Hypothyroid Advice

[Judthepud]

Hi all,

I remember reading a post a few months ago that mentioned advice from an Endocrinologist (I think he may have been linked to the British Thyroid Association). The advice was about optimal blood results, something like T3 and T4 should be in the top 25% of the range and TSH should be below 2. Those numbers are probably completely wrong, but can anyone put me right. I have a friend who's just been diagnosed with hypothyroid, and I said I'd try to find out for her. Thanks.

[SeasideSusie Remembering]

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):

"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).*" *He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at

[e-mail]

This information is in reply to question 6.

Remember to point out to your friend that it is a long, slow journey, possibly taking many months, increases in Levo can only be made in 25mcg increments every 6 weeks. It may take a long time for symptoms to abate, biochemistry results may look good long before that.