so in your opinion what is an ideal TSH

[motherelle]

I have been on Thyroxine for 7 yrs never feeling totally well. My last TSH was 1.8 after reducing to alternate

125/100 from 125 as i was over medicated TSH 0.012 . I am still having days of fatigue and Hypo symptoms.

Would the Drs advise that I might feel better with a slight increase say by 12.5 micro grams.

Your advice would be most welcome. Motherelle.

[Mireille]

Hi there

It's impossible to advise without having your fT4 and fT3 readings with their reference ranges as well. A TSH only will not tell anyone anything. If you have them then you may have more success if your posted them.

Mireille

[motherelle]

Unfortunately my labs will not do anything other than TSH even though my Gp has requested them .

Motherelle.x

[Dr Graham Beastall]

It is not possible to answer the question 'what is an ideal TSH?'

The best advice available in thyroid hormone replacement therapy is to reduce or alleviate symptoms whilst maintaining the serum TSH within the reference range (broadly 0.5-4.5mU/L). In most patients this can be achieved. However, in a significant proportion of patients symptom relief is a little better if the TSH is kept a little lower than the reference range. As long as the TSH remains detectable (broadly above 0.05mU/L) then there is no strong evidence of harm from this level of 'over-replacement'. However, if the TSH remains fully suppressed (undetectable) for a lengthy period then there is evidence that some patients risk damage to the heart or to their bones.

I'm not sure that measuring FT4 adds anything to this equation and I am certain that adding FT3 measurement is a waste of time because it is always within the reference range when the TSH is controlled by replacement therapy.

I am aware that some doctors rely heavily on the TSH result. It is certainly the best biochemical test but it should not be used without consideration of symptom control.