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Ms. Warren's TSH level is 41. The normal range for the TSH , depending on your...

Ms. Warren's TSH level is 41. The normal range for the TSH , depending on your institution is approximately ( 0.4-5.0 mU/L ) What is her diagnosis ? What medication, if any, should the Nurse Practitioner prescribe ? How often should the Nurse Practitioner monitor a TSH ? What should the TSH goal be?

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Ans.

Normal Values:

Normal values are from 0.4 to 4.0 mIU/L for those with no symptoms of an under- or over-active thyroid. If you are being treated for a thyroid disorder, your TSH should be between 0.5 and 2.0 mIU/L.

Your TSH levels will be increased, if: Your thyroid gland is not working as it normally should. Your thyroid gland is infected or inflamed, as in Hashimoto's thyroiditis, or autoimmune thyroiditis. This occurs when your body is attacking your thyroid gland, for some unknown reason.

The treatment of choice for Hashimoto's thyroiditis is typically synthetic T4 or thyroxine (levothyroxine). Brand names for this medication include Synthroid, Levothroid and Levoxyl. The medication must be taken indefinitely, and successful treatment alleviates the symptoms and signs of hypothyroidism.

Monitor TSH A TSH blood test should be obtained at least every 6-12 months while you are on a stable thyroxine dose, and more often if your dose is changed. Your doctor will usually wait 6-8 weeks after a thyroxine dose adjustment to measure your TSH, when the levels of thyroxine have reached a steady state.


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