What is your approach to the patient who has a TSH of 2.5—well within the normal range—but the patient still has symptoms? Is there a rationale for bringing the TSH down to, let’s say, 1. 0 or 0.7, that is, to a lower level within the normal range?
no. Another point that's interesting is, uh, let's say a patient Has a we're treating that patient, and the TSS is 2.5, well within the normal range. But the patient has symptoms and symptoms are vague and, you know, they can't put the finger, Is it worth increasing the dose of legal tire oxen and say, oh, yeah, let's bring this TSH down to one, let's bring this TSH down 2.7. Because that's also within the normal range. Is it worth doing that exercise? And I don't think we have a lots of clinical studies that addressed as clinical trials. Uh, There are some studies that show that this is really not very helpful. I can tell you that from my personal experience in my office. Uh Some patients respond very well to a change in TSH from 2.52 point 75. Other patients couldn't care less now, whether or not that's a placebo effect just because the patients taking that extra half a tablet on sunday morning. uh, and if that makes a difference, uh or it's a it's the placebo. Is it the extra thyroid hormone that we're giving? I don't know the answer to that. However, It shows that you care for the doctor to be interacting with the patient and say, I hear you, I see that you have a problem, You're you're complaining and there is something I can do. I can give you a little bit more of legal tire oxen or whatever replacement therapy and I can reduce safely your TSH because it's still within the normal range. I think patients appreciate that, appreciate that the doctor is taking ownership and is trying to help again, whether this is actually uh biological effect that's triggered by the slightly elevated those of thyroid hormone or if it's a placebo effect, I don't know, but that helps in many cases, but very, you know, in other cases, it really is not helpful
