Thyroid Tsh Values

[theo1212]

  Hi Doctor,

  I was wondering what the best lab values are in your mind for someone to be withing the "optimal range" as far as thyroid values are concerned.  I have heard so many differing opinions even from different doctors I have seen.  Right now mine is at 4.59 since my last blood test a month and a half ago.
  My Gastro Enterologist/Internal Medicine doctor says this is fine.  I have read others say that I am still way to high and that is why I am feeling awful still.  Fatigue, body aches and pains and horrible anxiety.  I have Celiac Disease as well as the Hypothyroidsim and it took almost a year to even get me close to normal range because nothing was being absorbed.
  I would just like to know if you think I should as my doctor to get me closer to a TSH value of one.  I have been to the forums and talked to alot of other patients that say they don't feel well at the higher end of the scale but see improvement when they are around 1.  
  I take synthroid.  75mcgs and I am still at 4.59 how much more do you think I would take for me to get to around a TSH value of 1?

[gimel]

Trying to dose a hypo patient based on TSH is like driving a car blindfolded.  TSH is a pituitary hormone that is affected by many variables.  It is inadequate to use as a diagnostic by which to determine meds.  At best it is an indicator to be considered along with more important indicators, which are symptoms and also the levels of the actual, biologically actie thyroid hormones, FT3 and FT4.  

FT3 is the most important because it is four times as active as FT4 and FT3 correlates best with hypo symptoms.  In my opinion the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever meds are required to alleviate symptoms, without being constrained by resultant TSH levels.  Frequently this requires that FT3 be adjusted to the upper part of its range and FT4 adjusted to at least midpoint of its range.

Obviously you need an increase in meds, but before that is done, I suggest that you get FT3 and FT4 tested and then discuss with your doctor your desire to be treated for your symptoms, as I outlined above.  If the doctor has a problem with this you will need to start looking for a good thyroid doctor that will do so.  

[6hashi]

Hello ,
this is the patients forum
we are not doctors but according to my experience
I would add 50 mcg/week aka 575 mcg/week instead of 525 mcg/week .

feel well ,