The Endogenous and Exogenous Principals
TSH concentrations……………...… what value should be aimed for ?
The Endogenous and Exogenous Principals and effect.
“The difficulty in interpreting serum TSH concentrations is to decide what value should be aimed for in patients taking thyroxine replacement. It is not sufficient to satisfy the recommendations of the American Thyroid Association or the AMA (Australia) by simply restoring both serum T4 and TSH concentrations to normal (most people would be under treated), as in our experience most patients feel well only with a dose resulting in high / normal free T4 and low / normal TSH concentration, and those patients with continuing symptoms despite ‘adequate ( blood tests say you should be well ) doses of thyroxine’, may be slightly under-replaced. Some patients (the majority) achieve a sense of wellbeing only if free T4 is slightly elevated and TSH low or undetectable ( ................
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