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Old Thu, Mar-10-05, 11:51
Natrushka Natrushka is offline
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Posts: 11,512
 
Plan: IF +LC
Stats: 287/165/165 Female 66"
BF:
Progress: 100%
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Quote:
Originally Posted by JennyU1976
Question 1:
About two years ago I was diagnosed Hypothyroid, while having a TSH level of 3.5. My doctor put me on 100 mcg of Sythroid to help. I was retested, and the TSH came back as 3.0.

My doctor thinks this (TSH 3.0) level is normal/fine...but as latest research has come out, this not in the normal range. Is that a correct assumption? If this is correct, does anyone know if a good article I can print off and show him that this level is not now considered normal?

Yes, 3.0 is too high. Healthy people have a TSH below 1.0. More importantly he should not be using just your TSH to decide your dose. He should be looking at your FT levels every time he tests your TSH. Furthermore, your FTs should be high - in the upper 3rd of the lab range for normal. Here's some supporting evidence to present him

TSH Level Explanation

Until recently, physicians accepted the normal TSH range of 0.5 to 5.0 mIU/L. Recent data suggest that normal serum TSH levels may have a narrower range. For example, the National Academy of Clinical Biochemistry (NACB) guidelines believes that a sustained TSH level above 2.5 mIU/L might not be normal and that current TSH upper limits of >4 mIU/L are likely skewed by the inclusion of individuals with occult thyroid deficiency. The NACB guidelines were published in their entirety in the January issue of the Thyroid.

And here's a few research papers on TSH ranges from altsupportthyroid:

http://www.altsupportthyroid.org/tsh/tshmedrefs1.php

With respect to having FTs in the upper third of the range, this is the recommendation of The National Academy of Clinical Biochemistry, which is part of the Academy of the American Association for Clinical Chemistry (AACC), and it can be found in their Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease: (PDF file)

"It is likely that the current upper limit of the population reference range is skewed by the inclusion of persons with occult thyroid dysfunction."

"In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

"A serum TSH result between 0.5 and 2.0 mIU/L is generally considered the therapeutic target for a standard L-T4 replacement dose for primary hypothyroidism."

"Thyroxine requirements increase during pregnancy. Thyroid status should be checked with TSH + FT4 during each trimester of pregnancy. The L-T4 dose should be increased (usually by 50 micrograms/day) to maintain a serum TSH between 0.5 and 2.0 mIU/L and a serum FT4 in the upper third of the normal reference interval."

"A serum FT4 level in the upper third of the reference interval is the therapeutic target for the L-T4 replacement dose used to treat central hypothyroidism due to pituitary or hypothalamic dysfunction."

"It is now well documented that hypothyroid patients have serum FT4 values in the upper third of the reference interval when the L-T4 replacement dose is titered to bring the serum TSH into the therapeutic target range (0.5-2.0 mIU/L) (219,220)."


Quote:
Question 2:
I am continuing with my 100 mcg dosage daily, and it helps with the fatigue/energy but not really with the weightloss. Weightloss is a huge concern to me, as we are hoping to get pregnant. I have read Synthroid deals strictly with replacing the T4, and doesn't deal with the T3. Is this correct?

Correct. If you're planning on getting pregnant it is even more important that your thyroid hormones be stabilized. Your doctor should not even be using TSH to treat you - he should be using your FT levels. FTs not in the upper 3rd during pregnancy can result in serious complications; for both of you. See the quote above in red and bold about pregnancy needs.

Quote:
Question 3:
If Synthroid only deals with T4, isn't this where Selenium would come in to help the T4 convert to T3? Have you found doctors to have a problem with Hypothryoid patients taking Selenium in general? Would Selenium help my metabolism run more correctly...and thus help me loose weight more efficiently?

T3 is the active hormone; your thyroid produces both T4 and T3, but mainly T4. This is then converted in the liver and peripherally into T3. The selenium helps this process. Selenium is also a very powerful antioxidant, like vit E and C.

Quote:
Question 4:
Finally, concerning Selenium Dosage. I purchased the only Selenium I could find at our local drug store which was 200 mcg. I live in Germany and we don't have access to a local drug store like in the States.

200mcgs is the correct dose. As you're in Germany you can probably take this much every day - selenium deficiency in the EU is rampant.

Quote:
I have been reading online all day about the normal daily recommended dosage is 70 mcg for adult females.
If this is so, why do all Selenium supplements come in 100/200 mcg bottles?
The suggested amount of overdose seems to vary from 500 to 900 mcg daily.


RDA is not what you need to be healthy; it is the bare minimum to keep you from being sick. For instance, the RDA for Vit C is 75mg, barely enough to keep you from getting scurvy!

Quote:
Bottom Line:
I am eating a low calorie/low carb diet, and would like to take my 200 mcg pill without worry of overdosing. Taking into account the extra amounts from small portions of chicken/cheese/broccoli/asparagus etc. that my diet contains. So even if I got 300 mcg total (pill & food) is that too much??

I doubt you're getting enough from your diet because of your geographical location. Also, I'd bet you'd been deficient for a while, 200mcgs would be fine, IMHO.

Jenny, I would suggest you do two things:

1) get your FT levels checked - your FT4 and FT3. This might not be easy in Germany. I know a few people in the EU who have had to fight for this, but there are some doctors out there who can and will help you. Using just a TSH to give you your dose is wrong and it will keep you undermedicated - which is just as bad as not being medicated. If your doctor will not help you here is a list of doctors in Germany who are known for being innovative Fat loss is one the last things to happen once your dose is optimized (once your FTs are where they need to be)

2) I would suggest you raise your carbs a little. Ketosis is hard on the thyroid; it likes some carbs and it likes to not be in ketosis. Ketosis causes T3 levels to fall (T3 is the active hormone that controls metabolism) and TSH to fall - it's likely your TSH is really higher than 3.0.

Best,
Nat
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