BellaOnline Forums Health and Fitness Thyroid Health Maureen's hashimoto's story

Maureen, truly, thank you for sharing. I'm in the minority, in remission from Graves, but I've heard enough stories like yours to know how important your article is.
One question: you mention the importance of monitoring more than just TSH, e.g. symptoms. How important are the Free T4 and FT# numbers? We hypers, for whom TSH may be unmeasurably low know how important those numbers are, and I get the impression they're important for hypOs, too.

Fayge,

If I may express my opinion on T-3 and T-4 testing:

I've always felt the Free T-4 and Free T-3 need to be tested along with TSH when testing a patient suspected of having thyroid disease. This comes from the fact that some people have unreliable TSH levels. They do not accurately reflect the T-4 and T-3, so all need tested in my opinion.
The same is true of hypothyroid patients already being treated. Some patients for different reasons (sometimes unknown), need a very suppressed TSH level, below normal to have best-normal T-4 and T-3 levels from their thyroid hormone dose. Others need a TSH that is at 2.0 or even above for their thyroid med dose to relieve symptoms and get their T-4 & T-3 at correct level for them. This can be due to mild pituitary problems or due to having co-morbid diseases or conditions that also affect the endocrine system.
If a hypothyroid patient has follow testing on the first 1 or 2 retests that show the TSH is accurately reflecting the T-4 and T-3 level, then TSH only testing would be appropriate.
This is just my lay-opinion but comes from reading many testimonials from thyroid patients whose TSH levels didn't reflect their T-4 and T-3 well.

My lay opinion is probably even more laic than yours, as I haven't done anywhere near the research you have. But I have heard testimonials from many hypER patients whose TSH has stayed suppressed long term, so in fact their TSH was NOT reliable to dose by.
I've also met many hyper patients, myself included, whose drs. relied on the old TSH range of 5, who've kept patients miserable and on high doses of anti thyroid drugs (which can induce the reactions that will lead drs. to withdraw patients off these same drugs) because they were TSH worshippers.