This is such an excellent conversation. Very exciting to hear Soren Diederichsen's thoughts about how to interpret the data, how to think about what may seem obvious but doesn't actually lead to better outcomes for patients, and how to start to rethink our understanding of AF. If only all physicians used such a reasoned approach to patient care! I just hate to think of all the people who are routinely tested for AF and get anticoagulated for brief bursts of PAF and then may end up with a hemorrhagic stroke. My experience as a nurse who worked in the Holter lab, among many other roles, is that the internists are the ones taking their patients down this particular dangerous path. How can we get the word out to them? Well, Sensible Medicine is a start. Thank you John Mandrola!
A Fib is a classic iatrogenic issue, caused by low T3, high rT3, and often brought about by prescribing only T4. A criminal treatment of common hypothyroid disorders causes a fib and heart failure as well.
The evidence is everywhere. Yet, treating thyroid properly doesn’t compare to doing cardiac ablations and expensive drug therapies, so nobody teaches doctors about it.
For instance, surgery itself lowers T3. After cardiac surgery they treated patients with T3, quite inadequately in my mind, but incidence of a fib declined in those treated with T3
“ PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.”
The pieces are there to be put together. Medicine treats heart failure and a fib as two different things, and thyroid involves still another condition. All are associated with high estrogen, high cortisol, low androgens (including in women), and estrogen and cortisol block conversion of T4 into T3.
How many a fib patients are given T4 only? Criminal and obvious if you just look at the studies and think. Today’s doctors don’t look at these studies and they don’t think.
What is the marker that Dr. Diederichsen mentions? It sounds like Propien P but I could not find information about that.
This is such an excellent conversation. Very exciting to hear Soren Diederichsen's thoughts about how to interpret the data, how to think about what may seem obvious but doesn't actually lead to better outcomes for patients, and how to start to rethink our understanding of AF. If only all physicians used such a reasoned approach to patient care! I just hate to think of all the people who are routinely tested for AF and get anticoagulated for brief bursts of PAF and then may end up with a hemorrhagic stroke. My experience as a nurse who worked in the Holter lab, among many other roles, is that the internists are the ones taking their patients down this particular dangerous path. How can we get the word out to them? Well, Sensible Medicine is a start. Thank you John Mandrola!
So nice to listen to a real scientist speak with humility about his work
A Fib is a classic iatrogenic issue, caused by low T3, high rT3, and often brought about by prescribing only T4. A criminal treatment of common hypothyroid disorders causes a fib and heart failure as well.
The evidence is everywhere. Yet, treating thyroid properly doesn’t compare to doing cardiac ablations and expensive drug therapies, so nobody teaches doctors about it.
For instance, surgery itself lowers T3. After cardiac surgery they treated patients with T3, quite inadequately in my mind, but incidence of a fib declined in those treated with T3
https://pubmed.ncbi.nlm.nih.gov/8633935/
The cat is out of the bag:
https://www.nel.edu/userfiles/articlesnew/NEL370416A12.pdf
“ PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.”
The pieces are there to be put together. Medicine treats heart failure and a fib as two different things, and thyroid involves still another condition. All are associated with high estrogen, high cortisol, low androgens (including in women), and estrogen and cortisol block conversion of T4 into T3.
How many a fib patients are given T4 only? Criminal and obvious if you just look at the studies and think. Today’s doctors don’t look at these studies and they don’t think.