# synthroid dosage based on TSH alone



## mememe (Mar 18, 2010)

Hello, this is a question for someone close to me, this is not my lab result.

TSH 4.1 (.35-5.50)

This is while on Synthroid 50 mcg. once a day.

I am just curious because we don't think the doctor ever checked any T3 or T4 levels-we believe the TSH has only been checked.

Is it unusual for a doctor to prescribe synthroid based on only TSH and symptoms? (being cold all the time) And this person is beginning to feel cold all the time again, and is going in for labs soon to see if there needs to be a dosage change. I suggested some more labs :tongue0015:


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## Lovlkn (Dec 20, 2009)

> Is it unusual for a doctor to prescribe synthroid based on only TSH and symptoms?


No - most do prescribe on TSH alone and the opinon of most thyroid disease boards is to RUN and find a doctor who is willing to test the Free T-4 and Free T-3 and consider those as well to dose properly.


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## Andros (Aug 26, 2009)

mememe said:


> Hello, this is a question for someone close to me, this is not my lab result.
> 
> TSH 4.1 (.35-5.50)
> 
> ...


I agree w/ Lovlkn 100%; get those running shoes on.


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## HoneyBee (Jul 28, 2010)

No...not uncommon at all. It can be a struggle to find a doc who will not guide the hormone therapy based on TSH alone. All the TSH says is what the pituitary gland is doing. Dosing strictly T4 such as Synthroid based on TSH alone is not only ignorant, but lazy IMHO.

If your friend is still over a 3 on 50mcg daily. I would consider 2 things. #1 Are the meds being taken properly? In the morning on an empty stomach with only water 45-1hour before breakfast...? If so, then consider #2.

#2 Is the T3 low and the T4 high? If so, they may also need a T3 med along with the Synthoid, or ease into Armour to kill 2 birds with one stone.

My advice; demand a full thyroid work up that includes antibody testing or find another doctor. It wouldn't hurt to request a vitamin and mineral count either.


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## mememe (Mar 18, 2010)

Thanks all, I will relay the information!


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