Thyroid meds/ target levels

My last thyroid test was much higher than what it has averaged the last 10 years. But was still within “normal” limits. My previous endo was aggressive with keeping at lower end of range. But current one doesn’t agree. (I have been on T-meds synthroid, levoxyl, etc for over 30 years).

So i agreed to wait and get another test, which is coming up. I did have, and still have symptoms related to low thyroid, but until i saw previous results, had attributed that to other factors.

Any suggestions regarding thyroid ranges that work for you ? (TSH)

For example i found this, supporting lower ranges.

What should your TSH level be?

Normal TSH levels for the average adult range from 0.4 ‑ 4.0 mIU/L (milli-international units per liter) (3).

However, many organizations agree that a reading of 2.5 or less is truly ideal for normal thyroid levels, with anything 2.5 – 4.0 mIU/L considered “at risk”.

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I’ve never taken thyroid meds (yet). My last TSH was around 11. When confronted with this test result, I asked my Dr to run a free T3 test, which was normal. I’m asymptomatic, near as I can tell, so he agreed that drug therapy isn’t warranted at this time.

I’m under the impression that TSH is an indicator that doesn’t tell the full story - T3 and T4 tests are what’s needed. Correct?

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Sounds right. But my endo didnt agree to order tests, since my tsh was in range.

My opinion is the reference range on thyroid tests is very fuzzy.

We have had lots of thyroid lab work. So rather than use lab reference range, we watched trend over many tests. Typically it was a panel and not just the one test.

In addition to lab work, just as important was symptoms that were likely thyroid related. Can’t only use symptoms IMHO as some of the symptoms are so general that pretty much anybody could say they have them.

But symptoms in conjunction with trending lab work is (IMHO again) a good approach.

And at the end of the day, what would the treatment be? For some thyroid issues, the treatment may not necessarily have significant side effects so potentially if borderline, it might be worth it to try the treatment, see if the symptoms resolve, run some more labwork while on treatment and see what that looks like. Then decide. Continue treatment, increase treatment, decrease treatment or stop treatment.

It is not always so easy to be exact. With some stuff, a good approach can be to feel your way through.


Thanks. Unfortunately current endo believes in the reference range. Maybe he will order the full suite. Hopefully i will be armed with information to have a constructive conversation with him.

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Yep, that is correct. For my cat, too!


In the years before I developed thyroid problems, my TSH was checked yearly and was almost always between 1.5 to 2.5.

Based on that evidence, I would say I do feel best when my TSH is between 1.5 and 2.5. However, my endocrinologist considers anything within the lab’s range (which for my lab is up to 5.0) to be normal.

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I have been athyroid for about 40 years after papillary carcinoma/ hashimotos destroyed my thyroid. For all that time I was on 150mcg daily.

My last idiot endo who I weat to after my endo passed away told me I had to cut down to 135mcg daily.

I tild him that I had tried that about 15 years ago and I ended up with triglycerides over 1000 and in near thyroid crises. I told him thank you but I’ll just stay on 150mcg. He unceremoniously dismissed me from his practice. I told him the feeling is mutual.

Needless to say I’m still taking 150mcg/day.