Optimal Thyroid levels

[Guest guest]

This was a great and very informative article about what optimal levels for a

hypo patient should be, just wanted to pass it on! =)

http://thyroid.about.com/od/hypothyroidismhashimotos/a/The-Optimal-Treatment-For\

-Hypothyroidism.htm

EXCERPT/HIGHLIGHT OF ARTICLE: Tests to Aid in Assessment of Optimal Thyroid

Replacement

Dr. Holtorf has a number of tests that he feels are useful in helping to assess

optimal thyroid replacement.

TSH—Dr. Holtof considers a TSH above 2 as clear indication that there is low

tissue thyroid levels. Says Dr. Holtorf: " A normal TSH does not rule out thyroid

dysfunction and a low TSH is shown to be an indication of excessive tissue

thyroid levels only 20% of the time (80% of the time that is not the case). The

TSH becomes an extremely poor marker for tissue thyroid levels if there is any

inflammation, depression, chronic illness, chronic dieting, obesity, stress,

chronic fatigue syndrome, fibromyalgia, diabetes, insulin resistance, leptin

resistance present. "

T4--Dr. Holtof feels that with T4, if there is a problem with thyroid hormone

transport (T4 and T3 being transported into the cell), high T4 levels may be

associated with lower cellular levels of thyroid.

Free T3-- Dr. Holtorf believes that in general, the free T3 should be in the

upper 25th percentile of the normal range. Says Dr. Holtorf: " The 'normal; range

is, however, applicable when prescribing T4, which is converted to T3 in the

cell and then the amount that leaks back into the serum is the " normal " level.

When treating with T3, this is not the case so standard reference ranges cannot

be used. "

Reverse T3—According to Dr. Holtorf, Reverse T3 is both a marker for reduced T4

to T3 conversion and for reduced transport of T4 into the cell -- and has

antithyroid activity (blocks the effect of thyroid) -- and should be less than

150.

SHBG—Sex hormone binding globulin (SHBG) is a marker for tissue level of

thyroid, so if less than 70 in a woman, Dr. Holtorf considers it a marker for

low or suboptimal tissue thyroid activity. If thyroid replacement is given and

SHBG does not increase proportionally, he feels this is an indication of thyroid

resistance.

Leptin—Dr. Holtof believes that the serum leptin level should be less than 12.

The higher the leptin level, the greater the leptin resistance, which suppresses

TSH production and T4 to T3 conversion. Thus, the higher the leptin the more

useless the TSH becomes.

Iron/Iodine —Dr. Holtorf also believes that iron and iodine levels should be

checked and deficiencies should be treated, as they are required for thyroid

activation.

Basal Metabolic Rate (BMR)—Dr. Holtorf finds that tissue thyroid levels are a

major determinant of overall metabolism so the overall metabolic level can be

considered the gold standard for the body's thyroid level. Thus, the BMR can be

used to help determine the most optimal level. This is test that can done in

some doctors' offices.

Relaxation Phase of Tendon Reflex—According to Dr. Holtorf, numerous studies

have shown that this is a more accurate measure than serum blood tests, as it is

more of a measure of tissue activity, rather than serum levels, and the optimal

level should be faster than 110 msec.