Pam....I copied and pasted this about the ranges. I also am kind of a math retard so will be posting my labs and really want to hear your advice. I "think" I am improving at times, but I think the ferritin is what keeps holding me back. I am going to try to get a venofer infusion very soon. I did bring my ferritin up from 20 to 36 but it took over a year and I had to get endometrial ablation done also. I also hear ya about the ND's saying iodine is OK. I wouldn't take a chance with that personally. Here's that info on ranges. Would love to know what you agree/disagree with.
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Okay this is an excerpt from my week 2 thyroid care and concerns post. It has some basics on thyroid treatment issues. Hashimoto's is controversial.. but if you go through enough MDs you should be able to find one willing to try medication in order to shrink your goiter/nodules.. even if they do not want to treat subclinical hypothyroidism.
BASICS: What is normal TSH, FT3, and FT4 range versus optimal?
Optimal FT range is 50-80% of normal range. This statistic comes from the N A C B where they determined 85 – 90 % of non-dysfunctional thyroid MALES had TSH levels between 0.89-1.1. Women of child bearing years need to have FTs in the 60-80% range of normal. Women after menopause tend to need slightly lower Ft values in the 40-70% range. (This is just my MFM and 2 Obs knowledge on this.. trying to dig up a public access postable journal article on this information) Many MDs do not know how to determine where you are in the normal range. So here is the formula you need to know and come to love.
Given the following formate:
Free T or Total T value (lower limit - upper limit)
0.85 (0.8-1.
Your percentage is calculated as follows:
[Your FT value - lower limit]/[upper limit - lower limit]*100 = %
[0.85 - 0.8]/[1.8-0.8]*100 = 5%
Optimal care is when your TSH is around 1 on a T4 supplement alone with Ft's are in the 50-80% range of normal. T3 supplementation such as cytomel or Armour results in TSH suppression and as a result you must gauge thyroid supplementation on your actual T4 and T3 hormone levels and symptoms alone.
Here is a summary of the A A C E and N A C B statements on the latest normal TSH range.
November 2002: The National Academy of Clinical Biochemistry (NACB), part of the Academy of the American Association for Clinical Chemistry (AACC) was first to issue new laboratory medicine practice guidelines. This is their job so it is to be expected they alter the requirements MDs use for the diagnosis and monitoring of thyroid disease. The particular statements of interest in the 2002 guideline announcement are:
"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."
Non-US Mds may turn their nose up at this information.. but it is always worth a shot. This announcment and research was then picked up and reviewed by the A A C E. Based on the N A C B's findings, in January 2003, the American Association of Clinical Endocrinologists (A A C E) made the following important announcement that all the MDs should get.. but haven't yet:
"Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now A A C E encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0. The A A C E believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now."
You want to know the neat thing. In 2006 the 0.3-3.0 level change once more according to the N A C B and the A A C E. Normal TSH range for a patient with out Autoimmune thyroiditis is now recommended to be 0.30-2.5. In patients with documented Autoimmune thyroiditis.. the normal TSH range is 0.3-2.0. So if you have a TSH above 2.5 there should be a MD out there SOME where that has the guts to prescribe 50 mcgs of T4 minimum. You just need to find them. I would check the Armour physician finder database and look for one in your area that is in your network. Call and ask them about their practices policy in treatment and care for autoimmune thyroiditis given symptom onset. This will tell you whether or not you want to waste money on an appointment. I founf one SMALL group of MDs in my city (We have FOUR hospitals!! But only one forward thinking group willing to treat my Hashimoto's.) It took people here, my family and A LOT of research and slogging through medical journals to convince and brow beat my MDs into proper treatment. Only 2 were on my side from the get go. The others needed to be convinced. If they weren't willing to listen and be questioned.. they got the boot. I wish you luck finding your thyroid specialist. They are a rare breed. I readily pass the name of my integrative medicine internal medicine specialist on whenever I am asked. So far she has helped me and six others I have referred to her. Pity you all don't live in my town. You could benefit from my leg work.
MG
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If we learn by our mistakes, I am working on one hell of an education
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confused results
(But we find doctors who ONLY give T4 who get used to SEEING it way high!). And not everyone wants their FT3 way high either. 
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