Hi Stuart,
 
It's worth looking at the "about us" section of Thyroid UK. It's the Armour thyroid lobby in a new disguise.
The paper quoted draws attention to the fact that its findings need to be confirmed.
 

"Replication of this result, including prospective studies with genotype-selected populations, are required

before changes in treatment approach can be recommended in routine practice."

 
Why would one do gene testing on the basis of a single small study whose measured variable is how the subjects feel? Most people feel energised on a bit too much thyroid hormone but we know there are risks.
 
T3 therapy may at some time in the future be shown to have benefits so we should keep an open mind. For now genetic testing is not justified.
 
Robert
 
Dr Robert Hill
Consultant Clinical Biochemist
 
From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of JONES Stuart (Pathology) (RF4) BHR Hospitals [[log in to unmask]]
Sent: 01 November 2013 13:52
To: [log in to unmask]
Subject: Private thyroid genetics

Dear all, our endocrinologists have a patient who has arranged private genetic testing for polymorphisms in the DIO2 (diodinase) gene. She is apparently now quite insistent that she should be started on T3 despite being biochemically euthyroid with TSH/FT4/FT3 all well within the normal range. I attach an extract of the report and what little explanation came with it. It appears testing is oganised via http://www.thyroiduk.org.uk/tuk/testing/DIO2_test.html who are promoting the test. The analysis is seems to be carried out in a lab in Luxembourg. 
 
ThyroidUK state:
 
"If your report shows that you have inherited either one or both faulty genes, it may be worth taking your report, along with the research article, to your GP or endocrinologist and asking for a trial of T3 to be added to your levothyroxine."
 
The website references one paper in JCEM (http://jcem.endojournals.org/content/94/5/1623.full.pdf+html) which suggests "poorer psychologic well being" and "enhanced response to combined T4/T3 therapy" in patients with polymorphisms in the DIO2 gene.
 
Has anybody else come across this? Any help/advice/views much appreciated.
 
Stuart
 

Stuart Jones  | Principal clinical scientist
Clinical biochemistry / Pre-natal screening
King George Hospital
Barking, Havering and Redbridge University Hospitals NHS Trust
Barley Lane
Ilford
Essex
Technical lead | Lab Tests Online UK
http://www.labtestsonline.org.uk/

 

 

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