TSH Monitoring and Dose Adjustment (Per Harrison’s):
✅ Normal TSH Range:
0.4 – 4.0 mIU/L (some labs accept up to 5.0)
🟠 TSH 5.0:
Mildly elevated, but improved from baseline 9.0
Suggests partial correction, dose is likely effective
But may still need slight adjustment if target is full normalization
🟢 Recommended Plan:
Continue current dose (100 mcg) for 6–8 more weeks without missing any days
Repeat TSH at 8 weeks total from current dose stability
If TSH drops into 1–3 range, maintain or reduce to 88 mcg
If still >5, increase slightly only under supervision (to 112.5 mcg)
❗Important Notes:
Do not change the dose on your own
Take Thyronorm on empty stomach, same time daily
Avoid iron/
calcium supplements within 4 hours of dosing
📘 Reference:
Harrison’s Manual of Medicine, Endocrinology section:
TSH should be monitored 6–8 weeks after dose change; adjust dose in 12.5–25 mcg steps. Goal TSH: mid-normal range for age.
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