Thyroid Therapy Online Journals
When brooding about monitoring thyroid therapy it's important to think about the function of the hypothalamic pituitary system also because the thyroid. In primary hypothyroidism, the hypothalamic/pituitary system also becomes functionally 'hypothyroid' and takes time to recover and answer the rising levels of thyroxine. Thea's hypothyroidism has probably been present for 1–2 years and she or he is now profoundly hypothyroid with a really high TSH. However, gradual replacement as described above should allow many time for her system to recover. The half-life of T4 is 1 week. Generally, it's thought that six half-lives of the medication are required before levels reach a gentle state. Thea's thyroid function should be checked 6 weeks after starting the complete replacement dose. In primary hypothyroidism, TSH levels are the foremost useful test for monitoring. Free T4 is usually ordered as well, however, TSH is thought to be the most accurate measure. After commencement of treatment the TSH should gradually decrease into, but not below, the reference range. Free T3 isn't useful in diagnosis or in monitoring replacement and isn't usually provided by the laboratory. But it's useful to notice that with therapeutic thyroxine therapy, free T3 levels tend to be slightly lower and free T4 levels slightly above normal. This is because the thyroid normally produces all the circulating T4 and 25% of the circulating T3, with most of the T3 produced in the
tissues by conversion of T4 to T3. In therapeutic thyroid replacement, only T4 is given then subsequently converted to T3 within the
tissues leading to lower levels of serum T3. With adequate replacement the TSH will vary round the middle of the traditional range, the free T4 are going to be high normal or high and therefore the free T3 are going to be low normal or low.
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