Re: Is a TSH of 0.027 too low? Or just right?

[Guest guest]

Joan,

Generally speaking 0.027 is an unnecessary suppression, it's very

hyper. Are you sure he didn't say 0.27? The fact that your TSH was

1.7 after only 5 weeks on meds was excellent. In another month it may

have been at 0.10 on your 150mcg. Your doctor appears to be pushing

the envelope to get you to suppression faster. If you start having

palpatiations or get really tired (it can be a hyper symptom) make

sure you call him and ask for another TSH. Once in suppression we

become super sensitive to dose changes. A tiny dose change can make

you feel great or darn right miserable.

Here is a TSH scale:

1.00 down>>0.75 >>0.50..0.25.. 0.15 and you goal is 0.10...0.05

Keep us posted.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

> I just met with my endo to review my first blood test results since

> RAI. Blood work was 5 weeks after starting back on meds (150mcg

> Synthroid) and my TSH was 1.7. He has upped my dosage to 175 mcg and

> says he is shooting for my TSH to be 0.027 (which sounds a lot lower

> then <0.1 that I keep seeing in messages. But I am not a doctor nor

> a mathematician....

>

> So, I would love to hear your opinions about his recommendations for

> the TSH level.

>

> This guy has been a real pain to deal with but today I think we may

> have finaly found a way to work together - he gave and I gave and we

> both felt good when the session ended. I am still not sure that I

> fully trust him but I think he will now let me help determine my

> treatments (yes!). So if a TSH of 0.027 is too low then I want to

> know to discuss it with him.

>

> Thanks

> Joan

[Guest guest]

Joan,

Generally speaking 0.027 is an unnecessary suppression, it's very

hyper. Are you sure he didn't say 0.27? The fact that your TSH was

1.7 after only 5 weeks on meds was excellent. In another month it may

have been at 0.10 on your 150mcg. Your doctor appears to be pushing

the envelope to get you to suppression faster. If you start having

palpatiations or get really tired (it can be a hyper symptom) make

sure you call him and ask for another TSH. Once in suppression we

become super sensitive to dose changes. A tiny dose change can make

you feel great or darn right miserable.

Here is a TSH scale:

1.00 down>>0.75 >>0.50..0.25.. 0.15 and you goal is 0.10...0.05

Keep us posted.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

> I just met with my endo to review my first blood test results since

> RAI. Blood work was 5 weeks after starting back on meds (150mcg

> Synthroid) and my TSH was 1.7. He has upped my dosage to 175 mcg and

> says he is shooting for my TSH to be 0.027 (which sounds a lot lower

> then <0.1 that I keep seeing in messages. But I am not a doctor nor

> a mathematician....

>

> So, I would love to hear your opinions about his recommendations for

> the TSH level.

>

> This guy has been a real pain to deal with but today I think we may

> have finaly found a way to work together - he gave and I gave and we

> both felt good when the session ended. I am still not sure that I

> fully trust him but I think he will now let me help determine my

> treatments (yes!). So if a TSH of 0.027 is too low then I want to

> know to discuss it with him.

>

> Thanks

> Joan

[Guest guest]

Christy,

The well known YMMV applies here. .02 is fine for some people. The

differenece between .02 and .01 is of no importance IF YOU FEEL OKAY.

Do you feel okay? Generally speaking doctors prefer to keep their

patients at a higher number. You are on a very high dose to achieve

suppression...do you know if you will hold suppression at a lower

dose? I do not know why the doctor wants you at a non-detectable

0.00, did you ask him why? On this list 0.10 has always been the

guideline and goal.

As for losing weight to fit the dose, I was told that actually the

dose is based on lean body mass. In my case there is NO lean body

mass that I am aware of ( but my doctor assured me it's lurking

underneath the excess baggage. If weight was the basis for medication

I would be on an astronomical dose. Losing weight is always a better

way to go but I don't know how it effects the dosage. Maybe someone

else here can give you better input on that.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

>

> Gail -

> My TSH was recently measured at .01 and my doctor said we're

shooting for non-detectable! If .02 is two low, isn't .01?? And why

would he want to go lower? He didn't increase my dosage (I'm

currently on .325 right now) but suggested I lose 10 pounds to better

" fit " my dosage. Your thoughts? Thanks..

> Christy

[Guest guest]

Christy,

The well known YMMV applies here. .02 is fine for some people. The

differenece between .02 and .01 is of no importance IF YOU FEEL OKAY.

Do you feel okay? Generally speaking doctors prefer to keep their

patients at a higher number. You are on a very high dose to achieve

suppression...do you know if you will hold suppression at a lower

dose? I do not know why the doctor wants you at a non-detectable

0.00, did you ask him why? On this list 0.10 has always been the

guideline and goal.

As for losing weight to fit the dose, I was told that actually the

dose is based on lean body mass. In my case there is NO lean body

mass that I am aware of ( but my doctor assured me it's lurking

underneath the excess baggage. If weight was the basis for medication

I would be on an astronomical dose. Losing weight is always a better

way to go but I don't know how it effects the dosage. Maybe someone

else here can give you better input on that.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

>

> Gail -

> My TSH was recently measured at .01 and my doctor said we're

shooting for non-detectable! If .02 is two low, isn't .01?? And why

would he want to go lower? He didn't increase my dosage (I'm

currently on .325 right now) but suggested I lose 10 pounds to better

" fit " my dosage. Your thoughts? Thanks..

> Christy

[Guest guest]

Christy,

If you have had doubts about your endo's knowledge then obviously you

need to seek another opinion. Yes, you should ALWAYS question a

doctor if there is something you want to clarify. You might also ask

him how many thyca patients he has treated and IS treating right now.

This will give you some idea of his level of experience. It is

important to use a doctor experienced in the management of thyca with

a significant case load. ly, it sounds like the doctor just has

the suppression number turned around in his head.

If you need to be an *uncooperative patient* in order to get the

appropriate treatment then so be it. Your life and your health are

more important than appeasing a doctor.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

-- In Thyca@y..., Christy <thycamail@y...> wrote:

>

> Hi Gail,

> I feel fine although I do have occasional bouts of high blood

pressure on standing, but I had those long before I was diagnosed with

Thyca. I have to admit, though, after reading the threads on this

subject, I'm more confused than ever. My endo said the recommended

supression levels for thyca are <.01, or undetectable, but this

certainly sounds low based on your comments.

> Unfortunately, I've had " questions " about my endo's depth of thyca

knowledge and have even more, now. I know he's good in diabetes

because he treated my daughter for years, but he seems somewhat

out-of-touch with thyca. He was going to do my first scan with

thyrogen until I objected. He " consulted " with another doctor who

agreed it was important to do a withdrawl scan. There have been

several other issues I've disagreed with him on, mainly, his

reluctance to ablate based on an almost undetectable Tg level but a

scan showing " minimal uptake " .

> Question: Should I question him on my levels, too? I don't want to

be an " uncooperative patient " but everything I read here is

contradictory to what he says.

> As always, thank you and everyone for their valuable input!

>

>

[Guest guest]

Christy,

If you have had doubts about your endo's knowledge then obviously you

need to seek another opinion. Yes, you should ALWAYS question a

doctor if there is something you want to clarify. You might also ask

him how many thyca patients he has treated and IS treating right now.

This will give you some idea of his level of experience. It is

important to use a doctor experienced in the management of thyca with

a significant case load. ly, it sounds like the doctor just has

the suppression number turned around in his head.

If you need to be an *uncooperative patient* in order to get the

appropriate treatment then so be it. Your life and your health are

more important than appeasing a doctor.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

-- In Thyca@y..., Christy <thycamail@y...> wrote:

>

> Hi Gail,

> I feel fine although I do have occasional bouts of high blood

pressure on standing, but I had those long before I was diagnosed with

Thyca. I have to admit, though, after reading the threads on this

subject, I'm more confused than ever. My endo said the recommended

supression levels for thyca are <.01, or undetectable, but this

certainly sounds low based on your comments.

> Unfortunately, I've had " questions " about my endo's depth of thyca

knowledge and have even more, now. I know he's good in diabetes

because he treated my daughter for years, but he seems somewhat

out-of-touch with thyca. He was going to do my first scan with

thyrogen until I objected. He " consulted " with another doctor who

agreed it was important to do a withdrawl scan. There have been

several other issues I've disagreed with him on, mainly, his

reluctance to ablate based on an almost undetectable Tg level but a

scan showing " minimal uptake " .

> Question: Should I question him on my levels, too? I don't want to

be an " uncooperative patient " but everything I read here is

contradictory to what he says.

> As always, thank you and everyone for their valuable input!

>

>

[Guest guest]

Christy,

If you have had doubts about your endo's knowledge then obviously you

need to seek another opinion. Yes, you should ALWAYS question a

doctor if there is something you want to clarify. You might also ask

him how many thyca patients he has treated and IS treating right now.

This will give you some idea of his level of experience. It is

important to use a doctor experienced in the management of thyca with

a significant case load. ly, it sounds like the doctor just has

the suppression number turned around in his head.

If you need to be an *uncooperative patient* in order to get the

appropriate treatment then so be it. Your life and your health are

more important than appeasing a doctor.

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

-- In Thyca@y..., Christy <thycamail@y...> wrote:

>

> Hi Gail,

> I feel fine although I do have occasional bouts of high blood

pressure on standing, but I had those long before I was diagnosed with

Thyca. I have to admit, though, after reading the threads on this

subject, I'm more confused than ever. My endo said the recommended

supression levels for thyca are <.01, or undetectable, but this

certainly sounds low based on your comments.

> Unfortunately, I've had " questions " about my endo's depth of thyca

knowledge and have even more, now. I know he's good in diabetes

because he treated my daughter for years, but he seems somewhat

out-of-touch with thyca. He was going to do my first scan with

thyrogen until I objected. He " consulted " with another doctor who

agreed it was important to do a withdrawl scan. There have been

several other issues I've disagreed with him on, mainly, his

reluctance to ablate based on an almost undetectable Tg level but a

scan showing " minimal uptake " .

> Question: Should I question him on my levels, too? I don't want to

be an " uncooperative patient " but everything I read here is

contradictory to what he says.

> As always, thank you and everyone for their valuable input!

>

>

[Guest guest]

>

> My endo said the recommended supression levels for thyca are <.01,

> or undetectable, but this certainly sounds low based on your

> comments.

>

> Question: Should I question him on my levels, too? I don't want to

> be an " uncooperative patient " but everything I read here is

> contradictory to what he says.

The TSH goal is < 0.1, not < 0.01 - it's the TG that should be

undetectable. I would DEFINITELY question the endo about this.

Assertiveness training 101 - You can question him without confronting

him (the difference between " My understanding is that my TSH should be

<0.1. I'm curious as to why you why you want it to be <0.01 instead "

and " You idiot, don't you know that my TSH should be <0.1, not

<0.01 ?!?! " )

Asking questions does not make you an uncooperative patient, it makes

you an informed one. A good doctor will have no problem having you

politely ask questions.

> He didn't increase my dosage (I'm currently on .325 right now) but

> suggested I lose 10 pounds to better " fit " my dosage.

I don't know about you, but I find this comment to be insensitive and

insulting. My opinion only.

Cheers,

Alisa

Currently off Levoxyl and on Cytomel for scan 12/16/02

2/15/2002: Nodule found 2/27/2002: FNA

3/4/2002: Hysterectomy/oopherectomy-possible ovarian cancer - BENIGN!!

4/9/2002: TT - Stage 2 pap 2.5 x 2 x 1.6 cm nodule, dx Hashimotos

5/28/2002: TBS and 100 mCi RAI 6/6/2002: TBS - No sign of mets

Age: 48 -- Location: near Seattle WA --- Check out my posts:

Radioactive Girl - http://groups.yahoo.com/group/Thyca/message/19472

My LID - http://groups.yahoo.com/group/Thyca/message/15872

My RAI - http://groups.yahoo.com/group/Thyca/message/15873

[Guest guest]

>

> My endo said the recommended supression levels for thyca are <.01,

> or undetectable, but this certainly sounds low based on your

> comments.

>

> Question: Should I question him on my levels, too? I don't want to

> be an " uncooperative patient " but everything I read here is

> contradictory to what he says.

The TSH goal is < 0.1, not < 0.01 - it's the TG that should be

undetectable. I would DEFINITELY question the endo about this.

Assertiveness training 101 - You can question him without confronting

him (the difference between " My understanding is that my TSH should be

<0.1. I'm curious as to why you why you want it to be <0.01 instead "

and " You idiot, don't you know that my TSH should be <0.1, not

<0.01 ?!?! " )

Asking questions does not make you an uncooperative patient, it makes

you an informed one. A good doctor will have no problem having you

politely ask questions.

> He didn't increase my dosage (I'm currently on .325 right now) but

> suggested I lose 10 pounds to better " fit " my dosage.

I don't know about you, but I find this comment to be insensitive and

insulting. My opinion only.

Cheers,

Alisa

Currently off Levoxyl and on Cytomel for scan 12/16/02

2/15/2002: Nodule found 2/27/2002: FNA

3/4/2002: Hysterectomy/oopherectomy-possible ovarian cancer - BENIGN!!

4/9/2002: TT - Stage 2 pap 2.5 x 2 x 1.6 cm nodule, dx Hashimotos

5/28/2002: TBS and 100 mCi RAI 6/6/2002: TBS - No sign of mets

Age: 48 -- Location: near Seattle WA --- Check out my posts:

Radioactive Girl - http://groups.yahoo.com/group/Thyca/message/19472

My LID - http://groups.yahoo.com/group/Thyca/message/15872

My RAI - http://groups.yahoo.com/group/Thyca/message/15873

[Guest guest]

>

> My endo said the recommended supression levels for thyca are <.01,

> or undetectable, but this certainly sounds low based on your

> comments.

>

> Question: Should I question him on my levels, too? I don't want to

> be an " uncooperative patient " but everything I read here is

> contradictory to what he says.

The TSH goal is < 0.1, not < 0.01 - it's the TG that should be

undetectable. I would DEFINITELY question the endo about this.

Assertiveness training 101 - You can question him without confronting

him (the difference between " My understanding is that my TSH should be

<0.1. I'm curious as to why you why you want it to be <0.01 instead "

and " You idiot, don't you know that my TSH should be <0.1, not

<0.01 ?!?! " )

Asking questions does not make you an uncooperative patient, it makes

you an informed one. A good doctor will have no problem having you

politely ask questions.

> He didn't increase my dosage (I'm currently on .325 right now) but

> suggested I lose 10 pounds to better " fit " my dosage.

I don't know about you, but I find this comment to be insensitive and

insulting. My opinion only.

Cheers,

Alisa

Currently off Levoxyl and on Cytomel for scan 12/16/02

2/15/2002: Nodule found 2/27/2002: FNA

3/4/2002: Hysterectomy/oopherectomy-possible ovarian cancer - BENIGN!!

4/9/2002: TT - Stage 2 pap 2.5 x 2 x 1.6 cm nodule, dx Hashimotos

5/28/2002: TBS and 100 mCi RAI 6/6/2002: TBS - No sign of mets

Age: 48 -- Location: near Seattle WA --- Check out my posts:

Radioactive Girl - http://groups.yahoo.com/group/Thyca/message/19472

My LID - http://groups.yahoo.com/group/Thyca/message/15872

My RAI - http://groups.yahoo.com/group/Thyca/message/15873