Campfire Medicine

This multi module course in thyroid offers clarity to the often confusing world of thyroid diagnosis, prescribing and monitoring. There is a lot of erroneous information out there and we hope to answer some of the most burning questions in both basic and advanced thyroid conditions. 

The Webinar Series Includes: 

TSH 

• Why is there so much controversy over the TSH range? 
• What is a normal TSH and what is an ideal TSH? 
• It may not be what you think. What are the latest guidelines for thyroid disease diagnosis? 
• Is the TSH range used for diagnosis the same as the TSH used to monitor hypothyroidism? 
• Do you know what TSH level is safe for the elderly? 
• What is the TSH set point? 
• Do you measure TSH in the morning, afternoon or night? 
• Fasting or non fasting? 
• Do you know why a suppressed TSH is actually harmful and who it harms? 
• What is the correct way to diagnose subclinical hypothyroidism? 
• How do we predict Hashimoto’s disease?

TPO Antibodies

• Are thyroid antibodies always bad? 
• Why do healthy people have thyroid antibodies? 
• Do thyroid antibodies predict disease? 
• Are there different levels of acceptable thyroid antibodies? 
• When does subclinical hypothyroidism turn into overt hypothyroidism? 
• How do antibodies affect fertility and pregnancy? 
• How can you reduce thyroid antibodies? 
• What is a meaningful reduction in thyroid antibodies?

TPO and Miscarriage 

• Why should we care about TPO antibodies in pregnancy? 
• Why do thyroid antibodies cause miscarriage? 
• Can TPO predict who is at a higher risk of miscarriage? 
• How does subclinical hypothyroidism affect pregnancy? 
• Should all patients with antibodies be given levothyroxine to reduce risk of miscarriage? 
• What are the safest ways to reduce antibodies in pregnancy? 

Desiccated Thyroid (NDT)

• Why did the medical world abandon desiccated thyroid for synthroid? 
• Have you reviewed the only good modern RCT on desiccated? 
• Do you know why we see low serum free T4 while on desiccated? 
• Can we use fT4/fT3 ratios to accurately measure thyroid hormone replacement? 
• When does desiccated harm a patient? 
• Why do endocrinologists fear desiccated in pregnancy? 
• Does T3 cross the placenta? 
• Can we safely recommend the use of desiccated in autoimmune thyroid disease? 
• Do you know how to predict who does best on desiccated? 
• Does desiccated need to be dosed multiple times per day?

Reverse T3 

• Why should you stop using this test? 
• Is rT3 the test ever useful? 
• Can thyroid replacement make meaningful changes of rT3 levels?

Graves Disease 

• Graves disease does not mean you're hyperthyroid. Why
• How to use TSH, T4 and T3 to diagnose and monitor Graves.
• How relevant is measurement of thyroid antibodies for diagnosis of Graves?
• Can we use serum antibodies to help us determine course of action and treatment?
• How does a patient go from Graves to Hashimoto's and back to Graves?
• How low do antibodies need to go?
• What are natural treatments for Graves?
• What use is Carnitine in Graves Disease?
• Can Carnitine be used in pregnancy? If so, what dosage?
• How to use Low Dose Naltrexone for Graves?
• What are the best agents to treat orbitopathy? Yes, it can be treated non surgically.
• Do anti-thyroid herbs potentiate anti-thyroid drugs?
• How anti-thyroid is Lycopus?
• Which drug therapies are best?
• Can we avoid drug therapies for Graves? If so, in which context can we?
• What can we do for resistant cases?
• What role does iodine play with treatment of Graves?
• How do we compare RAI vs ATD vs surgery?
• H Pylori and Graves? Wtf?

Thyroid Cancer

When can we use T3 monotherapy in hypothyroidism?

We are told time and time again to be scared about only using T3 prescriptions with patients. We're warned this is unsafe and that it should only rarely be considered. Is this true? Are the fears warranted?

In this webinar we discuss:
1. Is T4 ever not enough?
2. What is the evidence for using T3?
3. Why is T3 used for patients with thyroid cancer?
4. What are the drawbacks of using T3?
5. What are the benefits of using T3?
6. How do T4 and T3 ratios make sense?
7. What versions of T3 are available to prescribe?
8. How compelling is the evidence against using T3?
9. What are cautions and contraindications of using T3?
10. Can you therapeutically use T3 in pregnancy?
11. Is RT3 helpful in T3 monotherapy monitoring?
12. Any updates on RT3
13. Using T3 monotherapy for euthyroid depression?
14. T3 therapy - how to do it?

BCNA ANM 2021: Cheryl Tomalty PhD - Thyroid Testing in BC ⁠

Oh you know NDs have a LOT to say about thyroid labs, ranges, tests, interpretation, ratios, antibodies, monitoring, RT3. So let's learn what the latest is with respect to all of this.⁠ And you KNOW we have questions.⁠

In October 2018, the BC Ministry of Health, in collaboration with the Doctors of BC, published an update to the BC Guidelines on thyroid testing, last issued in 2010. The guideline titled Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder is available on the BC Health website. This guideline outlines the testing of pediatric and adult patients, including pregnant patients, along with the monitoring of patients treated for primary function disorders. ⁠

Cheryl Tomalty PhD FCACB
Clinical Biochemist
LifeLabs Burnaby Reference Laboratory

Upcoming Webinars include:

• Thyroid Nodules
• Basal Body Temperature 
• Fertility and Thyroid
• Case Studies