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Paper challenging TSH only testing


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#1 GOLGO13

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Posted 05 July 2019 - 03:08 PM

https://www.ncbi.nlm...les/PMC6471951/

 

Good article challenging TSH only testing. And within it there are a lot of good linked articles.


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

112 Synthroid Daily (Mar 2020)  TSH 2.069 range .350-5.000 uIU/ml |  FT3 2.8 range 1.7-3.7 pg/mL | FT4 1.08 range .7-1.25 ng/Dl (doing pretty good in general)

 

 


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Posted Today, 04:02 PM



#2 Lovlkn

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Posted 07 July 2019 - 06:58 PM

Link not working


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#3 GOLGO13

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Posted 08 July 2019 - 11:45 AM

I fixed the link now...not sure what happened.


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

112 Synthroid Daily (Mar 2020)  TSH 2.069 range .350-5.000 uIU/ml |  FT3 2.8 range 1.7-3.7 pg/mL | FT4 1.08 range .7-1.25 ng/Dl (doing pretty good in general)

 

 


#4 Lovlkn

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Posted 09 July 2019 - 12:30 PM

 

 

Conclusion

It appears that we are witnessing a consequential historic shift in the treatment of thyroid disease, driven by over-reliance on a single laboratory parameter TSH. The focus on biochemistry rather than patient symptom relief should be re-assessed. A joint consideration together with a more personalized approach may be required to address the recent surge in patient complaint rates.

Wouldn't it be nice if this could be presented to every doctor who only tests TSH in hormone replaced patients or patients who have thyroid symptom related complaints!

 

I for one am someone who has no or close to zero TSH - going on 15 years and multiple bone dexa scans to track diagnosed osteopenia - I am happy to report NO ADDITIONAL bone loss which in my eyes debunks the low TSH low bone myth.  After my initial bone scan I did however begin taking calcium supplements and addressing low vitamin D levels.

 

I'm very thankful I met my OD 10 years ago - the one who ignored TSH and focuses on FT-4 and FT-3


  • creepingdeath and GOLGO13 like this
Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#5 creepingdeath

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Posted 09 July 2019 - 04:57 PM

"We The People"...….

 

When enough people get fed up and start to speak up is how to get things changed....

The complaints have always been there.....but were ignored.

The new wave social media is responsible for the surge of awareness for this issue.....

 

The more we spread the word the more things will start to change.



               





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