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Jim - Re: T4

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The stons wrote:

> What about your T4 when you are supressed between scans? What # should it be?

As others have said, our primary focus is on our TSH, and a suppressed TSH

usually means a higher than normal T4. However, there is some evidence that a

higher serum T4 level can lead to bone loss, especially

in women (although I don't know if it's studied in men) which is why doctors

treating thyroid cancer patients usually try to balance the two - suppressed

TSH, with a minimal serum T4 increase.

From Synthroid prescribing information (page 4):

" Effects on bone mineral density - In women, long-term levothyroxine sodium

therapy has been associated with increased bone resorption, thereby decreasing

bone mineral density, especially in post-menopausal

women on greater than replacement doses with increased serum levels and urinary

excretion of calcium and phosphorous, elevations in bone alkaline phosphatase

and suppressed serum parathyroid hormone levels.

Therefore, it is recommended that patients receiving levothyroxine sodium be

given the minimum dose necessary to achieve the desired clinical and biochemical

response. " http://synthroid.com

Dr. Ain has written:

" It seems prudent to consider this level of thyroid

hormone therapy to enhance osteoporosis risk factors if sufficient

other such factors exist (i.e. post-menopausal female without

estrogens, very thin, Caucasian, lack of weight-bearing exercise,

poor calcium intake, low levels of vitamin D, etc.). The

hypothesized mechanism of this effect is related to altering the cell

cycles of the bone cells which make bone (osteoblasts) and consume

bone (osteoclasts). For those members well-grounded in Cell Biology,

a large amount of published research can be read in your nearest

medical library. The decision to use slightly higher levels of

thyroid hormone to suppress TSH is based on a careful consideration

of its known benefit in suppressing thyroid cancer and preventing

recurrences or tumor progression, compared to a variety of minor

risks which can be minimized with careful attention to minimizing

risks and optimizing health. "

-- see entire letter at http://groups.yahoo.com/group/Thyca/message/24955

I hope this helps.

(note a doctor)

NYC

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