Thyroid hormone replacement is simple to administer and requires that a patient take a daily dose of synthetic or natural thyroid hormone to restore bodily metabolism. While the method of treatment is simple, it is also important that a treating doctor is sensitive to the needs of individual patients. This demonstrates the importance in hypothyroid patients being treated by qualified thyroid doctors and in patients being fully communicative about progress and symptom-relief (or a lack in these) with their treating doctors.
Optimized Treatment Goals
It is a fact that there are doctors who specialize in thyroid treatments and those who do not. Those who do often have targeted treatment goals for patients, rather than simply treating them to get their thyroid hormone levels replaced back into the normal values range. The two major thyroid hormones that are monitored with hypothyroid therapy are the T4 and T3 levels. A low-normal thyroid hormone level or even one that is at about mid-range will not be optimal for some patients who instead need the levels at between mid-range and high-normal to experience significant symptom relief.
TSH Suppression
Looking at it from the point-of-view of the TSH level (pituitary hormone that reflects thyroid hormone levels), the goal of a replacement thyroid hormone dose is to suppress the elevated TSH level, which elevates with hypothyroidism, back down to normal range. Some patients however, need a significantly suppressed TSH to cause thyroid hormones (T4 and T3) to rise slightly above mid-range in the body.
If the TSH normal values range at a blood lab is for example from “0.5 to 5.0IU/L”, a thyroid hormone dose that only suppresses TSH down to “3.5” may not result in adequate increases in thyroid hormone levels or in the symptom relief that is needed. The U.S. National Institutes of Health states that hypothyroidism should be treated to place a patient’s TSH level at between “0.5 and 3.0 mIU/L”. Levels such as “1.0” and “2.0”, are within that treatment goal range.
Patient Individuality
The scenario addressed in the previous subheading is sometimes reversed and a hypothyroid patient may not need a significantly suppressed TSH for thyroid hormone levels to become optimized. Some patients in fact will experience mild hyperthyroid type symptoms if their TSH is suppressed below a “2.5” or “2.0”. It is not always apparent as to why patients may vary in this area but could be due to differences in the functioning of their regulating brain glands (the master endocrine ones), or more specifically in how their pituitary function may vary slightly in response to thyroid hormone coming into the body from an outside source (the resulting TSH level).
Blood Retesting TSH and Thyroid Hormones
Detecting differences in the needs of individual patients may require blood testing their T4 and T3 levels in addition to TSH, to better evaluate how these levels all correlate. Once a doctor knows where the TSH level needs to fall within the treatment range to optimize a patient’s thyroid hormone levels via a replacement dose, he can then blood retest using TSH-only. If TSH and thyroid hormones are not first evaluated together in follow up on hypothyroid therapy, opportunity to better optimize a patient’s treatment might be missed.
Jim Lowrance - James M. (Jim) Lowrance has authored over 100 book and ebook publications since year 2004.
