Is it best to have t4 middle of range or top

[Sharon-1152]

Hi haven’t posted for a while . Was just wondering if anyone could give me some advise about t4 ? Is it best to be middle of the range or top of the range .

I read an article that Dr Toft said it is best to be at very top of range or even slightly over that , then another article I read said it should be in the middle, any ideas which is right ?

[SeasideSusie Remembering]

Sharon-1152

The best place for FT4 is where it suits you, for some of us that's at the top of the range, for some of us it can be lower. The important result is actually FT3 - T3 is the active hormone which every cell in our bodies need and it's low T3 that causes symptoms.

What Dr Toft says in his article is not that FT4 is best to be at very top of range or even slightly over that but the appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range which means that FT4 is likely to be in the upper part of its reference range or even slightly elevated. He says that most patients will feel well in that circumstance. He goes on to say that some need a higher dose of levothyroxine to suppress TSH and then the FT4 will be elevated and that this 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) although he did state durng a public meeting that it applied to FT3 as well as Total T3.

So nothing is set in stone, we just need our levels to be right for us as an individual.

[Sharon-1152 in reply to SeasideSusie]

Thanks so much 🙂