For observing the dose increment, T4/T3 or FT4/FT3

[Guest guest]

1. For diagnosing the Hypothyroidism, FT4 and TSH is used. but what if

after systemetic treatment? T4 or FT4 mainly?

2.I just read one great academic paper concerning about the treatment of

Hypothyoidism.It said that suppressed TSH could lead to the changes in

heart condition.

3.And I am nost sure if the serum T3/T4, or FT3/FT4 and TSH could be

used as an indication of appropriate dose?

[Guest guest]

fragrance_seen,

You wrote:

> 1. For diagnosing the Hypothyroidism, FT4 and TSH is used. but what if

> after systemetic treatment? T4 or FT4 mainly?

For the vast majority of hypoT people on T4 medication only, TSH is still a

valid indicator and used to titrate the dose. It is when the TSH says you are

normal but you definitely aren't that other, more expensive, tests become

necessary. Since there are several possible conditions that can cause this, the

best set of tests is a panel that includes FT3. My understanding from posts last

week, though, is that the UK system does not allow the FT3 test.

>

> 2.I just read one great academic paper concerning about the treatment of

> Hypothyoidism.It said that suppressed TSH could lead to the changes in

> heart condition.

Yes, but keep in mind the conditions studied were for TSH suppressed by T4

medication. It is not clear that suppression by a T3 based med will have the

same dangers. The conclusion from the study is that keeping the TSH below 0.1

for three months will cause measurable changes in heart muscle and bone density.

That is why the lower limit on the TSH reference range was changed to 0.3. The

factor of 3 is a " safety margin. "

>

> 3.And I am nost sure if the serum T3/T4, or FT3/FT4 and TSH could be

> used as an indication of appropriate dose?

>

Again, FT3 is the best overall indicator for that, although TSH is the most

commonly used, and it is sufficient for most of us. The ratio FT4/T4 which is

the same as FT3/T3 indicates whether their is abnormal binding by globulin or

albumin proteins. That is why you need a total or two in the panel with the

Frees.

Chuck

[Guest guest]

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____________________________________

Thanks, Chuck.

For 3, so you think the best indication should be T3,FT3,T4, FT4, and

TSH, the overall 5 items of checks? I am sorry that I don't undertand

you fully

>

> You wrote:

> > 1. For diagnosing the Hypothyroidism, FT4 and TSH is used. but what

if

> > after systemetic treatment? T4 or FT4 mainly?

>

> For the vast majority of hypoT people on T4 medication only, TSH is

still a valid indicator and used to titrate the dose. It is when the TSH

says you are normal but you definitely aren't that other, more

expensive, tests become necessary. Since there are several possible

conditions that can cause this, the best set of tests is a panel that

includes FT3. My understanding from posts last week, though, is that the

UK system does not allow the FT3 test.

>

>