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Clinical · Bloodwork · continued

Thyroid function tests during substantial weight change posts 61–90

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

HF
h.ferrariTL214 Sep 2025#61

I think the thyroid function tests during substantial question is answerable and has not been answered, which is a more optimistic position than most of this thread.

24 likes 10mo
RV
r.villalobosTL215 Sep 2025#62
DOdendaal, post #14: Add biological variation and analytical imprecision to that base rate and the probability of a meaningless flag on a multi-analyte panel is substantial. This has been discussed before and I could not find the thread, so, again. Go to post

Rate of change is frequently more informative than absolute value, and it is only available if the earlier results were kept.

This is the version I would want a new member to read first.

0 likes in reply to #14 10mo
LA
l.aguirreTL216 Sep 2025#63

Post #62 is right about the mechanism and I think understates the practical bit.

A note on scope: what I am saying about thyroid function tests during substantial applies to the case in the first post and I would not extend it further without checking.

3 likes 10mo
RF
r.friskTL217 Sep 2025 · edited#64

Coming back to post #60, because the follow-up matters more than the original answer.

Thyroid function tests during substantial has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.

11 likes 10mo
AP
ar.petrovTL217 Sep 2025#65
r.coelho, post #57: Answering the thyroid function tests during substantial question as asked, then the question I think is meant. As asked: yes, with the qualification below. As meant: it depends on how the first measurement was taken. Go to post

Lipid changes during substantial weight loss are expected and their trajectory is not always monotonic. A single mid-course panel can be misleading.

I would treat the number as indicative rather than as a measurement.

17 likes in reply to #57 10mo
FF
f.fenwickTL3Regular18 Sep 2025#66
w.verhoeven, post #8: I read post #6 twice before replying, because I had assumed the opposite. Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same. Small point, but it is the one that usually catches people. Go to post

Liver enzyme changes during rapid weight loss are commonly reported and have several possible explanations, which is exactly why they need clinical interpretation rather than forum interpretation.

The rule of thumb is fine; the edge cases are where it earns its keep.

33 likes in reply to #8 10mo
SH
s.hartmannTL219 Sep 2025#67

That is a fair summary of where the discussion has got to.

1 like 10mo
K
KForsbergTL2Member20 Sep 2025#68

I read post #64 twice before replying, because I had assumed the opposite.

Two claims get bundled together under thyroid function tests during substantial and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.

Almost every disagreement in threads like this one dissolves once you say which of the two you are making.

7 likes 10mo
PW
PharmNotes_WhitfieldTL4Pharmacist21 Sep 2025 · edited#69
DOdendaal, post #14: Add biological variation and analytical imprecision to that base rate and the probability of a meaningless flag on a multi-analyte panel is substantial. This has been discussed before and I could not find the thread, so, again. Go to post

Taking post #66 at face value and following it one step further.

I changed my mind about thyroid function tests during substantial after someone here asked me for the source and I could not produce one. That is worth saying out loud because it is the ordinary way it happens.

11 likes in reply to #14 10mo
SM
s.mbekiTL222 Sep 2025#70

Post #68 and I disagree about the size of the effect, not about the direction.

Glycaemic markers integrate over different periods. A point glucose and a longer-term marker disagreeing is not a contradiction; it is two different questions.

Speaking for myself and not for anyone else who has posted here.

25 likes 10mo
AN
a.novakTL223 Sep 2025#71

That matches what I have seen, for whatever a single anecdote is worth.

16 likes 10mo
AB
a.batistaTL224 Sep 2025#72

A definition problem is doing most of the work in this thyroid function tests during substantial discussion. Once the term is pinned down I suspect the disagreement mostly goes away and what is left is small.

6 likes 10mo
EV
e.vargaTL225 Sep 2025#73

I would be cautious about generalising from the thyroid function tests during substantial example above. It is a good example. It is one example.

0 likes 10mo
BN
bench_notesTL4 Moderator26 Sep 2025#74
s.grigorescu, post #7: Nobody has said the unglamorous part of thyroid function tests during substantial yet, so: most of the variation is explained by things that are boring to write about and easy to check. Go to post

Post #72 answers the question as asked. The question underneath it is different.

Reference intervals: constructed to contain the central 95% of a reference population, which means one in twenty healthy people falls outside one by definition. Add biological variation and analytical imprecision and the base rate of a meaningless flag is substantial.

Posting it because the silence on this was starting to look like agreement.

31 likes in reply to #7 10mo
SO
s.okaforTL226 Sep 2025 · edited#75

Reading this thyroid function tests during substantial thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.

22 likes 10mo
RA
r.aldana_pharmdTL4Pharmacist27 Sep 2025#76

The number people quote for thyroid function tests during substantial is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

10 likes 10mo
DV
d.vukovicTL228 Sep 2025#77

Everything in post #75 holds. The case it does not cover is the one I have.

TSH and free hormones: TSH is a reasonable screening test but does not tell you about actual free hormone levels. If TSH is abnormal, free thyroid hormones confirm whether there is a real thyroid problem.

Reading it back, the second half matters more than the first.

1 like 10mo
LG
lc_gradientTL3Analytical chemist29 Sep 2025#78
e.dalgleish, post #16: The arithmetic in post #14 is right; the assumption feeding it is the part to check. Taking thyroid function tests during substantial seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences. Go to post

Narrowing post #75, because the general version has more than one answer.

Filing a mild objection to the consensus on thyroid function tests during substantial. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

0 likes in reply to #16 10mo
MS
m.stephanopoulosTL3Regular30 Sep 2025#79
r.weiss, post #6: Analytical imprecision: any measurement has an error margin. A small difference in consecutive tests is usually measurement noise, not a real change. Knowing the imprecision helps distinguish noise from signal. The interesting part of this is the exception, and I do not understand the exception. Go to post

Where I part company with post #75, and it is a narrow parting.

Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.

I am describing what is, rather than arguing for what should be.

6 likes in reply to #6 10mo
BN
b.nwosuTL21 Oct 2025#80

This is the sort of exchange that makes the archive worth searching.

1 like 10mo
GV
g.valckenaereTL3Regular2 Oct 2025#81

Post #79 is the version of this I will quote in future. One addition.

Rate of change is frequently more informative than absolute value, and it is only available if the earlier results were kept.

I would hold that lightly until someone with a larger sample weighs in.

13 likes 10mo
FF
f.fontaineTL23 Oct 2025#82

Where I part company with post #78, and it is a narrow parting.

Practical experience of thyroid function tests during substantial, offered as one case with the conditions stated, not as a general finding. Conditions first, because they are what make it interpretable.

27 likes 10mo
RM
r.marsdenTL3Regular3 Oct 2025#83
Isaksen, post #58: Following this. I have the same question and no better information than the first post. Go to post

Thyroid function tests during substantial: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.

0 likes in reply to #58 10mo
NS
n.serranoTL24 Oct 2025#84

Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason.

Reading it again, the caveat matters more than the finding.

2 likes 10mo
BO
b.oylerTL1Member5 Oct 2025#85

Confirming post #84 from a second method, which matters more than confirming it from a second person.

What I would check first on thyroid function tests during substantial is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

19 likes 10mo
MR
m.ramosTL26 Oct 2025#86
citation_peak, post #50: Quietly grateful for the plain phrasing. Not every thread gets that. Go to post

Renal function markers: eGFR is estimated, not measured. It depends on creatinine, age, and weight. A small change in creatinine might not mean a real change in kidney function.

0 likes in reply to #50 10mo
DN
desiccant_notesTL2Member7 Oct 2025#87

Add biological variation and analytical imprecision to that base rate and the probability of a meaningless flag on a multi-analyte panel is substantial.

I would want to see it done twice before believing it once.

0 likes 10mo
SR
s.roosTL28 Oct 2025#88

Right, and stated more narrowly than I would have dared to state it.

4 likes 10mo
JH
j.habermannTL3Regular9 Oct 2025#89

Thyroid function tests during substantial has a well-known answer and a correct answer, and the interesting work is establishing that they are the same. Nobody has done that here yet.

26 likes 10mo
NS
ni.stanescuTL29 Oct 2025#90
e.nilsen, post #24: Liver enzyme changes during rapid weight loss are commonly reported and have several possible explanations, which is exactly why they need clinical interpretation rather than forum interpretation. Go to post

Adding what did not work for me on thyroid function tests during substantial, since the failures never get written up and they are half the useful information.

0 likes in reply to #24 10mo