TSH is a pituitary hormone that functions only to signal the thyroid glands to increase/decrease output. TSH is affected by many variables, including the time of day when blood is drawn for the test. It does not correlate very well at all with hypo symptoms. A low TSH does not mean a lot unless it is accompanied by hyper symptoms.
Far more important are the actual, biologically active thyroid hormones, free T3 and free T4. FT3 is actually four times as potent as FT4, and it largely regulates metabolism and many other body functions. FT3 also correlates best with hypo symptoms. Just being in the so-called normal range is sometimes not enough because the ranges are so broad, that many patients need to be in the upper part of the ranges to alleviate symptoms.
In my opinion the best way to treat a patient is to listen to symptoms and test and adjust FT3 and FT4 with meds, as required to alleviate those symptoms.
If you get a reading below l.00 then you are getting to much medication. If you get anyting 2 or above it would be that you maybe need more synthroid for it may be getting to low.
A rule of thumb a low reading means to much medication and a high reading means not enough. It is opposite of what you think it should be.
I understand that it should read between 1 and 2 always. This is a tsh reading. I think everybody have to find a level that they feel better with for not enough gives you symptons as well as to much. Some symptons of hyper is losing weight but not every time; hair coming out and can not sleep.
With hypo you may want to sleep all of the time and always be tired. I had an ablation or radioactive iodine and never would I have it again without a 2nd. opinion. Also an uptake test should have a diet you follow before the small amount of radioactive iodine is injected and then you should be told what to eat or not to eat before they do the uptake test. I was not done this way and it was injected immediately. I do not feel it was accurate and now I had the ablation and I wish I had been better informed.
I know that a lot of doctors would agree with you about TSH, but I have to disagree. As I stated above, TSH is a pituitary hormone that is affected by so many variables, including the time of day when blood is drawn for the test, that it is totally inadequate as a diagnostic for thyroid state. TSH was developed as a test for thyroid back when accurate testing for the actual, biologically active thyroid hormones (FT3 and FT4) was not available.
Unfortunately TSH has become the standard test for thyroid, even though there is no statistically valid test data that shows an adequate correlation to levels of the actual thyroid hormones, much less a correlation to the variables we are really trying to control, which are symptoms. The medical community is so slow/reluctant to change that 8 years after the AACE recommended changing the ref. range for TSH, it still hasn't been adopted by most labs and doctors. I don't know what it is going to take to get them to change the reference range, much less start using more appropriate testing, for FT3 and FT4. The only ray of hope was that we heard of one University that was teaching the primacy of FT3 and fT4, and that TSH was considered old hat.
When it comes to symptom relief, just getting TSH into the range you suggested, does not relieve symptoms in many cases, as evidenced by the many members who have experienced this very problem. Only upon getting their FT3 adjusted into the upper part of the range and FT4 adjusted to at least midpoint of its range, were their symptoms relieved. Whatever TSH this creates is what is best for that person. They certainly won't have hyper symptoms. They are trying to get rid of their hypo symptoms and become Euthyroid. And you cannot adjust TSH independently from FT3 and FT4, since TSH in this case is a dependent variable.
It is not at all unusual for a patient taking thyroid medication to have TSH suppressed to low end of range or below. For example, with my medication, I have had a TSH of around .05 for over 25 years, with no hyper symptoms or adverse effects. In fact, even with that TSH , I had lingering hypo symptoms until I learned from this Forum about FT3 and was able to get a prescription for a source of T3 meds. Now I feel best ever. There are numerous other members with similar stories about their low TSH.
So the bottom line is test and adjust FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.
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