If as per the Health Unlocked community guidance the optimal TSH for Hypo is around 1.0 mlU/L, why then is there no support for this anywhere for example with Thyroid UK?
They must be aware that there's a big Thyroid knowledge base within the Health Unlocked community.
Everywhere you look on the Internet the recommended TSH range is between 0.4 - 4.0 mlU/L which is always what my GP refers to.
What chance have I got of convincing my doctor if this is set in stone right across the board?
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Totoro25
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'Aim to maintain TSH levels within the reference range when treating primary hypothyroidism with levothyroxine. If symptoms persist, consider adjusting the dose of levothyroxine further to achieve optimal wellbeing, but avoid using doses that cause TSH suppression or thyrotoxicosis.'
So it doesn't give a specific number but you can say you want to trial an increase to see if you can feel better with a slightly lower (but not under range) TSH
The problem is, doctors don't understand what ranges are, how they're set nor what they mean. If fact, they have no real idea how to interpret blood test results at all. They shouldn't be dosing by the TSH, anyway, but the whole thing is so messed up none of they have a clue what they're doing.
I think it often helps if you tell doctors that you understand the 'risks' of a low TSH (there aren't any and you're will to take full responsibility. A lot of people do that. After all, your doctor is there to advise you, not to dictate to you, and there's no law that says you have to do what he advises. And if that doesn't work, buy your own levo and give yourself a rise.
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Some people need a bit less than guidelines, some a bit more
Previous private test results show you have plenty of room to increase your dose
Request “trial” increase in Levo from GP
If they refuse then request referral to endocrinologist of your choice
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email there’s a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
There are lots of references to it in various guidelines / guides for GP's : healthunlocked.com/thyroidu.... /my-list-of-references-recommending-gps-keep-tsh-lower-in-range
Its the fatal flaw in dosing by TSH, once on replacement hormones then TSH becomes the least important number. But doctors around the world are trained to do it and very many are fixated on it.
What they should do is also look at your frees, but these are getting tested less and less often. And again if they are vaguely within range then that's good enough, apparently.
Unfortunately it sounds as though your GP has just looked at your results, seen your TSH falls somewhere in the range and decided that is good enough. Many of us have had the same experience.
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
and you're will to take full responsibility. A lot of people do that. After all, your doctor is there to advise you, not to dictate to you, and there's no law that says you have to do what he advises. And if that doesn't work, buy your own levo and give yourself a rise. 
latest blood results
Optimal Ferritin for New Zealand / Australian range
Any idea what’s going on?
Please could someone give advice on blood results 
