How to adjust synthroid dosage

[LB1976]

Is there a standard for adjusting thyroid meds?  
I am still symptomatic (ie tired, weak leg muscles, lump in throat, etc), but my doc said as long as I was within the normals, she would not increase my dosage.  I thought I read in another post to you that the goal is to keep the TSH around 1, is that true?  (Mine went from .774 to .887).  I would like to send her an article or a standard of care if there is one.  I have access to all journals.  Can you recommend something that might give her more information.

[Mark Lupo, M.D.]

Your TSH is in the target range (0.5-2.5) -- not likely any more that can be done from a thyroid standpoint.

These are 2002 guidelines -- not a lot of new data since then except lots of debate on what a normal TSH is....

http://www.aace.com/pub/pdf/guidelines/hypo_hyper.pdf

[ChitChatNine]

May I ask what your diagnosis is for taking the Synthroid.  For straight hypothyroidism or are you on meds because of a thyroid cancer finding and/or surgery?

Those components help me with my opinion for you before I give my thoughts.

I have many bad symptoms of a TSH <1.0 and optimal for me is 1.8 while even 1.3 caused anxiety.  So I am a firm-believer that even though it is "normal" it may not be "normal" for the patient .. it is a quality of life + med dosing but your diagnosis plays into that equation too.

Cheryl (papillary microcarinomas 1/07   75mcgs Synthroid TSH 1.8 which is NOT optimum for Cancer Supression)

[GravesLady]

For me, it has been a hit and miss, until I found the hit and found the miss.  I just have to find the in-between.

I go low and slow, either go up or down to the next dose as not to over or under shoot my target level.

One level does not fit all, as with one shoe does not fit all. Everyone is not the same.  Hypo's and hyper's are not the same.  So I don't necessarily believe in one set level  or rule for everyone, as long as level is within Labs range. Science has proven and stated that tweaking within the Labs range has no benefits.  However, if levels is way to the extreme either direction and patient is not happy, level should be CAREFULLY tweaked.  Although, this is my personal opinion as a thyroid patient.  Dr. Lupo will have a different opinion, I'm sure, so wait for his response.  
Good Luck!

GL