To my Colleagues,Here is a useful clinical pearl. It comes from 40 years starting at Harvard, University of Pennsylvania, & NIH; then in government-funded community health centers, followed by decades in private practice.Thyroid imbalance can be as complex and as difficult to manage as diabetes. It deserves our full creative attention.One over – rated test (TSH alone) is not able to provide a complete diagnosis.One over – rated medicine (levothyroxine alone) is far from optimal treatment.