Tsh result

[naveed123]

My latest Tsh result is 2.9 where as range is 0.4-4.9.Is this result is optimal?

[lisabax]

If you are on medication, the optimal level is usually around 1, so you are a little high. But are you having symptoms? LB

[shaws Administrator]

Some doctors believe if our TSH reaches 'within normal range' we are on sufficient medication. They are very wrong. The aim is to have a TSH around 1 or lower. This is an excerpt from Dr Toft (ex President of the BTA) and if you'd like a copy of the whole Pulse article email [e-mail]

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg