Clinical thyroidology: beyond the 1970s' TSH-T4 Paradigm.

ABSTRACT: The 2012 American endocrine associations' guidelines on hypothyroidism were a reiteration of the TSH-T4 Paradigm from the 1970s. They likewise defined hypothyroidism as hypothyroxinemia, assumed that almost all hypothyroidism was primary, and relied upon the thyroid stimulating hormone (TSH) test and inactive prohormone thyroxine (T4) for diagnosis and treatment. The guidelines' authors acknowledged many TSH and other "pitfalls" in the paradigm yet warned physicians against attending to patients' signs and symptoms and relative free T4 (FT4) and free triiodothyronine (FT3) levels-the only means by which to identify and avoid all pitfalls and provide individualized diagnosis and treatment. This inadequate paradigm has distorted medical practice and research for 50 years, including laborator

SUBMITTER: Lindner HH 

PROVIDER: S-EPMC12234311 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature