Why your thyroid labs NEED to be checked at peak hormone levels

You guys want to know why we check labs at the peak of thyroid hormones? I'll tell you why. Patient comes in to one of our clinicians. We reviewed the case this morning. In August and November, her active thyroid hormone on NP and cytomel was 2.9 and 3.5. 2.9 is low. So what do they do? They increase it. 3.56, still kind of low. What do they do? They adjust it, they increase it. Now she comes in to see us on an obscene amount of T3 or Cytomel twice a day. We check her labs at her peak and her peak T3 is 9.4. Not okay, not safe, massively over medicated. But what would have happened if this person went back to the same clinician again, had her thyroid labs, checked off her meds? They would have increased her meds again had she not seen us. This is how people get into dangerous situations with over medication of Cytomel or T3 meds in general because we are not getting good information. This also take into consideration when other people say, oh you guys, y' all put up people on too much T3. No, we are checking their labs at the very tip top of their medication so that we can protect them from over medication.