Have you had a book that is so compelling & transporting you can’t put it down?
In the last year or so I’ve rewritten my own little book of sorts, on thyroid physiology and results interpretation and during that process I came across a paper that referred to ‘the thyroid biography of each individual’. I was so struck by this concept, how it brings into life my new appreciation of how a patient’s thyroid function speaks to the totality of their exposures – from their diet to their dopamine, from their exercise regime to their environmental pollutants, from their sex hormones to their stressors.
Being immersed in the research was deeply rewarding but the obsession proper began when I started applying everything new I’d learned to patient labs.
Reading the ‘thyroid biography’ of every individual is the book I just can’t put down.
Not just because it enables us to see that our clinics are full of responsive thyroids more so than rogue and that the ultimate tailored ‘treatment’ is spelt out, right there, in the nuances of each patient’s TFT & other pathology patterns but also because these results themselves are a portal into the patient’s bigger story. During a recent interview on this topic, where I had the good fortune to be interviewed by someone who really understands health, we got deep into a discussion about how differing macrophage dominance (M1 or M2) in our adipose tissue disturbs thyroid function differently. The interviewer then asked – well how do you know if your patient is M1 or M2 dominant – is it just based on different measures like waist-circumference etc? and I said something to the effect of, ‘Well these can be indicators but actually more and more in someone with excess adiposity I look to their TFTs to tell me the answer to that!’
And that was actually a Tada! moment right there!
I realised the truth and gravity of what I’d just said – increasingly I’m looking to patients’ thyroid function to tell me the rest of their story – to reveal not only their totality of exposures but to shine a light into some darker corners that are otherwise hard to see or measure or know…like macrophage dominance patterns in fat tissue, or HPA setpoint recalibrations following trauma, or subinflammation that remains under the inflammatory marker radar.
We’re understandably critical of the over-stretch a name like ‘Thyroid Function Tests’ conjures up – how can 1 panel of 3 (ideally!) markers deliver on such a promise?! But I am here to tell you it can and in fact, it can deliver on far more than that once we learn to read TFTs as Thyroid First-Responder Tests, instead. And of course, we generally don’t see TFTs in isolation – so we can couple these with patient results for routine labs that add to our understanding, support our suppositions or challenge them based on their FBE, their renal or metabolic markers etc. This is integrative endocrinology within the broader framework of integrative medicine after all. This necessitates de-compartmentalisation while being able to disentangle one source of HPT directive or disruption from another. This is real-world results interpretation that optimises our insights and understanding & patient outcomes.
The back cover of my copy of this well-thumbed thyroid biography so far reads:
⇒Rather than rogue thyroids our clinics are full of responsive ones – responding to the totality of each individual’s exposures.
⇒If you don’t read patient TFTs through the lens of the HPT as a first responder – you’ll misinterpret what’s happening within their HPT.
⇒If you don’t read these results through this lens you will miss out on a much bigger understanding of their whole health story.
Of late, I’ve been woken at night to find I have been page-turning through a patient’s thyroid biography and a lightbulb moment of discovery is coming into land! I wish for everyone else the same…not the sleep disruption bit of course but those glorious Aha! moments. Oh and don’t get me started on HPA Assessments – that’s another page-turner!
MasterCourse II: Thyroid & Adrenal Diagnostics is NOW available. Click here to read more and here to purchase it and sign up for the Free Watch Party commencing 3rd August 2023 with is included with each purchase of the MasterCourse II.