Thyroid UK
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Tyranny of the TSH

I realize most of you already know this, but I just wanted to reiterate how perfectly stupid it is for doctors to rely on the TSH test. Over the past 6 months, I have finally been able to get my thyroid hormone dose up to a truly therapeutic level. During that period, I told my doctor that we would use FT3 and FT4 (in addition to how I feel) to decide correct dose. I weigh about 76 kg, and finally reached the dose T3+T4=12+112 mcg before testing, which is a bit above my T4-only equivalent full replacement dose. After being on this dose 6 weeks, I tested about 27 hours after my last dose and found:

FT3 4.66 pg/ml (2.77-5.27) (75% up in range)

FT4 1.27 ng/dl (0.59-2.19) (42% up in range)

TSH 0.017 (0.46-4.68)

The frees are perfect, but TSH lies. Fortunately I have a doc who is cooperative and non-authoritarian.

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76kg dosed at 1.8mcg T4 = 137mcg of T4 required. This is a rough guide on T4 dosing.

What amount of T4/T3 do you take ?

With a suppressed TSH this also means the uptake of T3 is not happening fast enough, so the brain thinks there is more thyroid in the blood than you really have. This means the adrenal side of the thyroid/adrenal axis is not working so well.

Your FT4 could be higher and i would want to see this up where the Ft3 is.

Good figures to me are ft3/4 in that upper 1/3 area, but with a TSH of 0.5-1. This shows you have plenty of fuel in the tank, but the body is still asking for more so the conveyor belt of thyroid production is going through nicely and is being used up.

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Let's not fall into the shoehorn trap of the establishment. Remember we can't diagnosis strictly by numbers in the range wherever they are, so let's not fall into the same trap. Individuals are unique and all that can be done is to try to achieve best balance in outcome, however the numbers come out with a treatment regime that suits.

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I agree wholeheartedly. These, modern, days they take more notice of the results than the patients disabling symptoms.

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Probably half of them don't know more than a couple of the 300+ symptoms, so they ignore symptoms.

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You're correct. Instead of concentrating on relieving clinical symptoms all the emphasis is on the TSH which many believe once it reaches some where in the range that the patient is on a sufficient dose and ignore all the disabling symptoms.

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If you feel well on that dose of t4 and t3 then that is the correct dose for you. It really doesn't matter what the readings are. xx

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Any idea on how I can share this please. Couldn’t stop laughing. Apart from the outfit it could have been me in the doctors before Christmas 😂😂

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Lol! Just click on the YouTube icon and copy the link in the browser bar. I have it bookmarked and just type holy miracle of the TSH which will probably bring it up in a search

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Just figured it out and posted on 3 thyroid sites. I have no doubt it will cause a stir on one as they refuse to say the doctor might be wrong( it must be run by receptionists) lol. Thank you 😄

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