10 doctors weighed in:

Isn't the effect of thyroid hormones at pituitary level altered in patients without a thyroid under levothyroxine monotherapy? Therefore, TSH cannot always be considered an appropriate marker? Isn't free T4 & T3 a more approriate marker in levothyroxine-

10 doctors weighed in
Dr. Quang Nguyen
Internal Medicine - Endocrinology
5 doctors agree

In brief: No

If your body is not handling the levothyroxine well, your TSH level will be off and you will need to increase the dose.
As long as your TSH is "normal", then it is accepting the levothyroxine as a hormone and is a good measuring parameter. Ft4 and ft3 varies throughout the day (especially if you are taking levothyroxine), thus they are not good tests to base your treatment on.

In brief: No

If your body is not handling the levothyroxine well, your TSH level will be off and you will need to increase the dose.
As long as your TSH is "normal", then it is accepting the levothyroxine as a hormone and is a good measuring parameter. Ft4 and ft3 varies throughout the day (especially if you are taking levothyroxine), thus they are not good tests to base your treatment on.
Thank
Dr. Kathleen Saradarian
Family Medicine
2 doctors agree

In brief: No

Currently, TSH is still the most reliable test to determine if thyroid is adequately being replaced.
The pituitary knows how much free T4 and T3 (liothyronine) is in the body and whether it is adequate or not. Free T4 and T3 (liothyronine) levels can vary hour to hour and day to day and are affected by other things.

In brief: No

Currently, TSH is still the most reliable test to determine if thyroid is adequately being replaced.
The pituitary knows how much free T4 and T3 (liothyronine) is in the body and whether it is adequate or not. Free T4 and T3 (liothyronine) levels can vary hour to hour and day to day and are affected by other things.
Thank
Dr. Troy DeLong
Pharmacology

In brief: Yes

There is increasing evidence that TSH may not be the best tool for monitoring thyroid.
There is not enough space here to give an in-depth breakdown of thyroid. I personally am of the opinion that the following labs are important: tsh, total t3&t4, free t3&t4, tpo, ferritin, and 25oh vit d. Others may be appropriate as determined by your physician. Do not over look food allergies such as gluten.

In brief: Yes

There is increasing evidence that TSH may not be the best tool for monitoring thyroid.
There is not enough space here to give an in-depth breakdown of thyroid. I personally am of the opinion that the following labs are important: tsh, total t3&t4, free t3&t4, tpo, ferritin, and 25oh vit d. Others may be appropriate as determined by your physician. Do not over look food allergies such as gluten.
Thank
Dr. Ed Friedlander
Pathology

In brief: Treat YOU not #'s

There's a lots of unknowns in the proper dosing of replacement thyroid, some outright untruths and some likely myths.
Some papers suggest titrating the dose based on what makes the patient feel best; other malpractice-shy physicians treat numbers for fear of late-life osteoporosis being blamed on too much replacement. Your can ask for the tests your reading suggests are best.

In brief: Treat YOU not #'s

There's a lots of unknowns in the proper dosing of replacement thyroid, some outright untruths and some likely myths.
Some papers suggest titrating the dose based on what makes the patient feel best; other malpractice-shy physicians treat numbers for fear of late-life osteoporosis being blamed on too much replacement. Your can ask for the tests your reading suggests are best.
Thank
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