(5):258-61. 123. Julia Bársony, P. Lakatos, J. Földes and T. Fehér. Effect of vitamin D3 loading and thyroid hormone replacement therapy on the decreased serum 25-hydroxyvitamin D level in patients with hypothyroidism: Acta Endocrinol November 1, 1986 113 329-334 124. B. CATARGI, F. PARROT-ROULAUD, C. COCHET, D. DUCASSOU, P. ROGER, and A. TABARIN. Thyroid. December 1999, 9(12): 1163-1166. doi:10.1089/thy.1999.9.1163. Published in Volume: 9 Issue 12: January 30, 2009 125. Bjørn G. Nedrebø, Ottar Nygård, Per M. Ueland, and Ernst A. Lien; Plasma Total Homocysteine in Hyper- and Hypothyroid Patients before and during 12 Months of Treatment. Clinical Chemistry September 2001 vol. 47 no. 9 1738-1741 126. JOHN E. JONESt PAUL C. DESPER, STANLEY R. SHANE, AND EDMUND B. FLINK .Magnesium Metabolism in Hyperthyroidism and Hypothyroidism: Journal of Clinical Investigation. Vol. 45, No. 6, 1966 127. Lawrence Wilson, MD .COPPER TOXICITY SYNDROME Revised, July 2011, The Center For Development. http://www.drlwilson.com/articles/copper_toxicity_syndrome.htm 128. Vivek R Joshi, Ayaz K Mallick, Manjunatha Goud B K, Ravindra Maradi, Maheshwar G Reddy, Raghavendra Tey, Gaurav Shorey. Effect of serum copper concentration and ceruloplasmin on lipid parameters leading to increased propensity to cardiovascular risk. Department of Biochemistry, Melaka Manipal Medical College, Manipal University. ISSN: 0975-8585 129. Iham Amir Al-Juboori , Rafi Al-Rawi, Hussein Kadhem A-Hakeim. Estimation of Serum Copper, Manganese, Selenium, and Zinc in Hypothyroidism Patients. IUFS Journal of Biology Short Communication 121 IUFS J Biol 2009, 68(2): 121-126 130. Rajagopal KR, Abbrecht PH, Derderian SS, Pickett C, Hofeldt F, Tellis CJ, Zwillich CW. Obstructive sleep apnea syndrome and hypothyroidism (a report of three cases)].Ann Intern Med. 1984 Oct; 101(4):491-4. 131. Rack SK, Makela EH. Hypothyroidism and depression: a therapeutic challenge Department of Behavioural Medicine and Psychiatry. Ann Pharmacother 2000 Oct; 34(10):1142-5 132. Jonathan Stephen Murray, Rubaraj Jayarajasingh, Petros Perros. Deterioration of symptoms after start of thyroid hormone replacementBMJ.2001 August 11; 323(7308):332-333 133. Annane D, Sébille V, Charpentier C, Bollaert PE, François B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaud P, Bellissant E.Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002 Aug 21;288(7):862-71. 134. C.Orian Truss, M.D. Restoration of Immunologic Competence to Candida Albicans [1] 135. Diabetes Care January 2011 vol. 34 no. Supplement 1 S11-S61 136. McDermott JH, Coss A, Walsh CH. Celiac disease presenting as resistant hypothyroidism. Thyroid. 2005 Apr;15(4):386-8. 137. John Saunders. The practice of clinical medicine as an art and as a science. Med Humanities 2000;26:18-22 doi:10.1136/mh.26.1.18 138. Wilson James L. Adrenal Fatigue, The 21st Century Stress Syndrome. Smart Publications. ISBN 1-890572-15-2 139. Robert H. Seller, MD and Andrew B. Symons, MD, MS ‗Differential Diagnosis of Common Complaints‘, 6th Edition. ISBN: 9781455707720 140. Differential Diagnosis (DDX) Definition: ―The distinguishing of a disease or condition from others presenting with similar signs and symptoms,‖ Merriam-Webster 141. Differential Diagnosis (DDX) ‖is a systematic method used to identify unknowns. This method, essentially a process of elimination, is used by taxonomists to identify living organisms, and by physicians and other qualified professionals to diagnose the specific disease in a patient. Not all medical diagnoses are differential ones: some diagnoses merely name a set of signs and symptoms that may have more than one possible cause, and some diagnoses are based on intuition or estimations of likelihood.‖ Wikipedia: http://en.wikipedia.org/wiki/Differential_diagnosis 142. Differential Diagnosis is a medical adaption of the process of elimination. These processes are based upon the logic of disjunctive syllogism, which is known from antiquity as modus tollendo poner 143. Barnes. Temperature v Basal Metabolism. Journal Of American Medical Association. 119:1072,1942 144. Henryk Zulewski, Beat Müller, Pascale Exer, André R. Miserez and Jean-Jacques Staub:Estimation of Tissue Hypothyroidism by a New Clinical Score: Evaluation of Patients with Various Grades of Hypothyroidism and Controls: The Journal of Clinical Endocrinology 145. Robin P Peeters, Wendy M van der Deure, Theo J Visser ―Genetic variation in thyroid hormone pathway genes; polymorphisms in the TSH receptor and the iodothyronine deiodinases‖ : Eur J Endocrinol November 1, 2006 155 655-662 146. Tolulope O Olateju and Mark P J Vanderpump. Thyroid hormone resistance. Ann Clin Biochem 1 November 2006 vol. 43 no. 6 431-440 147. The Royal College of Physicians Clinical Guidelines: http://www.rcplondon.ac.uk/resources/clinical/guidelines 148. Salman Razvi, MD, FRCP; Jolanta U. Weaver, PhD, FRCP; Timothy J. Butler, MRCGP; Simon H. S. Pearce, MD, FRCP.Levothyroxine Treatment of Subclinical Hypothyroidism, Fatal and Nonfatal Cardiovascular Events, and Mortality: Arch Intern Med. Published online April 23, 2012. doi:10.1001/archinternmed.2012.1159 149. Walsh, Dr. John P., Combined Thyroxine/Liothyronine Treatment Does Not Improve Well-Being, Quality of Life, Or Cognitive Function Compared to Thyroxine Alone: A Randomized Controlled Trial in Patients with Primary Hypothyroidism, J Clin Endocrinol Metabol, 88(10):4543-50. 150. Clyde, Patrick W, MD, Combinination Levothyroxine/Liothyronine Shows No Obvious Benefit Over Levothyroxine Alone in Patients With Primary Hypothyroidism, JAMA, December 2003 as reported by Joene Hendry of Doctor‘s Guide. 151. Sawka AM, Gerstein HC, Marriot MJ, MacQueen GM & Joffe RT. D oes a combination regimen of thyroxine (T4) and 3,5,31- triiodothyronine improve depressive symptoms better than T4 lone in patients with hypothyroidism? Results of a double-blind, andomized, controlled trial. Journal of Clinical Endocrinology and Metabolism 2003 88 4551–4555 152. Cassio, A., Cacciari, E., Cicgnani, A., et al. ―Treatment of congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine?‖ Pediatrics, 2003,111(5):1055-1060 153. Lowe, J.C.: Stability, effectiveness, and safety of desiccated thyroid . . . . Thyroid Science 4(3):C1-12, 2009 11 154. Grozinsky-Glasberg, S., Fraser, A., Nahshoni, E., et al.: Thyroxine-triiodothyronine combination therapy versus thyroxine monotherapy for clinical hypothroidism: meta-analysis of randomized controlled trials. J. Clin. Endocrinol. Metab., 91:2592- 2599, 2006. 155. Cobb, W.E. and Jackson, I.M.: Drug therapy reviews: management of hypothyroidism.Am. J. Hosp. Pharm., 35(1):51-58, 1978. 156. Bastemir, M., Akin, F., Alkis, E., et al.: Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss. Med. Wkly., 137(29-30): 431-434, 2007.hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 157. Nygaard B et al. Effect of combination therapy with thyroxine (T4) and 3,5,3′-triiodothyroxine versus T4 monotherapy in patients with hypothyroidism, a double-blind, randomised cross-over study. EJE 2009;161:895–902. 158. Harvinder Chahal, Anna Hawkins & Kash Nikookam. T3 a life saver. Department of Diabetes and Endocrinology, King George Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Greater London, United Kingdom. Endocrine Abstracts (2012) 28 P121 159. Simona Grozinsky-Glasberg, Abigail Fraser, Ethan Nahshoni, Abraham Weizman and Leonard Leibovici. ThyroxineTriiodothyronine Combination Therapy Versus Thyroxine Monotherapy for Clinical Hypothyroidism: Meta-Analysis of Randomized Controlled Trial. The Journal of Clinical Endocrinology & Metabolism July 1, 2006 vol. 91 no. 7 2592-2599 160. Celi FS, Zemskova M, Linderman JD, et al., The pharmacodynamic equivalence of levothyroxine and liothyronine. A randomized, double-blind, cross-over study in thyroidectomized patients., Clin Endocrinol, 2010 May; 72(5) 709-715, doi: 10.1111/j.1365-2265.2009.03700.x. 161. Bunevicius, R. and Prange, A.J.: Mental improvement after replacement therapy with thyroxine plus triiodothyronine: relationship to cause of hypothyroidism. Int. J. Neuropsychopharmacol., 3(2):167-174, 2000. 162. Bunevicius, R., Jakubonien, N., Jurkevicius, R., et al.: Thyroxine vs thyroxine plus triiodothyronine in treatment of hypothyroidism after thyroidectomy for Graves‘ disease. Endocrine, 18(2):129-133, 2002 163. Avantika C. Waring et.al. Thyroid Function and Mortality in Older Men: A Prospective Study. The Journal of Clinical Endocrinology & Metabolism January 11, 2012 jc.2011-2684 164. O'Reilly DS .Thyroid hormone replacement: an iatrogenic problem.Department of Clinical Biochemistry, Royal Infirmary, Glasgow, UK. Int J Clin Pract. 2010 Jun;64(7):991-4. 165. Warmingham, P.: Effect of exogenous thyroid hormone intake on the interpretation of serum TSH test results. Thyroid Science, 5(7)1-6, 201 166. Igoe, D., Duffy, M.J., and McKenna, T.J.: TSH as an index of L-thyroxine replacement and suppression therapy. Ir. J. Med. Sci., 161(12):684-686, 1992 167. Bjørn O. Åsvold, Lars J. Vatten,Kristian Midthiell and Trine Bjøro; November 2, 2011, doi: 10.1210/jc.2011-1724: The Journal of Clinical Endocrinology & Metabolism January 1, 2012 vol. 97 no. 1 93-99 168. Royal College of Physicians Remit: http://www.rcplondon.ac.uk/what-we-do 169. Good Medical Practice: Teaching and training, appraising and assessing. http://www.gmcuk.org/guidance/good_medical_practice/teaching_training.asp 170. British Thyroid Foundation and NHS Choices: http://www.talkhealthpartnership.com/forum/viewforum.php?f=123 171. Medicines and Healthcare Products Regulatory Agency: Interim Report of the Review of Unlicensed Medicines. http://www.mhra.gov.uk/home/groups/is-pol/documents/publication/con046467.pdf 172. Introduction to Tort: 2/14/2008 http://www.oup.com/uk/orc/bin/9780199292240/strong_ch01.pdf 173. Kirk E, Kvorning SA, Acta Med. Scandinav., Suppl. 184. pp 3-83. 1947 174. Means JH, Lectures on Thyroid, Cambridge, Harvard University Press, pgs 48-49, 1954 175. Refetoff S, Weiss RE, Usala SJ, The Syndromes of Resistance to Thyroid Hormone, Endocr Rev, 1993, 14(3):348-399 176. Wilson James L. Adrenal Fatigue, The 21st Century Stress Syndrome. Smart Publications. ISBN 1-890572-15-2 177. John Saunders. The practice of clinical medicine as an art and as a science. Med Humanities 2000;26:18-22 doi:10.1136/mh.26.1.18 178. British Thyroid Association.Armour Thyroid (USP) and combined thyroxine/ tri-iodothyronine as Thyroid Hormone Replacement. A Statement from the BTA Executive Committee November 2007- http://www.british-thyroidassociation.org/Guidelines/Docs/Armour_nov_07.pdf 179. Turner S. The Thyroid Patient Advocacy-UK (TPA-UK) Response to: ―A Statement from the British Thyroid Association Executive Committee on Armour® Thyroid‖ http://www.tpa-uk.org.uk/resp_bta_armour.pdf 180. Cooper, D.S.: Combined T4 and T3 therapy—back to the drawing board. J.A.M.A., 290:3002-3004, 2003. 181. Gorowski, T., Pucilowska, J., and Wernic, K.: Comparative effects of desiccated thyroid gland and sodium salt of Lthyroxine in the treatment of hypothyroidism. Pol. Tyg. Lek., 44(32-33):768-770, 1989. 182. Krenning, E.P., Docter, R., Visser, T.J., et al.: Replacement therapy with L-thyroxine: serum thyroid hormone and thyrotropin levels in hypothyroid patients changing from desiccated thyroid to pure thyroxine substitution therapy. Neth. J. Med., 28(1):1-5, 1981. 183. Felt, V. and Nedvidkova, J.: Comparison of treatment with L-thyroxine and a dried thyroid gland preparation in patients with hypothyroidism. Vnitr. Lek., 28 (11):1067-1073, 1982. 184. Wartofsky, L.: Combined levotriiodothyronine and levothyroxine therapy for hypothyroidism: are we a step closer to the magic formula? Thyroid, 14(4):247-248, 2004. 185. Rodriguez, T., Lavis, V.R., Meininger, J.C., et al.: Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone. Endocr. Pract., 11:223–233,2005 186. Kosowicz, J., Horst-Sikorska, W., Lacka, K., et al. Outcome of treating hypothyroidism with thyreoideum. Pol. Tyg. Lek, 48(27-28):599-602, 1993.Warszawie, C.M.K.P.: Treatment of hypothyroidism with L-thyroxine. Pol. Tyg. Lek, 48(27- 28):605-608, 1993. 187. Singh, S.P., Feldman, E.B., and Carter, A.C.: Desiccated thyroid and levothyroxine in hypothyroidism:comparison in replacement therapy. N.Y. State J. Med., 72(9):1045-1048, 1972. 188. Sawin, C.T., Hershman, J.M., Fernandez-Garcia, R., et al.: A comparison of thyroxine and desiccated thyroid in patients with primary hypothyroidism. Metabolism, 27(10):1518-1525, 1978. 189. Smith, R.N., Taylor, S.A., and Massey, J.C.: Controlled clinical trial of combined triiodothyronine andthyroxine in the treatment of hypothyroidism. Brit. Med. J., 4:145-148, 1970. 190. McGavack, T.H. and Reckendorf, H.K.: Therapeutic activity of desiccated thyroid substance, sodium Lthyroxine and D, Ltriiodothyronine: a comparative study. Am. J. Med., 20:774-777, 1956. 191. Escobar-Morreale, H.F., Botella-Carretero, J.I., Gómez-Bueno, M., et al.: Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone. Ann. Intern. Med., 142(6): 412-424, 2005.1 192. Map of Medicine: Royal College of Physicians Joint specialty societies. http://eng.mapofmedicine.com/evidence/map/thyroid_disorders1.html 193. Danzi S, Ojamaa K, and Klein I, Triiodothyronine-Mediated Myosin Heavy Chain Gene Transcription in the Heart, Am J Phys Heart Circ Physiol, Feb 27, 2003 194. Eisenstein Z, Hagg S, Braverman LE, et al., Effect of Starvation on the Production and Peripheral Metabolism of 3,3',5' Triiodothyronine in Euthyroid Obese Subjects, J Clin Endocrinol Metab, 1978, 47(4): 889-893 195. Nomura S., et al. Reduced Peripheral Conversion of Thyroxine to Triiodothyronine in Patients with Hepatic Cirrhosis, J of Clin Invest, Sept 1975, 56(3): 643-652hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 196. Refetoff S, Dewind LT, DeGroot LJ, Familial Syndrome Combining Deaf-mutism, Stippled Epiphyses, Goiter and Abnormally High PBI: Possible Target Organ Refactoriness to Thyroid Hormone, J Clin Endocrinol Metab, 27:279, 1967 197. Weiss RE, Refetoff S, Treatment of Resistance to Thyroid Hormone – Primum Non Nocere, J Clin Endocr Metabol, 84(2):401-404 198. Benson K, Hartz AJ, A Comparison of Observation Studies and Randomized Controlled Trials, NEJM, June 22, 2000, pgs 1878-86. 199. Fang L, Tan T. Development of hypothyroidism therapy with thyroid hormone.Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2005 Apr;22(2):396-9. 200. Rosenberg W, Donald A, Evidence based medicine: an approach to clinical problem-solving, BMJ 1995;310:1122-1126 (29 April) 201. Sackett DL, Rosenberg MC, Muir Gray JA, Haynes RB, Richard WS, Evidence Base Medicine: What It Is and What It Isn‘t, BMJ, 1996; 312:71-72 202. Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al. ―Initial Severity and Antidepressant Benefits: A MetaAnalysis of Data Submitted to the Food and Drug Administration.― 2008, PLoS Med 5(2): e45 doi:10.1371/journal.pmed.0050045: Access full article at http://medicine.plosjournals.org/perlserv/?request=getdocument&doi=10.1371/journal.pmed.0050045 203. Pop VJ, Maartens LH, Leusink G, van Son MJ, Knottnerus AA, Ward AM, Metcalfe R, Weetman AP. ―Are autoimmune thyroid dysfunction and depression related? ― J Clin Endocrinol Metab. 1998 Sep;83(9):3194-7 204. Haggerty JJ Jr, Stern RA, Mason GA, Beckwith J, Morey CE, Prange AJ Jr. ―Subclinical hypothyroidism: a modifiable risk factor for depression? ― Am J Psychiatry. 1993 Mar;150(3):508-10 205. Gold MS, Pottash AL, Extein I. ―Symptomless autoimmune thyroiditis in depression.― Psychiatry Res. 1982 Jun;6(3):261-9 206. O‘Shanick GJ, Ellinwood EH Jr. ―Persistent elevation of thyroid-stimulating hormone in women with bipolar affective disorder. ― Am J Psychiatry. 1982 Apr;139(4):513-4 207. Howland RH. ―Thyroid dysfunction in refractory depression: implications for pathophysiology and treatment.― J Clin Psychiatry. 1993 Feb;54(2):47-54 208. Kirkegaard C, Norlem N, Lauridsen UB, Bjorum N, Christiansen C. ―Protirelin stimulation test and thyroid function during treatment of depression.― Arch Gen Psychiatry. 1975 Sep;32(9):1115-8 209. Bauer MS, Whybrow PC, Winokur A. ―Rapid cycling bipolar affective disorder. I. Association with grade I hypothyroidism.― Arch Gen Psychiatry. 1990 May;47(5):427-32 210. Haggerty JJ Jr, Evans DL, Golden RN, Pedersen CA, Simon JS, Nemeroff CB. ―The presence of antithyroid antibodies in patients with affective and nonaffective psychiatric disorders.― Biol Psychiatry. 1990 Jan 1;27(1):51-60 211. Gaby AR.‖Sub-laboratory hypothyroidism and the empirical use of Armour thyroid‖. Altern Med Rev. 2004 Jun;9(2):157-79 212. Joffe RT, Marriott M. ―Thyroid hormone levels and recurrence of major depression.― Am J Psychiatry. 2000 Oct;157(10):1689-91 (―the time to recurrence of major depression was inversely related to T3 levels but not to T4 levels‖) 213. Afflelou S, Auriacombe M, Cazenave M, Chartres JP, Tignol J. ―Administration of high dose levothyroxine in treatment of rapid cycling bipolar disorders. Review of the literature and initial therapeutic application apropos of 6 cases.― Encephale. 1997 May-Jun;23(3):209-17 214. Bauer M, Baur H, Berghofer A, Strohle A, Hellweg R, Muller-Oerlinghausen B, Baumgartner A. ―Effects of supraphysiological thyroxine administration in healthy controls and patients with depressive disorders.― J Affect Disord. 2002 Apr;68(2-3):285-94 215. Schwarcz G, Halaris A, Baxter L, Escobar J, Thompson M, Young M. ―Normal thyroid function in desipramine nonresponders converted to responders by the addition of L-triiodothyronine.― Am J Psychiatry. 1984 Dec;141(12):1614-6 216. Prange AJ Jr. ―Novel uses of thyroid hormones in patients with affective disorders.― Thyroid. 1996 Oct;6(5):537-43 217. Birkenhager TK, Vegt M, Nolen WA. ―An open study of triiodothyronine augmentation of tricyclic antidepressants in inpatients with refractory depression.― Pharmacopsychiatry. 1997 Jan;30(1):23-6 218. Joffe RT, Singer W, Levitt AJ, MacDonald C. ―A placebo-controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression.― Arch Gen Psychiatry. 1993 May;50(5):387-93 219. Altshuler LL, Bauer M, Frye MA, Gitlin MJ, Mintz J, Szuba MP, Leight KL, Whybrow PC. ―Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature.― Am J Psychiatry. 2001 Oct;158(10):1617-22 220. Kikuchi M, Komuro R, Oka H, Kidani T, Hanaoka A, Koshino Y. ―Relationship between anxiety and thyroid function in patients with panic disorder.― Prog Neuropsychopharmacol Biol Psychiatry. 2005 Jan;29(1):77-81 221. Bauer M, Priebe S, Kurten I, Graf KJ, Baumgartner A. ―Psychological and endocrine abnormalities in refugees from East Germany: Part I. Prolonged stress, psychopathology, and hypothalamic-pituitary-thyroid axis activity.― Psychiatry Res. 1994 Jan;51(1):61-73 222. Magliozzi JR, Maddock RJ, Gold AS, Gietzen DW. ―Relationships between thyroid indices and symptoms of anxiety in depressed outpatients.― Ann Clin Psychiatry. 1993 Jun;5(2):111-6 223. Sait Gonen M, Kisakol G, Savas Cilli A, Dikbas O, Gungor K, Inal A, Kaya A. ―Assessment of anxiety in subclinical thyroid disorders.― Endocr J. 2004 Jun;51(3):311-5 224. Larisch R, Kley K, Nikolaus S, Sitte W, Franz M, Hautzel H, Tress W, Muller HW. ―Depression and anxiety in different thyroid function states.― Horm Metab Res. 2004 Sep;36(9):650-3 225. Constant EL, Adam S, Seron X, Bruyer R, Seghers A, Daumerie C. ―Anxiety and depression, attention, and executive functions in hypothyroidism.― J Int Neuropsychol Soc. 2005 Sep;11(5):535-44 226. Landen M, Baghaei F, Rosmond R, Holm G, Bjorntorp P, Eriksson E. ―Dyslipidemia and high waist-hip ratio in women with self-reported social anxiety.― Psychoneuroendocrinology. 2004 Sep;29(8):1037-46 (Serum levels of free thyroxin (14+/-2 vs. 16+/-4, P=0.04) were lower in subjects confirming social anxiety) 227. Venero C, Guadano-Ferraz A, Herrero AI, Nordstrom K, Manzano J, de Escobar GM, Bernal J, Vennstrom B. ―Anxiety, memory impairment, and locomotor dysfunction caused by a mutant thyroid hormone receptor,― 2005. 228. Nakanishi T. ―Consideration on serum triiodothyronine (T3), thyroxine (T4) concentration and T3/T4 ratio in the patients of senile dementia - is it possible to prevent cerebro-vascular dementia?― Igaku Kenkyu. 1990 Feb;60(1):18-25 229. Molchan SE, Lawlor BA, Hill JL, Mellow AM, Davis CL, Martinez R, Sunderland T. ―The TRH stimulation test in Alzheimer‘s disease and major depression: relationship to clinical and CSF measures.― Biol Psychiatry. 1991 Sep 15;30(6):567-76 230. Burmeister LA, Ganguli M, Dodge HH, Toczek T, DeKosky ST, Nebes RD. ―Hypothyroidism and cognition: preliminary evidence for a specific defect in memory.― Thyroid. 2001 Dec;11(12):1177-85 231. Monzani F, Pruneti CA, De Negri F, Simoncini M, Neri S, Di Bello V, Baracchini Muratorio G, Baschieri L. ―Preclinical hypothyroidism: early involvement of memory function, behavioral responsiveness and myocardial contractility.― Minerva Endocrinol. 1991 Jul-Sep;16(3):113-8 232. Baldini IM, Vita A, Maura MC, Amodei V, Carrisi M, Bravin S, Cantalamessa L. ―Psychopathological and cognitive features in subclinical hypothyroidism.― Prog Neuropsychopharmacol Biol Psychiatry. 1997 Aug;21(6):925-35 hyroid Patient Advocacy, Registered.Office: Squirrel Cottage, Ickornshaw, Cowling,Yorkshire. BD22 0DH Web site: www.tpa-uk.org.uk Telephone: 01535 636 014 Email: info@tpauk.com 233. Ganguli M, Burmeister LA, Seaberg EC, Belle S, DeKosky ST. ―Association between dementia and elevated TSH: a community-based study. ― Biol Psychiatry. 1996 Oct 15;40(8):714-25 234. Monzon Monguilod MJ, Perez Lopez-Fraile I. ―Subclinical hypothyroidism as a cause of reversible cognitive deterioration.― Neurologia. 1996 Nov;11(9):353-6 235. Kinuya S, Michigishi T, Tonami N, Aburano T, Tsuji S, Hashimoto T. ―Reversible cerebral hypoperfusion observed with Tc- 99m HMPAO SPECT in reversible dementia caused by hypothyroidism.― Clin Nucl Med. 1999 Sep;24(9):666-8 236. Monzani F, Del Guerra P, Caraccio N, Pruneti CA, Pucci E, Luisi M, Baschieri L. ―Subclinical hypothyroidism: neurobehavioral features and beneficial effect of L-thyroxine treatment.― Clin Investig. 1993 May;71(5):367-71 237. Medline Plus. The MedMaster™ Patient Drug Information database. ―Liothyronine‖:http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682462.html#side-effects 238. M Abu-Helalah, M R Law, J P Bestwick, J P Monson, N J Wald. A randomized double-blind crossover trial to investigate the efficacy of screening for adult hypothyroidism. J Med Screen December 2010 vol. 17 no. 4 164-169 239. Guardian: glaxosmithkline-pays-three-billion-dollars-to-settle-us-probe http://searchjustice.usdoj.gov/search?q=cache:YI31TqVHZqoJ:www.justice.gov/opa/pr/2010/November/10-civ- 1335.html+pfizer++billion&client=default_frontend&site=default_collection&output=xml_no_dtd&proxystylesheet=default_fr ontend&ie=iso-8859-1&num=10&lr=&access=p&oe=ISO-8859-1 240. £1.9bn fraud fine for Glaxo in US sparks calls for UK prosecution: http://www.independent.co.uk/news/business/news/19bn-fraud-fine-for-glaxo-in-us-sparks-calls-for-uk-prosecution- 7906833.html 241. Toft A, Beckett G, BMJ 2003 (8 Feb); 326:295-296

Your recent edits

Hello. In case you didn't know, when you add content to talk pages and Wikipedia pages that have open discussion, you should sign your posts by typing four tildes ( ~~~~ ) at the end of your comment. You could also click on the signature button or located above the edit window. This will automatically insert a signature with your username or IP address and the time you posted the comment. This information is useful because other editors will be able to tell who said what, and when they said it. Thank you. --SineBot (talk) 19:29, 6 September 2012 (UTC)[reply]

thank you SinetBot, much appreciated, as you already gathered I am new to all this, thank you.

--Paleohack (talk) 19:31, 6 September 2012 (UTC)[reply]

All you do is

Insert a colon (:) at the start of your reply on the page to indent Dbrodbeck (talk) 20:24, 6 September 2012 (UTC)[reply]

thank you Dbrodbeck :)

--Paleohack (talk) 17:47, 7 September 2012 (UTC)[reply]

Paleohack, you are invited to the Teahouse

Hi Paleohack! Thanks for contributing to Wikipedia. Please join other people who edit Wikipedia at the Teahouse! The Teahouse is a friendly space on Wikipedia where new editors can ask questions about contributing to Wikipedia and get help from peers and experienced editors. I hope to see you there! Theopolisme (I'm a Teahouse host)

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This message was delivered automatically by your friendly neighborhood HostBot (talk) 04:35, 7 September 2012 (UTC)[reply]

Thank you for this but I'll leave Wikipedia me thinks as user Novangelis as done a right down good job of being totally out of order and rude all the way through, he wanted references, I provided them, he deletes them and comments it's a 'load of crap' when there were REPUTABLE medical journals articles listed in there. If he thinks nothing is good buy what he thinks/likes I am not putting up with a dictatorship, I'm out, everyone else who stays here good luck. And happy day Novangelis, wish you all the best x --Paleohack (talk) 18:01, 7 September 2012 (UTC)[reply]

wow, I don't actually wish to be here anymore so well done Novangelis you get your biscuit

I don't believe the rudeness thrown my way, I am not here to offend anyone and certainly never intended too, but to be offended like this by a stranger.... you get what you want Novangelis I'm out and today is the best day of your life, but it's also mine as I realised how lucky I am in my life :) xx

not sure how you did this (see below I copied and pasted) but this appeared on my 'watchlist' (the 'eliminate massive load of crap' which was a list with many reputable references ie: British Medical Journal etc., then you commenting that levothyroxine 'is' the ONLY treatment):

(diff | hist) . . User talk:Paleohack‎; 17:47 . . (+121)‎ . . ‎Paleohack (talk | contribs)‎ (→‎All you do is: ) (diff | hist) . . Talk:Hypopituitarism‎; 05:57 . . (+1,392)‎ . . ‎Novangelis (talk | contribs)‎ (→‎why is levothyroxine the only treatment mentioned in this article for hypothyroidism?: because it is the only treatment -- epic WP:TRUTH fail) (diff | hist) . . User talk:Novangelis‎; 04:55 . . (-47,341)‎ . . ‎Novangelis (talk | contribs)‎ (→‎I never got personal Novangelis, why do you?: eliminate massive load of crap)

--Paleohack (talk) 17:57, 7 September 2012 (UTC)[reply]