What is the optimal tsh for a 61 year old female who 16 years ago operated thyroid gland due to hurthle cell ca. ? my tsh during all these 16 years (after the operation) was 0, 6 - 0, 4 . but two months ago i changed the original swiss medicine eltr

I : I agree with dr christensen. The idea is to suppress the pituitary gland from producing thyroid stimulating hormone (tsh). A rule of thumb that i and my endocrinology colleagues follow is to keep it as low as possible without causing symptoms of high thyroid hormone levels (hyperthyroidism). This suppression is done by taking slightly higher than normal doses of thyroid hormone replacment (levothyroixine is a generic equivalent). Normal TSH levels (at my lab--it can vary from lab to lab) is 0.45 to 4.5. The dosage needed will vary between people, but a good way to start is to go by weight. At this point in your treatment, i would only recommend yearly thyroglobulin levels. Normal thyroid cancer surveillance is not as protocol driven as other cancers (breast/lung/colon) and can vary between doctors.

As : As you know, TSH (thyroid stimulating hormone) is secreted by your pituitary gland to stimulate the synthesis and release of thyroid hormones from your thyroid gland (which has been removed, in your case). Since TSH can also stimulate the growth of thyroid cancer cells, one goal of therapy for thyroid cancer patients is to suppress their TSH to the lowest possible level while keeping their triiodothyronine level (t3) within a normal range. (many physicians strive for a TSH less than 0.1 as long as the patient's T3 (liothyronine) doesn't climb higher than normal). This usually requires a levothyroxine dose between 2.2 and 2.8 mcg per kg of body weight (about 170 to 220 mcg for a 172 lb individual). I hope that helps!