Diabetes guidelines by aace 2009
Common Questions and Answers about Diabetes guidelines by aace 2009
diabetes
Dear FTB4
Thank you so much for commenting on the AACE Facebook page. Every voice of dissent against their guidelines adds to the momentum for better care for all thyroid patients. I really appreciate you taking the time.
Dear MedHelp members, if you have not added your voice to patient discontent and concern over the AACE focus on TSH as the only appropriate diagnostic tool and T4 as the appropriate treatment for hypothyroidism, please consider doing it if you have a Facebook account.
A position paper updating the AACE/ATA guidelines for endocrinologists in the treatment of hypothyroidism was released today. Seems not to have considered either the Danish or Italian studies on the benefits of T4/T3 therapy previously published in EJM, and published by NIH here in February. At least they suggest including symptoms in making a diagnosis. Interesting read, highly recommend. Here is the PDF link :
http://aace.metapress.com/content/b67v7mk73g3233n2/fulltext.
AACE Diabetes Care Plan Guidelines, Endocr Pract. 2011;17(Suppl 2) 7. As far as I know the ADA obtyains their info from AACE. Is the ADA behind in its updates?
Thanks for the reply! Where would I go get these new AACE guidelines? I've tried their website but I can't find the guidelines.
There are many people on Thyroid Chat that say that the ACCE guidelines that state subclinical would be TSH over 10 with normal t/3 t/4 or TSH 5-10 with normal t/3 t/4 and goiter or antibody are outdated and todays guidelines say that TSH should be at 1 or at least below 3 EVEN with normal t/3 t/4.
Pressure around throat when leaning my head back with some light-headness. Fatigued, brain fog, weight gain, type 2 diabetes, etc. My last blood work said; Observations: Added new observation of T4, FREE: 0.9 (0.70-1.55) )ll/09/2009 14:19)
Added new observation of TSH: 2:45 (0.25-5.0) (11/09/2009 14:19 Why do I have good test results when I feel so bad?? Thank you for any info...
//www.medhelp.org/posts/Thyroid-Disorders/Major-Changes--AACE-Guidelines-for-Hypothyroidism-in-Adults-----------------/show/1810133#post_8339341
This is a huge change in guidelines, IMHO.
I agree with the above.
Here is a quote from the aace.com website:
"In November 2002, AACE published revised guidelines that provided a new range for normal thyroid function. Until this time, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range.
There is still debate despite AACE's recommendations. It is based on lack of clinical studies to show that treatment of a TSH >3 makes a difference. Many of us use AACE guidelines despite what the commercial lab range states.....It must be based on the individual patient as clearly one size does not fit all.
AASLD is an organization of liver disease specialists who publish annual treatment guidelines. Google AASLD 2009 hepatitis C treatment guidelines to find a copy.
The mouth sores are a sign that the main drug, interferon, is reducing his white blood cell level. There are medications to counteract that but they are very very expensive and that may have had a role in their decision.
LOL Recall that over 10 years ago the AACE finally acknowledged the very problem mentioned by the doctor. Accordingly, they purged their TSH test data base and removed data from patients that were suspect for being either hypo or hyper, and recalculated the reference range. It changed drastically, from .5 - 5.0 down to .3 - 3.0.
Yet, after all this time, what do we still see used as TSH reference ranges from most labs and doctors. You got it --- the old range.
I ran across this article written by a joint panel from the AACE, ATA and the Endocrine Society. I thought some of our members would find it to be worthwhile background material for trying to understand the obstacles we encounter at our doctor's office. To me it is clear that they are ultra conservative on deciding on when and how to treat a patient. This is of course what we have to contend with every day.
http://jcem.endojournals.org/cgi/content/full/90/1/581?
My family dr. says my 3.94 TSH is normal, yet I am informed by others that 0.03-3.0 is normal and my number is out of range. We have looked at chronic fatigue syndrome, fibromyalgia, RA, etc... This is very frustrating and confusing, especially when in pain and not feeling well at all.
According to the recommended guidelines by the AACE (http://www.aace.com/pub/guidelines/) the new range for TSH should be 0.3-3.0. You could be subclinical hypothryoid. It is too bad they didn't run a free T3. You will likely have a difficult time convincing a doctor you need treatment.
Many hypo folks do have anxiety and panic attacks a symptom.
2005
American Family Physician May 1, 2005
The National Academy of Clinical Biochemistry hypothyroid 2006 guidelines
British Columbia Medical Association and adopted by the Medical Services Commission - Guidelines and Protocols Advisory Committee Effective Date: October 1, 2004 Revised Date: April 1, 2007
I thought the jury was still out!
At least she admitted that thyroid cancer is a "good cancer" :(
This is expedient for the doctor, but does not work well for the majority of hypothyroid patients. Although unwarranted the SOC is derived from the AACE/ATA Guidelines for Hypothyroidism. Those Guidelines are based on three major assumptions which have all been refuted by current scientific evidence, thus invalidating the SOC..
You can confirm all I have said by reading the following link to the latest paper I co-authored.
If the normal TSH range were narrowed, as has been recommended by AACE and the National Academy of Clinical Biochemistry, what are the implications?
One study found that using a TSH upper normal range of 5.0, approximately 5% of the population is hypothyroid.
However, if the upper portion of the normal range was lowered to 3.0, approximately 20% of the population would be hypothyroid.
Well I did it. Actually my mom did. We got the right tests. She had to throw a fit but we got them. FT4, FT3, and TSH. Those are all the thyroid tests they could do. They're also redoing Vitamin D. Somehow they still manage to make me feel guilty for even daring to challenge them with this. Bad news is, it's not covered by my insurance. So it'll probably be costly unless we can take care of that. But now I'll know for sure if something--or nothing--is wrong with me. Now I wait.
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