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Thyroid testing
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Thyroid testing

I recently had  an acute GI episode where I went to the urgent care clinic and had some blood work done. I recovered from the GI symptoms and had a TSH level done at the time. The TSH level was 8.6(0.2-5.5). My primary care doc said that since my wbc count was slightly elevated the TSH level wasn't reliable and to retest in a week or so. I retested a week later or so and my TSH was still at 4.6. She then said that I probably retested too soon and it may have been falling. Fast forward 6 weeks. I had my TSH done on Tue(7/3) and it was still at 4.6. I have been feeling achey (achy) and foggy along with being tired alot. She says 4.6 is well within normal limits and no further testing is needed. Past medical hx(5 years ago), I had an episode of hyperthyroidism dx'd by lowered TSH and symptoms(palpitations, sweating). I had a nuclear med scan with radioactive Iodine dx'd as thyroiditis by the radiologist while I was still on the table.
Summary of Thyroid tests:
TSH 0.1 5 years ago
TSH 3.8 and free t4 1.2(0.8-1.7) 1/06
TSH 8.6 5/07
TSH 4.6 6/07 and free t4 1.1
TSH 4.6 7/07 4.6
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97953_tn?1193367871
The labs suggest mild underactive thyroid.  You may have never fully recovered from the thyroiditis last year.  Would test thyroid antibodies, as if these are positive, the hypothyroidism is likely not to improve on its own.  With these symptoms, a trial of treatment is worth considering.
2 Comments
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222507_tn?1255635649
I am sorry that you are having difficulties. I think it is time to find another doctor. TSH 4.something is not really or dangerously high but your doctor is wrong..... You are hypothyroid - although it could be beginning stage.  A healthy thryroid works with a TSH of 1.5 or so. Anything above 2 should be an alarm and if you have symptoms you need to take thyroid medicine. Most doctors prescribe Synthetics - which may work somewhat but deffinately make you feel better. They did not work for me after a while and I switched to Armour which is great for me but that is another story! I think you need to go to an Endo and tell your symptoms, let them run a few tests like TSH again, T4, T3, FreeT4, FreeT3, thyroid antibodies (TPO). You can have high antibodies which indicate Hashimotos thyroiditis (I have that) and that will make you have those symptoms with normal TSH and thyroid results too! Unfortunately most doctors do not know much about thyroid (there are exceptions!!!) so you have to educate yourself about this disease and how to live the best way even with the condition. Don't give up and find another doctor that will work with you. Your dr. is wrong about the range - the up to 5.5 range is no longer valid - she can contact the clinical endocrinologist association and check on that or have her do some reseach to find it out if she does not believe you. Good luck!
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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