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Neurology 349 van der SteltM.MazzolaC.EspositoG.MatiasI.PetrosinoS.De FilippisD.et al (2006)

Mayo Clin Proc 87(8):766778 Tamler R, Mechanick JI (2007) Dietary supplements and nutraceuticals in the management of andrologic disorders

They state It is clear that serum thyroid hormone and thyroid stimulating hormone concentrations cannot be used with any degree of confidence to classify patients as receiving satisfactory, insufficient, or excessive amounts of thyroxine replacement The poor diagnostic sensitivity and high false positive rates associated with such measurements render them virtually useless in clinical practice Further adjustments to the dose should be made according to the patients clinical response. Similar results were observed by Meier et al

Additionally, the robustness of our results was validated through funnel plots and leave-one-out analyses