Case Report: Hypothyroidism

Context: A person presents classic symptoms of hypothyroidism: extreme fatigue, weight gain, cold intolerance, depression, and cognitive difficulties. Laboratory tests reveal a slightly elevated TSH level, still within the “normal” range by medical standards (e.g. TSH at 4.5 mIU/L).

Problem: The physician refuses to prescribe hormonal treatment, considering the TSH to be within normal limits and the symptoms too vague. The individual is sent away without treatment and given general lifestyle advice.

Physiological rights analysis: Physiological rights recognise that laboratory reference ranges are statistical averages and do not necessarily reflect the optimal state for each individual. A TSH of 4.5 mIU/L may be abnormal for a person whose optimal level is around 1–2 mIU/L. Refusing treatment in this context constitutes a violation of the right to optimal hormonal levels.

Consequences: Without treatment, the individual continues to suffer from debilitating symptoms that affect their capacity to work, engage socially, and live fully. Quality of life is severely reduced.

Proposed solution: Physiological rights advocate an individualised approach to hypothyroidism, where treatment is based on symptoms and optimal hormonal levels for each individual — not on rigid laboratory reference ranges.