Why do Functional medicine physicians order this test when it has no clinical value in the diagnosis and treatment of thyroid disease? Thyroid May 2018 Lopresti J.L. et al DR.Guttler’s comments: Article from USC thyroid Lab on orders of over 400,000 thyroid tests. 400,000 orders for thyroid tests. 90,000 orders for rT3. Only 20% of physicians ordered rT3 but only once or twice. 100/61,000 ( 0.1% ) providers ordered 30% of the rT3 tests. 60/100 were functional medicine providers. They say it is used to diagnose rT3 dominance and direct T3 replacement therapy. There is little evidence to suppor ..read more

90% of patients with a diagnosis of hypothyroidism have Chronic Hashimoto’s thyroiditis CHT as the cause. The rest are due to surgery or radioiodine therapy. Did your primary physician evaluate you for CHT or just diagnose hypothyroidism without exploring the cause? CHT is a condition with a long latent period where the disease is slowly destroying your thyroid over years before you develop hypothyroidism, goiter or nodules. First degree relatives are at risk if they are not examined and tested for CHT. This is case finding not screening as the finding of a member of the family with CHT is a ..read more

Dr.Guttler’s comments: Most over the counter supplements are worthless and put billions in the pockets of the companies. Biotin is not only worthless but it causes thyroid blood testing abnormalities. Hair loss is a serious problem but if you take thyroid hormone Biotin can cause your studies to be off. Titration of the thyroid hormone dose for hypothyroidism and cancer can be altered by Biotin. Be smart and stop Biotin if you are treated with thyroid hormone. Dr.G. ThyroidVol. 31, No. 8 Original Studies Biotin Interference in Assays for Thyroid Hormones, Thyrotropin and Thyroglobulin Dorina ..read more

Endocrine Practice 27 ( 2021) page 691-97 Schumm M. et al Dr.Guttler’s Comments: Post lobectomy TSH of 87 115 patients had TSH >2. Older patients should think twice about a lobectomy unless necessary. Pre-lobectomy TSH > 1.8 was a risk factor for post op hypothyroidism. 80% of the patients developed hypothyroidism post surgery. This study was on thyroid cancer cancer patients. Imagine what happens when patients with a benign suspicious nodules are rushed off to lobectomy without outside opinions. This paper confirms what endocrinologists always knew that lobectomy was a risk for causing ..read more

Papillary Thyroid Cancer: Positive Thyroid Antibodies associated with less lymph node and extra-thyroidal extension and better prognosis.   DR. Guttler’s Comments: Study of 4000 patients that had thyroid surgery. 3000 were diagnosed with papillary cancer. The presence of thyroid antibodies was studied. High TSH, positive TPO and TG ab are all independent risk factors for predicting nodules with papillary cancer. Positive TPO ab alone was independent predictor of less central lymph node metastasis. Positive TG ab alone was independent predictor of less extra-thyroidal extension. Dual posi ..read more

Case Finding Screening of First Degree Relatives of Patients with Hashimoto’s Thyroiditis. THYROID Published Online: 19 Mar 2021 https://doi.org/10.1089/thy.2020.0213   Familial Risk of Hashimoto’s ThyroiditisAmong First-Degree Relatives: A Population-Based Study in Korea Hyun Jung Kim,et al Background: Few small-scale studies have reported a genetic and familial predisposition in Hashimoto’s thyroiditis (HT), however, quantified familial risk estimates from population-level data are unavailable. We aimed to estimate the incidence and familial risk of HT among first-degree relatives (FDR ..read more

Thyroid No Surgery: Rare Thyroid Lymphoma Presents with Enlarging Goiter After Years of Hashimoto’s Thyroiditis CHT Dr.Guttler’s comments:  In 46 years of my thyroidology practice I have diagnosed only a few thyroid lymphomas in my patients. They all had prior diagnosed Hashimoto’s thyroiditis CHT. I saw a 35 Y/O female with long standing hypothyroidism since age 14 with recent growth noted by the patient. She was finally diagnosed as CHT 2 years ago during a pregnancy. The right lobe had a firm nodule to my examination. However the US did not confirm a nodule but a hypoechoic area in th ..read more

Thyroid Center of Santa Monica Named to 2020 Top Thyroid Blog, Website and Influencer. One of the few only true thyroid physician driven websites and blog. www.thyroid.com. American thyroid association  thyroid.org is one of the others. Thyroid Center of Santa Monica named to 2020 top thyroid cancer blogs, websites and influencer. Ranked second after the American Thyroid Association. Read my blog and if you need a consultation before you consider surgery call 3103938860 or email to thyroid.manager@thyroid.com for an evaluation. Ask for Alicia. DR.G ..read more

 Thyroid Diseases 101: A Patient’s List Dr.Guttler’s comments: The thyroid is a butterfly-shaped organ that sits in the front of the neck. It makes thyroid hormones triiodothyronine (T3) and thyroxine (T4). Hyperthyroidism is one of the most common thyroid diseases. 1.2 percent of people in the U.S. suffer from hyperthyroidism (an overactive thyroid)—roughly one in 100 people. Women are two to 10 times more likely to have hyperthyroidism than men. Commonly caused by an autoimmune Graves’ Disease. Graves’ disease effects 1/200 people.  People with a family history of Graves’ or a rel ..read more

Why do Functional medicine physicians order this test when it has no clinical value in the diagnosis and treatment of thyroid disease? Thyroid May 2018 Lopresti J.L. et al DR.Guttler’s comments: Article from USC thyroid Lab on orders of over 400,000 thyroid tests. 400,000 orders for thyroid tests. 90,000 orders for rT3. Only 20% of physicians ordered rT3 but only once or twice. 100/61,000 ( 0.1% ) providers ordered 30% of the rT3 tests. 60/100 were functional medicine providers. They say it is used to diagnose rT3 dominance and direct T3 replacement therapy. There is little evidence to suppor ..read more