[smgj]

Legg inn
site:. medscape.com "Inappropriate TSH Secretion Syndromes"
akkurat som det står med gåseøyne og det hele i google og gå inn på svaret du får i google (ser ut som at google har kjøpt tilgang til medscape slik at man kommer inn via søk, ikke via direktelinking)

Etter det jeg kan lese ut av den linken så er (når en TSH-sekrerende tumor/cyste er utelukket) THR - hormonresistens det "valget" som de foreslår.

Sitat:

Thyroid Hormone Resistance. Thyroid hormone resistance (THR) is usually caused by a mutation of the thyroid hormone (TR), TR-beta receptor gene that occurs in 1: 50,000 live births.[239-242] Although the clinical presentation can be variable, patients have a similar biochemical profile. Specifically, serum FT4 and FT3 are typically elevated (from a minimal degree to a 2-3-fold elevation above the upper normal limit) and associated with a normal or slightly elevated serum TSH that responds to TRH stimulation.[242,243] However, it should be recognized that TSH secretion is not inappropriate given the fact that the tissue response to thyroid hormone is reduced, requiring higher thyroid hormone levels to maintain a normal metabolic state. THR patients typically have a goiter as a result of chronic hypersecretion of a hybrid TSH isoform that has increased increased biologic potency.[199,244] The clinical manifestation of thyroid hormone excess covers a wide spectrum. Some patients appear to have a normal metabolism with a near-normal serum TSH and whose receptor defect appears to be compensated for by high levels of thyroid hormone (Generalized THR). Other patients appear to be hypermetabolic and to have a defect that selectively affects the pituitary (Pituitary THR).
The distinctive features of THR are the presence of a non-suppressed TSH, together with an appropriate response to TRH despite elevated thyroid hormone levels.[242,245] Although rare, it is important to consider the diagnosis of THR when encountering a patient with elevated thyroid hormone levels associated with a paradoxically normal or elevated TSH.[242,246] Such patients have often been misdiagnosed as having hyperthyroidism and have been subjected to inappropriate thyroid surgery or radioiodide gland ablation.[242

Vel - ellers er jo det STORE spørsmålet hvordan du føler deg. Om symptomene tilsier at du har behov for stoffskiftemedisin eller ikke.