Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in to us. I have read through your query in detail. You might be taking eltroxin treatment for hypothyroidism. The T3 and freeT4 levels are also important when dealing with thyroid disorders. In primary hypothyroidism, TSH levels are significantly elevated, while in secondary and tertiary hypothyroidism, TSH levels are low or normal. The relation of TSH and hypothyroid state is as follows: Until 2002, the official TSH "normal range" that laboratories and most doctors used throughout the U.S. was a range of 0.5 to 5.0. On that range, a TSH under 0.5 (a low TSH) indicated hyperthyroidism (an overactive thyroid), and a TSH over 5.0 (a high TSH) indicated hypothyroidism (an underactive thyroid.) Since late 2002, however, the American Association of Clinical Endocrinologists (AACE) and other professional groups have recommended a narrower range of .3 to 3.0. This means that hyperthyroidism is suspected at TSH levels below .3, and 3.0 and above may be considered diagnostic of hypothyroidism. So going by the new set of rules you might be having hyperthyroidism based on the normal range of TSH. You may need to get your thyroid hormones (T4 and T3) levels checked. Your heart rate need not necessarily always be high and reflect hyperthyroidism. Hope you query is answered. Please do write back if you have any doubts. Regards, Dr.Vivek

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Brief Answer: Dose to be adjusted with TSH and free T4 levels Detailed Answer: Hi Thanks for writing in with an update. Once levothyroxine (eltroxin) treatment has been initiated, the dosage should be adjusted every four to eight weeks until the patient becomes euthyroid. The goal of therapy depends on the clinical situation. In elderly and younger patients with symptomatic heart disease, TSH levels should be maintained within the mid to upper range of normal. In healthy young patients, a TSH in the lower range of normal should be considered. A goal of 1 to 1.5 mU/L would be a reasonable starting point. Clinical progress should be evaluated at each appointment as the patient transitions from hypothyroidism to the normal thyroid state. A repeat TSH and free T4 levels are to be drawn before visiting your doctor. This will give a more comprehensive picture than TSH alone and help towards dose management. Hope you query is answered. Please do write back if you have any doubts. Regards, Dr.Vivek

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