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thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the interaction with existing levothyroxine dosing.

23 questions · sorted by votes

40 votes 5 answers26k views
Does TSH tell me anything about hepatic fat on dulaglutide?

What I have: TSH · dulaglutide. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident the…

liver-enzymes
liver-enzymes

ALT, AST, GGT and ALP: what they do and do not indicate about hepatic fat, why enzymes are a poor surrogate for histology, and where non-invasive…

91 questions
mash
mash

Metabolic dysfunction-associated steatohepatitis: histological endpoints, resolution without worsening fibrosis, fibrosis improvement by stage,…

56 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
dulaglutide
dulaglutide

A once-weekly GLP-1 receptor agonist built on an Fc fusion rather than fatty-acid acylation. Use this tag for questions about the fusion-protein…

200 questions
asked by sample_id 17k · 19 months ago
34 votes 1 answer25k views
Is TSH worth drawing at baseline before starting dulaglutide?

Stated plainly: TSH · dulaglutide. This is a planning question. I know what my options are; I do not know how to weigh them. What I want is the minimum viable…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
dulaglutide
dulaglutide

A once-weekly GLP-1 receptor agonist built on an Fc fusion rather than fatty-acid acylation. Use this tag for questions about the fusion-protein…

200 questions
asked by ayo_fadipe 9.4k · 13 months ago
34 votes3 answers17k views
What are the rodent C-cell findings behind the thyroid warning, and do they transfer to humans?

The US labelling for several drugs in this class carries a boxed warning about thyroid C-cell tumours, and it is stated fairly starkly — tumours in both rats and…

thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

745 questions
liraglutide
liraglutide

A once-daily GLP-1 receptor agonist and the compound that established the class. Still relevant for its shorter half-life, its paediatric and…

235 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

470 questions
asked by swab_and_wait 13k · 2.1 years ago
34 votes 5 answers17k views
Is TSH a better monitoring choice than magnesium on oral semaglutide?

Concretely: TSH · magnesium · oral semaglutide. I want to know what the trade-off actually is rather than which option is fashionable. I would rather have a…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
asked by ahmed_zerouali 15k · 17 months ago
34 votes 3 answers7.4k views
My TSH keeps drifting and I take levothyroxine — is it the weight loss or the gastric emptying?

Hypothyroid on 125 µg levothyroxine for six years, stable TSH around 1.4 mIU/L that whole time. Since starting tirzepatide nine months ago and losing 21 kg, my TSH…

thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

13 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

764 questions
asked by bea_forsberg 11k · 2 months ago
32 votes 5 answers65k views
Why did my TSH move after six weeks on oral semaglutide?

What I am working with: TSH · six weeks · oral semaglutide. Before I write this off, I want to check whether it is a known failure mode. I have the lot number, the…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
oral-glp1
oral-glp1

Oral routes for GLP-1 receptor agonism: peptide formulations rescued by absorption enhancers such as SNAC, and true small molecules that need no…

219 questions
asked by nadia_kowalczyk 20k · 2.3 years ago
29 votes 4 answers37k views
What interval makes sense for repeating TSH on dulaglutide?

What I have: TSH · dulaglutide. I would rather over-plan the first cycle and simplify later. I am prepared to do the work if someone can tell me which work matters.…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
dulaglutide
dulaglutide

A once-weekly GLP-1 receptor agonist built on an Fc fusion rather than fatty-acid acylation. Use this tag for questions about the fusion-protein…

200 questions
asked by laminar_bench 69k · 15 months ago
29 votes0 answers13k views
Should I screen calcitonin before starting?

My laboratory results are from the same laboratory each time, drawn fasting, which I gather matters. I am trying to build something sustainable rather than something…

thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

745 questions
asked by retest_please 9.7k · 22 months ago
27 votes 3 answers8.8k views
Should I get a baseline serum calcitonin before starting? Working the predictive value

A private clinic offered me a "pre-treatment endocrine screen" including serum calcitonin, with the reasoning that the boxed warning concerns C cells and calcitonin…

thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
cost-analysis
cost-analysis

Cost arithmetic done honestly: cost per milligram after dead-space loss, list versus net price, comparing a multi-dose vial to a fixed-dose pen,…

260 questions
asked by coldpack_88 50k · 13 months ago
26 votes 5 answers46k views
How do I interpret a TSH trend across three draws?

I am reading the trial table rather than the press release, which is why the numbers differ. This is presented as though it settles something, and I am not convinced…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
asked by vial_five 12k · 2.1 years ago
24 votes 5 answers32k views
Does TSH tell me anything about hepatic fat on retatrutide?

The case in front of me: TSH · retatrutide. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how…

liver-enzymes
liver-enzymes

ALT, AST, GGT and ALP: what they do and do not indicate about hepatic fat, why enzymes are a poor surrogate for histology, and where non-invasive…

91 questions
mash
mash

Metabolic dysfunction-associated steatohepatitis: histological endpoints, resolution without worsening fibrosis, fibrosis improvement by stage,…

56 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
retatrutide
retatrutide

An investigational GLP-1, GIP and glucagon receptor tri-agonist, studied in the TRIUMPH programme. Not approved anywhere. Use this tag for…

251 questions
asked by zainab_mustafa 21k · 2.3 years ago
21 votes0 answers18k views
Why did my TSH move after six weeks on liraglutide?

What I am working with: TSH · six weeks · liraglutide. Before I write this off, I want to check whether it is a known failure mode. I have the lot number, the…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
liraglutide
liraglutide

A once-daily GLP-1 receptor agonist and the compound that established the class. Still relevant for its shorter half-life, its paediatric and…

235 questions
asked by dmitri_savchuk 27k · 12 months ago
21 votes 5 answers17k views
Is TSH a better monitoring choice than magnesium on tirzepatide?

Setup, so nobody has to ask: TSH · magnesium · tirzepatide. I want to know what the trade-off actually is rather than which option is fashionable. I would rather have…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
asked by pieter_maas 14k · 8 months ago
19 votes 5 answers34k views
Is magnesium a better monitoring choice than TSH on retatrutide?

For reference: magnesium · TSH · retatrutide. These are treated as interchangeable and I do not think they are. If both are acceptable I would like to know that, so I…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
asked by mateo_iglesias 12k · 17 months ago
19 votes 5 answers3.7k views
What interval makes sense for repeating TSH on orforglipron?

The specifics, since they change the answer: TSH · orforglipron. I would rather over-plan the first cycle and simplify later. I am prepared to do the work if someone…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

219 questions
asked by cal_hennessy 17k · 15 days ago
15 votes 5 answers9.3k views
Is magnesium a better monitoring choice than TSH on dulaglutide?

For reference: magnesium · TSH · dulaglutide. These are treated as interchangeable and I do not think they are. If both are acceptable I would like to know that, so I…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
asked by ines_delacruz 16k · 2 months ago
14 votes 5 answers24k views
Is TSH a better monitoring choice than magnesium on liraglutide?

Stated plainly: TSH · magnesium · liraglutide. I want to know what the trade-off actually is rather than which option is fashionable. I would rather have a defensible…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
asked by Dr_Hanne_Solberg 36k · 20 months ago
14 votes 2 answers17k views
What interval makes sense for repeating TSH on retatrutide?

The specifics, since they change the answer: TSH · retatrutide. I would rather over-plan the first cycle and simplify later. I am prepared to do the work if someone…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
retatrutide
retatrutide

An investigational GLP-1, GIP and glucagon receptor tri-agonist, studied in the TRIUMPH programme. Not approved anywhere. Use this tag for…

251 questions
asked by wren_calloway 23k · 21 months ago
13 votes 4 answers9.2k views
Is magnesium a better monitoring choice than TSH on orforglipron?

What I am working with: magnesium · TSH · orforglipron. These are treated as interchangeable and I do not think they are. If both are acceptable I would like to know…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

141 questions
lipids
lipids

Lipid response on treatment: triglycerides, LDL-C, non-HDL-C, ApoB and Lp(a), which of them move with weight loss, and why a fasting panel drawn…

139 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

72 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
asked by per_haugen 13k · 12 months ago
12 votes 5 answers23k views
Do thyroid function tests shift enough during treatment to matter?

My laboratory results are from the same laboratory each time, drawn fasting, which I gather matters. The empirical answer seems settled. The explanation does not. If…

hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

13 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
asked by noor_alhassan 11k · 16 months ago
9 votes0 answers903 views
Does TSH tell me anything about hepatic fat on orforglipron?

For reference: TSH · orforglipron. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident…

liver-enzymes
liver-enzymes

ALT, AST, GGT and ALP: what they do and do not indicate about hepatic fat, why enzymes are a poor surrogate for histology, and where non-invasive…

91 questions
mash
mash

Metabolic dysfunction-associated steatohepatitis: histological endpoints, resolution without worsening fibrosis, fibrosis improvement by stage,…

56 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

219 questions
asked by ellis_thorne 17k · 19 days ago
5 votes 5 answers19k views
Does levothyroxine absorption change with delayed gastric emptying?

This is a question about interpretation, not about whether to act — I will take action questions elsewhere. The empirical answer seems settled. The explanation does…

thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

132 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
asked by yuki_morishita 10k · 16 months ago
4 votes 4 answers2.1k views
Is TSH worth drawing at baseline before starting orforglipron?

What I am working with: TSH · orforglipron. This is a planning question. I know what my options are; I do not know how to weigh them. What I want is the minimum…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

296 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

472 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

122 questions
thyroid
thyroid

Thyroid questions: the rodent C-cell findings behind the labelled warning, human calcitonin data, TSH drift during weight loss, and the…

23 questions
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

219 questions
asked by fiadh_cronin 58k · 2 months ago
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