Abnormal TSH levels

[LorriePalmer]

8 days ago I was being screened for a research study. As part of the screening process, fasting blood was drawn. The results showed a TSH level of 4.04 which is slightly out of the referent range. I called my doctor and faxed her the lab results. I have always been symptomatic but never out of range. She informed me that my last TSH was at 1.9 and suggested I come in for a complete panel which included an Antibody test. I went in and my blood was drawn again. After being drawn I filled a script for 50mcg of Levothyroxine and then began taking the medication. Labs came back yesterday and it showed my TSH at 1.8; remember, I still have not taken any medication.  Can a TSH level fluxuate that much from a fasting draw in the AM to a none fasting draw in the PM?

[Mark Lupo, M.D.]

A tsh can fluctuate a bit -- also could be the different lab assays used by the research study and your doctor.  At TSH of 1.8 does not necessarily need treatment, but if the antibodies are positive, the likelihood of progressing to consistent hypothyroidism is higher.

[cosmicsoul]

Do you have antibodies for Hashimotos? (TPO). If so - you are hypothyroid not yet needing medication... Remember TSH 4 is not normal, but TSH 1-2 is. So as long as you monitor - and your TSH is good you do not need to take medicine yet... However - your other thyroid numbers (T4, T3, FreeT3, FreeT4) should also be in the upper ranges...It is good that you notice this before things go abnormal and no one is diagnosing you. At this point you can keep your eye on this issue and act if needed. Good luck to you!

[1547]

My advice is always listen to trained medical professionals.  People on here are well meaning, but to state that "TSH of 4" is not normal is somewhat misleading, as many labs, rightly or wrongly, think 4 is upper normal.

Please follow the advice of your doctor, and don't cause yourself needless anxiety by heeding armchair advice.

[cosmicsoul]

Please research the controversies about lab "normal" ranges - tons of stuff out there. Just because the lab document lists TSH normal - in this particular case - the range is outdated and many doctors do not follow it. There is tons of stuff on the net about this - even the dr. on this forum believes that a TSH 4 is HIGH. He is a trained medical doctor and PROFESSIONAL.

[1547]

Yes, I am well aware of that.  You are not a doctor; don't pretend to be one please.  Just because you read something on the "internet" does not give you the right to diagnose people.  You may think you have the answers, but your little power trip could hurt someone.  Think of that, would you?