I just found this, written by diogenes some time ago, that I saved:
The following papers from the Japanese shows that, in people with no working thyroid, "normal" healthy-type conditions on T4 therapy only occur if TSH is between 0.03-0.5.
Above this, hypo symptoms are still present. You are miles away from achieving normality.
Ito M, Miyauchi A, Hisakado M et al. Biochemical markers reflecting thyroid function in athyreotic patients on levothyroxine mono therapy. Thyroid 2017;27:484-490
Ito M, Miyauchi A, Morita S et al. TSH-suppressive doses of levothyroxine are required to achieve preoperative native serum triiodothyronine levels in patients who have undergone total thyroidectomy. Eur. J Endocrinol 2012;167:373-378
I believe someone was looking for something like this a little while ago, but I can't remember who.
Hope it helps someone.
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greygoose
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“the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing”
Conclusions: The serum biochemical markers of thyroid function in patients on LT4 following total thyroidectomy suggest that the patients with mildly suppressed TSH levels were closest to euthyroid, whereas those with normal TSH levels were mildly hypothyroid and those with strongly suppressed TSH levels were mildly hyperthyroid.
Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.
“the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing”
ncbi.nlm.nih.gov/labs/pmc/a...
Hello,I know this is about levothyroxine and suppressed tsh. But would this apply to people on t3 only. My tsh is 0.006 I'm being told that's fine, it happens on t3 only treatment.. my ft3 is mid range 4.7
Well I was strongly suppressed for 30 years because they did not get all the cancer cells. For the majority of that time i was hyperthyroid, osteoporosis and now got coronary cardiac disease. Grrrr Annoys me though when cardiologists assume CAD is caused by bad lifestyle, paricularly diet.
Great paper Greygoose, just got to get TSH/t4/t3 to appropriate level now that endo stopped zealously dosing me with levo in 2020.
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TSH is just the 'opinion' of your Pituitary about your dose ~ but your Pituitary's 'opinion' is a bit warped once you take Thyroid Hormone.
