Thyroid Disorders Community
Elevated TSH
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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Elevated TSH

Hi, I finally requested bloodwork being the past 3 years weight gain bloating and so on age (49) so here are my results - in which by obgyn said was high -- so seeing doctor next week but not sure what to think till then... TSH 6.75 - Hemoglobin 12.1 - Hematocrit 36.4 -- those are the only 3 circled --- Could someone please give me some imput if possible?  thank you kindly
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Avatar_f_tn
TSH is the only thyroid test there.  It's somewhat elevated, which could indicate that you are hypo.

Did they run any other thyroid tests?  Do you see T3 or T4 or FT3 or FT4 to T4, free or T3, free on your lab report?  If so please post those results with reference ranges (they vary lab to lab and have to come from your own lab report).  These might not be circled, but it's important to look at them anyway.  Did the do thyroid peroxidase antibodies (sometimes called microsomal or abbreviated TPOab)) or thyroglobulin antibodies (TGab)?
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Avatar_f_tn
CBC/BCG/ET4/TSH/PROL/LH/FSH/ESTDL
6.75 H   Ref range 0.40 - 4.50 mIU/L
TSH

T4, Free   0.9    Ref range 0.8 - 1.8 ng/dL

CBC (H/H,RBC, IND, WBC, PLT)  
                   In range      Out of range       Ref range
WBC               5.2                                       3.8 - 10.8 thous/mcl
RBC                4.92                                     3.80 - 5.10 mill/mcl
Hemogloibin   12.1                                      11.7 - 15.5 g/dl
Hematocrit      36.4                                      35.0 - 45.0 %
MCV                                   74.1 L                80.0 - 100.0 fL
MCH                                   24.5 L                27.0 - 33.0 pg
MCHC              33.1                                      32.0 - 36.0 g/dL
RDW                                   15.5 H                11.0 - 15.0 %
platelet count    233                                      140-400 thous/mcL  
MPV                  9.6                                        7.5 - 11.5 fL

FSH                   11.2                                      mIU/mL

CBC/HCG/FT4/TSH/PROL/LH/FSH/ESTDL PROLACTIN
In range -- 6.1      
ref range  ng/mL female - postmenopausal - 2.0-20.0

ESTRADIOL  In range -- 88          
ref range - policular phase     19 - 144
                  mid cycle              64 - 257
                  luteal phase          56 - 214
                  postmenopausal  < or = 31

HCG, total, QN    
In range    < 2
Ref range  
Non preg or pre-menopausal     < 5      
Post menopausal                       < 10
              
Thank you
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Avatar_f_tn
My TSH is 6.75 - but my T 4 Free is  0.9 -- I listed my lab results -- just not sure what to think... have about 25 lbs up in a little more than 2 years and concerned that I cannot lose the weight but seem to increase 10 lbs year not to mention my health concerns.  Dr appt next week but in reading on here I see at times it is trial and error and only to find themselves years at the care of a Dr to only still not be clear from the symtoms (symptoms)!  This is scary!
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Avatar_m_tn
While the free T4 is within the range.  It is on the VERY bottom end of the range.

Many people have found that to feel well they need BOTH of the following to be true.

1) Their Free T4 to be in the MIDDLE of the range or higher.

AND

2) Their Free T3 to be in the UPPER 1/3 of the range.

Notice that these are WELL up in the range and not just "somewhere within the range". Do NOT let a Dr simply tell you that you are "normal" and everything is fine simply because you fall within the bottom part of the range.

Your elevated TSH and your very low in range Free T4 would suggest that you very likely are Hypothyroid.

I would recommend that you also DEMAND to be tested for Free T3.  Additionally I would recommend that you be tested for the two Hasimoto's antibodies. These are TPOab and TGab.  Furthermore testing a few vitamins is generally also recommended.  These being Vit D3, and Vit B-12 as well as selenium and iron.  it is pretty common for people with low thyroid to also be low in one or more of these as well.  Also with these many people have found that they need to be at least mid range or towards the upper end of these vitamin ranges to feel well.  The ranges on these are typically VERY broad.

Other than weight gain what other symptoms do you have? You may want to go to a hypo thyroid site to get a list of typical symptoms to see if you have some of them.  Common or more frequent symptoms are fatigue, dry skin, hair loss, cold insensitivity, high cholesterol, constipation and menstrual irregularities.

NEVER let a Dr only test or look at TSH. It is a screening tool at best and is TOTALLY inadequate to adjust medication levels. Any Dr relying solely on TSH will almost certainly keep you sick or not feeling your best.  Also any Dr who will only treat you to just barely get into the bottom part of the reference ranges for Free T3 and Free T4 will also keep you from feeling your best.  Every person is different but the mid-range or above is MUCH more common to start to feel well and a target to shoot for.
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Avatar_f_tn
Yes, your TSH is elevated, which indicates hypo.  Your FT4 is also too low.  It's in range, but way too low in the range.  Thyroid test ranges are flawed, and as a result, the whole bottom half of the FT3 and FT4 ranges is questionable.  Many people have to be at midpoint of range on FT4 before they feel good.  You're a long way below that.

You would probably feel better on thyroid meds.  Hopefully, since your TSH is elevated your doctor will want to put you on meds (TSH isn't all that important, but many doctors think it is).  

It is somewhat trial and error, especially at the beginning, trying to establish a correct dose.  Probably the most important thing you can do is request FT3 and FT4 every time labs are run.  Get a copy of your lab report and note meds and symptoms just prior on it.  Then, keep your own history and be your own advocate.  If your doctor wants to treat on the basis of TSH only, you may have to find a more enlightened doctor.  

Many people start meds seamlessly.  We're all on this forum because we weren't textbook cases.  There's no reason you shouldn't assume fo now that you'll be one of the lucky ones.
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649848_tn?1357751184
Your MCV, MCH and RDW indicate anemias...... the low MCV indicates iron deficiency anemia and the RDW indicates pernicious anemia.  MCH is a calculated result that indicates the oxygen carrying hemoglobin inside the red blood cells.

You should get a full iron panel, along with vitamin B12 to confirm/rule out both types of anemia.  

If you get the thyroid antibody tests, be aware that TPOab can be slightly elevated with pernicious anemia, which is another autoimmune, so a low positive may not definitively indicate Hashimoto's.
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Avatar_m_tn
Great response!  Brief, informative and right on point.
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649848_tn?1357751184
That's my goal - no use adding a bunch of "fluff" that doesn't apply to the situation...........lol
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Avatar_f_tn
Thank you for your very informative response that all makes so much sense when reading this I feel somewhat better.  I will ask for those tests upon my visit with him on wednesday.  Once I get my results I will post.  

Other symtoms (symptoms) there were times hair loss more than usual.  Some anxiety at night, where my heart feels like it is racing - have to catch my breath.  Irregular menstrual, last was in Sept, but now it returned in March and April on schedule.  I had thought all the symptoms was pre-menopausal... but that is not the case based on my test results.  

Thank you again.
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Avatar_f_tn
lol yea so the road to it all begins.  Well at least Im with a very lucky great group to have found and thank you for being so helpful and informative.  I will take those tests and hope that I see the results least I get this weight gain under control, for me that is the worse part.  Not to mention the lack of breathing I feel at times not sure if it just worrying or it is all related.  Getting my T3 up and running again, seems to be the key and that gives me hope to get back to more healthy lifestyle again.

Thank you and will post my new results.
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Avatar_f_tn
Thank you Barb, I will add those tests to the list, seems I have my work cut out for me but I will give all the blood they need to get me tuned up again... lol   It just shows how important it is to request certain tests regardless, Drs can be great, but we know ourselves and this forum has been a blessing!

Thanks again for your input.
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1139187_tn?1355710247
I'd like to chime in and focus on something barb said.   You need to get the tpo and tgab antibodies checked because although your tsh isn't crazy high,   This could be the beginning of the destruction and diminished activity of the gland.  Some of your doctors may tell you not to worry because the tsh is still under 10 but if you test positive for antibodies will be a more definitive clue as to what's happening and what lies ahead.
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Avatar_f_tn
Thank you kindly Bruce for your input, and so very welcomed, I will be asking to take those tests too.  In this day and age we have to look beyond the obvious.  It seems there is so much more going on and is it ever simple?  Oh the agony of it all... but very thankful that you all have made me feel welcomed and so informative with your responses.  When  you get diagnosed with whatever it is, you feel so lost and empty -- you need answers to have and not only relay on the doctors.

Thank you so very much again.

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Avatar_f_tn
Also forgot to add... to the symptoms... headaches.  Guess that is all part of the inbalance
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1139187_tn?1355710247
I got horrible headaches on synthroid and t4 only.  God i wish i could just take that stuff.   The headaches were in the front and very bizarre.
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Avatar_f_tn
That is tougth to deal with - I know at times my headache was in front but not due to meds.  They seem less frequent, but not sure if related to this.  Perhaps the stress of it all or my system off balance.
What are you taking now - or are you no longer need to take?
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1139187_tn?1355710247
I have tinkered around with almost every medication until recently.  I have been taking erfa which is the candadian version of armour here in the states.  I order it from a mail order company.   My doctor tried adding in a little t4 as the generic version of synthroid to try to build my reserve ft4 tank but it was too overwhelming for me and i had to get off of it after only 10 days.   The headache was horrible and have since gone away since stopping the additional t4.
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Avatar_f_tn
That sounds so frustrating and yet the alternative seems better.  How are you now and are you currently taking anything?
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1139187_tn?1355710247
I'm on 2.5 grains armour which is natural hormone therapy.   Equal to about   100 mcg t4. And 20 mcg t3.   I cannot tolerate synthetics at all.   Synthroid makes me almost unable to function,    But everyone is different.    I am far from good but I make it to the next day.   I don't want to turn this thread about me.  The people on this board are wonderful so if therebis anything you need, you are in the right place.
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Avatar_f_tn
I was reading up on how it affects us all different.  I think natural is more better as to synthetic, but will see what the dr says for my case.  Yes that they are including yourself.   We are all in this together.  :)
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