I don't think the non sexual benefits of testosterone in women should be so easily dismissed - those with significant symptoms would be unlikely to participate in a trial where they could end up on placebo. Objective data on body composition, bone mass, strength, endurance, metabolic parameters and long term cognitive effects should also be gathered.
Hello. Is the t3 withdrawal chart for patients on T3 mono therapy or people who have been taking both T3 and T4 simultaneously (and who would still be taking T4)? Thank you
The case at 1h 35m of Recurrent thyrotoxicosis in pregnancy, the following was in the chat: The case of recurrent thyrotoxicosis in pregnancy with negative TRAb is likely due to a mutant TSH receptor hypersensitive to hCG. K183R (replacement of lysine for arginine at position 183) has been described giving a similar picture to the patient presented and can be familial (Rodien et al. NEJM 1998).
From the chat: 10:13:24 From Alison Bransfield To Everyone: Is anyone investigating the use of procalcitonin in place of calcitonin? Easier to measure Answer: There are a few papers on this from Italy. This is a meta analysis which suggests a good diagnostic performance. I do use this marker together with calcitonin, as procalcitonin is a routine analyser test, which comes back within the same day. However, the caveat should be that the patient is not having a bacterial infection at the same time which in most cases with a stable patient is not a problem. academic.oup.com/jcem/article/106/12/3634/6348893
For the question about imprinting and which surgeons would transmit a genetic condition, the condition should be SDHD, which is imprinted, not SDHB. This is otherwise a good way to explain that SDHD is transmitted from fathers, but is maternally imprinted, which means that children of a female who has the gene do not express the condition. Thus all the female surgeons in the picture have a zero chance of transmitting SDHD to their offspring clinically, although they would still carry the gene.
Imma remember this as Kentucky Fried Horse (gallop)... I know, its grim but, it gets the job done And for Americans, since Kentucky is famous for Horse racing, that could be easier and less.... dark
Thank you professor for this video. I have just started the liothyronine withdrawal intervention after a very impressive hour with yourself where you answered all my questions and explained your process. I shall be getting regular blood tests and filling in the questionnaire, let alone monitoring my weight, sleep and exercise frequency, etc to see how I progress. I have imported my own T3 so I can resume should it not be a success but I am certainly going to be giving it a good trial.
Very useful video thank you so much, but your point at @57:19 was interesting especially since F1 doctors [the SJT perspective] start out at equivalently Band 5 pay which is the same starting band as nurses with F2 moving up to Band 6 equivalent, not a great rhetoric for explanation nor for potential F1s with the strike ballot coming up.
Hello, I am a patient with pan-hypopituitarism, i have been on hydrocortisone for 22 years following my surgery and my consultant has just suggested I switch to prednisolone 5mg daily. My hydrocortisone dose is 27.5 daily and so she feels that I might need a little more than usual but having just watched your video I am concerned that you say that doses must be under 5mg a day to prevent comorbidity. Please can you give me your thoughts on this. Many thanks for your work.
For many years, many of us used higher doses of both drugs, but increasing evidence of co-morbidity caused by excess of either drug is becoming apparent. Getting the dose right is not easy, but the lowest possible dose that makes you feel well is what you need. For most patients this is 3mg, and for some 4mg, and for very few indeed 5mg *(there are some who need that dose as evidenced by blood tests, but it is rare). I also have a few patients who are only on 2mg. In general, I divide the daily hydrocortisone dose by 7, so 28mg of hydrocortisone would be 4mg once daily prednisolone.
This arrogant dismissal of T3 seems to be based on a rather thin observation that 'everyone has good weeks and bad weeks' and the suggestion that ' they will feel better whatever you give them if they saw you when they were at their tiredest', conveniently ignores the reality that it takes most patients months to get an appointment to see anyone at all. It is disingenuous and undermines the credibility of your argument to show the outdated price chart of loithyronnine. Why not show the current price which has significantly reduced as a result of the investigation by the CMA? You accept the credentials and methods of the study from Shakir et al.(Comparative effectiveness of Levothyroxine ,Desiccated Thyroid Extract, and Levothyroxine + Liothyronnine in Hypothyroidism) but then attempt to dismiss their findings of "improvements in all four primary outcomes and a strong preference .." by using a homemade 'tiredness' diagram which has no detail or scientific credibility whatsoever . You say you have evidence 'which may convince some but not all' . The credibility and accuracy of the 'evidence' you have presented here to support your argument to deny all patients the opportunity to trail T3 will hopefully not convince anyone with any degree of intelligence .
I am looking for any help for a calcified mitral valve. I had my mitral valve repaired in 2005 at Duke Hospital. They used a Divinchy robotic surgery and could only fit a small ring for repair. Now it is calcified with severe stenosis leaving me very short of breath. I am only 62. I feel like I am aging in "dog years."
can you share the reference for mechanism showing steroid dependent AQP2 recycling?thanq. Glucocorticoid deficiency results in increased AVP release and thereby increased AQP2 expression right?thats the usual mechanism described na?
