johnlawrenceaspden

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How strong is the evidence for hydroxychloroquine?

Having had a look, it does seem to me that the malarial areas of the world are much less affected than malaria-free Europe and America, not sure what to read into that, how accurate their figures are, when the first cases were, how slowly we expect coronaviruses to spread in hot places, etc

A shame, since either not-spreading-there or going-like-wildfire would have given a pretty clear answer to the chloroquine question.

At the moment I'm guessing it's weak evidence in favour of effectiveness.

How strong is the evidence for hydroxychloroquine?

It occurs to me that chloroquine is still taken widely in malarial regions as a prophylaxis, even though malaria has developed resistance to it.

So if it worked to deter COVID19, we should be seeing very few cases in, say, Nigeria, where it's a popular over-the-counter treatment even though it's no longer recommended as first-line treatment, and in, say, the Dominican Republic, where malaria isn't yet resistant and it's still the best treatment.

March Coronavirus Open Thread

That's the right stuff I think (chloroquine phosphate, very bitter tasting), would you say that reliablerxpharmacy is a good and trustworthy source?

(not for chloroquine, for meds generally without a prescription)

Popular religions suggest extrapolated volition is non-existence and wireheading

I'm not sure if this is insightful enough to share here, but I'll try anyway.

It sure is. Nice to see someone post something thought-provoking.

Popular religions suggest extrapolated volition is non-existence and wireheading

I think my personal extrapolated volition is wireheading, and I'm definitely in the "Ooh science, what fun" camp.

But maybe I'm not very good at extrapolating, and an AI could come up with something better. It would, for instance, be great to be in a permanent state of bliss whilst actually acting in the world. Or in some private sandbox world occupied by myself and a few hundred friends.

I can't see how those possibilities would feel any different to me from a good wireheading though. And maybe the AI is trying to conserve resources.

Fact Posts: How and Why

"Asimov on Chemistry" was a childhood favourite of mine.

The Thyroid Madness: Two Apparently Contradictory Studies. Proof?

Hi FriendlyBuffalo, welcome to Less Wrong!

I've got no problem with the TSH test as a test for TSH. It's really good for that, and I seriously admire its cleverness and accuracy.

In fact it probably is a good test for primary gland failure. I can't see how the gland itself could go seriously wrong without driving TSH into the stratosphere.

What I hate is the idea that TSH normal <=> 'Thyroid Symptoms, improve when treated with thyroid hormones'. I think there are other dysfunctions going on. The very idea of assessing the state of a system that complicated by measuring one variable (or even three) is ridiculous.

I'm pretty much 'clear clinical picture => therapeutic trial, and sod the blood tests' at the moment, as I think Gordon Skinner was. Of course the problem with that is you end up endorsing leeches and aromatherapy that way. I do have a lot of sympathy for basal metabolic rate, and for waking temperature as a proxy for that.

I think we both agree that some CFS/FMS is just thyroid dysfunction, and will improve with various combinations of thyroid hormones.

The only remaining question for me now is 'Is all of CFS/FMS thyroid related, or just a significant portion of it'?

Lowe reckoned that it was 1/4 primary that had been missed, 1/2 central that there's no test for, and 1/4 the mysterious resistance that he had to overwhelm with high doses of TSH. I see no reason currently to doubt his word, and I'm pretty sure that his work has saved my life (I wouldn't have put up with CFS for much longer. It was awful, and there's no way I'd have found out it was thyroid without Lowe.) So I want to dig into his ideas until I can convince myself that they're either true or false.

If they're false that's really strange. There are now two different diseases, which came into being in the 1970s, which look exactly the same as hypothyroidism, only one of them is, and one of them isn't. I have real trouble with that on Occam's razor grounds.

And that's assuming FMS/CFS/MDD are the same thing. If not then there are three new diseases and some misdiagnosed/mistreated thyroid stuff all pretending to be each other.

I'm really really busy at the moment. I'm so sorry. I've been looking for someone who knows more about this than me for months, and now you show up willing to talk and I've got urgent other things to do. But let us resume discussion at a later date. I've written quite a lot about it here as the idea developed, feel free to debunk it all in absentia mea. I'll come back to all this soon, I'm absolutely sure. I'm obsessed.

I've printed off that paper, it looks really interesting. I'm going to try very very hard not to read it instead of doing the thing I'm supposed to be doing. Thank you very much, and hope to resume discussion soon.

A Medical Mystery: Thyroid Hormones, Chronic Fatigue and Fibromyalgia

That's what I was expecting, but 2.5 isn't suppressed, it's actually quite high compared to the average for healthy people, (or at least normal, depending on what you think normal is). And roughly the same as it was at the start of all this. And both the free hormones look low. You'd think adding a fair bit of thyroid to a healthy system would have bumped up the free hormones and maybe lowered TSH to somewhere like the hyperthyroid range.

What's really weird is that I've tripled the dose of NDT since the last time I had blood drawn, and my TSH has gone up slightly in response. I thought I'd be seriously suppressing my own system by now.

It's possible that I've just developed a primary gland failure, but that's weird because there was no sign of it when I first showed severe symptoms.

A Medical Mystery: Thyroid Hormones, Chronic Fatigue and Fibromyalgia

At the fourth attempt, my doctor managed to get the local lab to test TSH,T3 and T4 simultaneously. He had to ring them up and ask them in person, apparently. It turns out that I've currently got TSH~2.5, and FT4,FT3 low-in-range. Given that that looks like central hypothyroidism, and that's under the influence of 1 grain/day of desiccated thyroid, we've decided we that we have no clue, and I'm carrying on messing around with random thyroid drugs aiming for relief of symptoms (which are all gone, but I keep having to up the dose to keep it so).

Basically Christ knows. If I'm not medically unique, there's something very funny going on.

Welcome to Less Wrong! (8th thread, July 2015)

Welcome Alia! You sure sound like one of us. Hope you like it here.

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