Posted by Ritch on March 12, 2002, at 18:17:55
In reply to Re: Lithium; thyroid site » Ritch, posted by noa on March 12, 2002, at 17:07:08
> I think one problem is that with the ease of TSH tests, testing is done more widely but the guidelines of "normal" being in the range of about 1 to 5 have been relied on too rigidly at the expense of listening to how the patient feels. Also, many doctors rely too heavily on just the one test--TSH--when other data may be needed. TSH is a good *screening* tool in my opinion, but not the be-all and end-all of diagnosing thyroid problems. But I think that manged care being what it is, unfortunately, SOP for many doctors is to rely on such screening tools as well as quick and easy numbers guidelines which were really intended to be statistical norms and not the definition of what is normal functioning for any one individual.
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> The 2.0 that you are referring to, I believe comes from an article in a British medical journal (please see the thyroid and depression folder --it is linked there) which suggests that anything 2.0 or above has a high correlation with subsequently emerging signs and symptoms of hypothyroidism, and therefore TSH results in the lower 1/4 of the so-called "normal" range should be considered not normal and treatment should be considered.
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> For me, I had a TSH at around 4.5-5. My pdoc prescribed cytomel and later, synthroid. My TSH then hovered around 2.5 for a while and I felt better than before, but not great. On lithium, the TSH went up to 3.8. I saw an endo who raised my doses gradually based on how it affected how I felt. He anticipated that my TSH target would be below 1, and subsequently wrote a letter to my Primary Care doctor saying that in his experience, patients with hypothyroidism and depression do best when thyroid is treated to the point of getting TSH below 1. My improvement leveled off at around .3, although even after that, I continued to feel increasingly better at that level of treatment.
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> I think the endocrinology *establishment* (ie organizations) should be distinguished from endocrinologists. You should go to an endo that you have recs about from other people--one who is up on the latest research about hypothyroid undertreatment, etc. and who does not rely solely on blood tests, but combines this data with listening to the patient about how they feel--but don't write off the whole profession, either. My endo has been fantastic--and my life drastically improved because I went to see him.Thanks Noa, for that information. Got a couple of questions though. Did you ever get adverse reactions from the supplementation? If so, what were they and at what TSH level seemed to be the most troublesome (you mentioned mood improvement leveling off at .3). I have just half a thyroid and my latest TSH was 1.4. I have a stable calcification in the side that is left (my right). I don't want to get another tumor. The thyroid augmentation is used to supress tumor growth isn't it?
thanks in advance,
Mitch
poster:Ritch
thread:96147
URL: http://www.dr-bob.org/babble/20020307/msgs/97676.html