Regrettably, what I neglected to put in my last email were the reasons why
I was so blatantly wrong, as pointed out by Prof. Ekins.
An increased loss of thyroid hormones from circulation would require an
increased production by an increased TSH only if the total thyroid hormone
concentrations are to be maintained at the same level. This is obviously
not the case in TBG deficiency.
Also, the same free hormone levels can be maintained at a lower total
hormone concentration if the capacity or affinity of the binding proteins
is decreased. This is of course what you have in TBG deficiency.
Many apologies for the terrible mistakes that may have been misleading. As
Claude Bernard wrote in Experimental Medicine: "It is not enough to say: I
made a mistake. You have to explain how."!
Furthermore, below is the reply I got from Dr. Wu, the author of the two
papers on ACB in MI, regarding albumin concentrations and ACB. Again, I
was wrong.
Reza Morovat
From: Alan Wu <[log in to unmask]>
To: "r.morovat" <[log in to unmask]>
Subject: Re: ACB in AMI
Much to our suprize, the answer is no, there is no affect, except
perhaps in extremely low cases.
>Dear Dr. Wu,
>We have read with interest your articles on the use of albumin cobalt
>binding for the diagnosis of AMI. One possibly relevant question
>that has arisen is whether ACB is affected by albumin concentrations.
>I'd be very grateful if you'd let me know whether ACB values should
>be corrected for albumin levels.
>Many thanks and best regards,
>Reza Morovat
>Clinical Biochemist
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