What is the best levels to be

[Sleepyachy]

Hi what is the ideal serum TSH level we should be ?

And what level should serum free T4 level should we be ?confused ......

[SeasideSusie Remembering]

Sleepyachy

Generally, for most people, as I mentioned in my reply to you here:

healthunlocked.com/thyroidu...

[Sleepyachy in reply to SeasideSusie]

Hi , waiting for doctor to ring. Read the Dr Anthony Toft piece . My results are classed as normal range .. 16.1 ( 11.0 _ 26.0) T4 . Normal range 18_22.But Anthony Toft states some need a higher dose to suppress the serum TSH. Making the T4 in 24_ 28 range.

I think possibly this is me .

And hopefully the doctor agrees to upping my pills to 125. Also may mention about if sertraline is causing a negative effect on levothyroxine? Thanks

[Sleepyachy in reply to Sleepyachy]

Having another bloodtest on thurs . Also checking antibodies. See what results are friday

[SeasideSusie Remembering in reply to Sleepyachy]

Sleepyachy

My results are classed as normal range .. 16.1 ( 11.0 _ 26.0) T4 . Normal range 18_22

Sorry, but that doesn't make sense.You have given two ranges there.

The only range that is relevant is the one that comes with your results which, I assume, is the one you have put in brackets, i.e. 11-26.0 so I don't know to what the "18-22" refers.

Where you have put "Normal range 18-22" is not a wide enough range for any of the labs' reference ranges we see here, from the lower limit to the top limit of the range is usually a minimum of 10, eg 7-17, 9-19, 12-22, or maybe as much as 15 as the one you have quoted next to your result, i.e. 11-26.

If we take it that your result is 16.1 with a reference range of 11-26 then your result is 34% through range and most people would feel better if it was in the upper part of it's range at around, say, approx 70% which would be approx 21-ish.

But Anthony Toft states some need a higher dose to suppress the serum TSH. Making the T4 in 24_ 28 range.

Dr Toft doesn't actually quote a reference range in his article which is unfortunate, so we have to just take this bit:

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated

The figures he quotes mean nothing without the reference range he is basing his figures on. So if you are using this in your discussion with your GP, forget the actual numbers that Dr Toft quotes and just use "the upper part of it's reference range or even slightly elevated" to get your point across, or use the figures based on your lab's reference range which I have mentioned above, pointing out that 16.1 is not in the upper part of the range 11-26.

Also may mention about if sertraline is causing a negative effect on levothyroxine?

I have read that taking sertraline with levothyroxine may mean that the Levo doesn't work as well so you may to increase your dose, something to keep an eye on.

[Sleepyachy in reply to SeasideSusie]

Thank you , The( 18 _ 22 ) is the ideal range . My T4 16.1 is in (11.0_ 26.0) range .yes I understand not sure whereabouts in the range I actually am. Yes I meantioned Anthony Toft. Said different specialists say different things. That they like to go with bloodtest results. So going to check it again thurs . And antibodies and decide then if needs upping. Said having too much levothyroxine is also dangerous. So it is difficult.

[Sleepyachy in reply to Sleepyachy]

I also meantioned my vit D , he said it wasnt lower enough to feel so bad. Mines 41 . 50+ is normal

[tattybogle in reply to Sleepyachy]

"Said having too much levothyroxine is also dangerous."

True , but your doc say's he likes to go by blood results, right ?and one way to test if someone is on too much levothyroxine (LT4) is the fT4 test, if your fT4 result comes back within the lab range used for that test, then that indicates you are not on 'too much'.

Whether that is the amount that makes you feel best is a slightly different question, some people feel best with fT4 high in range /slightly over range , and some do not.

[Sleepyachy in reply to tattybogle]

True.

[SeasideSusie Remembering in reply to Sleepyachy]

Sleepyachy

The( 18 _ 22 ) is the ideal range .

Who says that is ideal?

My T4 16.1 is in (11.0_ 26.0) range .yes I understand not sure whereabouts in the range I actually am.

I mentioned above that you are 34% through range. Here is the calculator:

chorobytarczycy.eu/kalkulator

[Meanbeannyc]

0.5-1 (?)