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Normal TSH range
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Normal TSH range

Hi,

I am a 30 yr old and i had conceived my first baby when i was 27 yrs. I had thyrod disorders and doc advised me to take 50 mcg of Thyronorm before i conceived. Once pregnancy was confirmed it was increased to 100 mcg and i was continuing with this till last Dec 2011. Had a blood test in dec and it was observed that the TSH had gone really low and doc advised me to stop the medicine. I did another blood test after 11/2 months and saw that TSH was 3.06 and in another 2 weeks it was 2.19. On consulting my doc he said TSH is normal and i can continue without any medicine. But i am a bit worried as I am trying for a second kid. Worried if there can be any complications when i conceive.  Please advise.
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649848_tn?1357751184
Your doctor needs to be testing Free T3 and Free T4, as well as the TSH.  FT3 and FT4 are the actual thyroid hormones, while TSH is a pituitary hormone and not indicative of actual thyroid hormone levels.  

Adequate thyroid hormones are essential to the growth and development of a baby; if your current doctor won't test the FT3 and FT4, you should find a different doctor.

What thyroid disorder had you been diagnosed with? Do you know if you have Hashimoto's Thyroiditis?
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Avatar_f_tn
Hi Barb,
Thanks a lot for the response. Yes, I had Hashimotos Thyroditis when i was trying to conceive the first time. Some how it was detected late, when thyroid was tested. The reason why it was tested was because I was not getting pregnant. That time doc advised 50 mcg thyronorm and asked me to contact him once i conceive. Once I was pregnant i was asked to take 100 mcg thyronorm. I was having this till by baby was 1.4 yrs old. Once i stopped feeding him, doc advised me to test the TSH. By then TSH had gone really down to 0.09 or so and asked me to stop the medicine and have a blood test in another month or so. The test was taken not only for TSH but also for FT3 and FT4 and it was found with in range.. but the TSH of 3.09 or 2.19 does not give me confidence to go ahead. Because it is almost touching the border and just wondering if there might be some adverse effects when i conceive.
The reason i was detected with thyroid disorder initially seems to be becasue i was given some medicines to stimulate the ovulation and egg formation when i was not getting pregnant. This might have initially resulted in excess growth of Ovum and extra need of TSH. But I am sure by the time I conceive the second time.. i would be asked to start the medicine again. But not sure why the doc is not advising to have the medicine now itself.. just to ensure that i am really healthy before i start trying for a baby. He just says i am healthy now. Please advise.
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Avatar_m_tn
First of all what symptoms are you having?

Second "simply being within range" for your FT3 and FT4 is NOT sufficient for many people.  Similarly many people are clearly Hypo and need medicine when their TSH is even over 1.0.  

The reference ranges are FAR too broad.  And many people find that in order to feell well lthey need to keep their FT4 levels at the MIDDLE of the range if not even slightly higher AND (that means in addition to) their FT3 must be in the UPPER 1/3 of the range.

It is far too common for many people to be tested towards the bottom of the range and they are having Hypo symptoms but are told that they are "normal" simply because they are within the range.  NOTHING could be further from the truth for a lot of people.  Maybe you are one of those people.

Please post your most recent lab results including the reference ranges as the ranges vary from lab to lab.

TSH is at best a screening tool and should NEVER be used to adjust medication dosages.  However this is exactly how most Dr's do it.  And it is a travesty in the medical industry in my opinion. Countless people are left untreated or mis-treated or under-treated because of this very reason. putting the patient on a hormonal roller coaster or leaving them feeling ill.  Don't be one of these people!
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Avatar_f_tn
Thanks for your response.

Actually i am not having any symptoms of unhealth. i am feeling good and feel healthy as well. However, as i am planning to try for a baby i want to be pretty sure that my tsh is on the good side. Also, i have a history of thyroid and was taking medicine when i was first pregnant. So ensuring the best health for the second kid as well.

Below are the details of the lab report.

T3    - 85.3ng/dl   Range 60-181 ng/dl
T4    - 7.5 ug/dl    Range 4.5-12.5 ug/dl
TSH - 2.19 mIU/L Range 0.3 - 4

Could you advise me if i need to consult a different doc and get the tsh reduced to the range of 1. something. Also, once i get conceived it is sure that i would need to have the medicines as TSH is almost touching the border.
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Avatar_f_tn
Hi Barb,
Thanks a lot for the response. Yes, I had Hashimotos Thyroditis when i was trying to conceive the first time. Some how it was detected late, when thyroid was tested. The reason why it was tested was because I was not getting pregnant. That time doc advised 50 mcg thyronorm and asked me to contact him once i conceive. Once I was pregnant i was asked to take 100 mcg thyronorm. I was having this till by baby was 1.4 yrs old. Once i stopped feeding him, doc advised me to test the TSH. By then TSH had gone really down to 0.09 or so and asked me to stop the medicine and have a blood test in another month or so. The test was taken not only for TSH but also for FT3 and FT4 and it was found with in range.. but the TSH of 3.09 or 2.19 does not give me confidence to go ahead. Because it is almost touching the border and just wondering if there might be some adverse effects when i conceive.
The reason i was detected with thyroid disorder initially seems to be becasue i was given some medicines to stimulate the ovulation and egg formation when i was not getting pregnant. This might have initially resulted in excess growth of Ovum and extra need of TSH. But I am sure by the time I conceive the second time.. i would be asked to start the medicine again. But not sure why the doc is not advising to have the medicine now itself.. just to ensure that i am really healthy before i start trying for a baby. He just says i am healthy now. Please advise.
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Avatar_m_tn
TSH is really not that  important compared to the FREE T4 and FREE T3.

The lab you listed above did  NOT indicate that they were free.  Almost always that means that they were "total" and not free.  Total is an outdated test and not all that valuable.

The reason total is not that good is because it counts BOTH the free and attached hormone.  Once a hormone molecule attaches to a  protein it is worthless.  ONLY the free unattached hormone is useful to the body.  This would be like measuring how much total fuel is in the gas tank of your car versus what amount of fuel actually gets to your engine (free).  Obviously you  really want to know what gets to your engine. That is why it is so important to get the free hormones tested and not total.

Finally if you are feeling well and not symptomatic then you are most likely perfectly fine.  Some people feel fine with a TSH of 2.2.  you sound like you are one of them.  The American Academy of Clinical Endocrinologists (AACE) recommends a TSH range of (0.3 to 3.0) this is narrower than most labs use even though the AACE recommended this range about 10 years ago.  But you even fall within that range.

So if you feel good I think your just worrying too much.
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Avatar_f_tn
Hi,

Thanks a lot for sharing so much information. I will try to get a Free T3 and T4 test done soon.

Also, this 2.19 TSH that i have mentioned is sometime 8th Feb 2012. But just 2 weeks back it was 3.06. So i am not sure if it is fluctuating also. Could you please advise.

Also, by end of march i am planning to get another checkup done.Would surely keep you posted on the details.

Thanks a lot for all your help.
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649848_tn?1357751184
TSH fluctuates wildly, even intraday, which makes it absolutely unreliable for diagnosing/treating a thyroid condition. TSH is a pituitary hormone that "signals" the thyroid to produce more hormones; the thyroid does not always respond adequately, which is why it's SO important to get the Free T3 and Free T4 tests (always make sure to specify FREE or you will get tests for the total T3 and T4).  

Since you already know you have Hashimoto's, your thyroid function will continue to decline, as the antibodies destroy the healthy thyroid tissue, so it's unable to produce hormones.

You're fortunate not to have symptoms of being hypo, but that's probably just a matter of time.  A doctor who treats thyroid conditions based only on TSH will eventually make/keep you ill. If your doctor refuses to test the FT3 and FT4, you should think about finding a different doctor.  
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Avatar_f_tn

Thanks for the update. I am planning to get the test done by March end for Free T3 and T4 and would post the results. Would also check for a different doctor.
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Avatar_f_tn
I just got the test done yesterday for Free T3 and Free T4 and TSH
Results as below.

Could you let me know if it shows that I am Hypothyroid.

TSH   2.37 mIU/l

Free T3  2.6 pg/ml   Range 1.8 - 4.6 pg/ml
Free T4  0.8 ng/dl

Range as below for FT4

0.8 - 2.0 ng    Euthyroid
ND - 1.03 Hypothyroid
2  - 11.4 Hyperthyroid
NTI  0.8 - 1.9
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Avatar_f_tn
I just got the test done yesterday for Free T3 and Free T4 and TSH
Results as below.

Could you let me know if it shows that I am Hypothyroid.

TSH   2.37 mIU/l

Free T3  2.6 pg/ml   Range 1.8 - 4.6 pg/ml
Free T4  0.8 ng/dl

Range as below for FT4

0.8 - 2.0 ng    Euthyroid
ND - 1.03 Hypothyroid
2  - 11.4 Hyperthyroid
NTI  0.8 - 1.9
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649848_tn?1357751184
Your FT3 is just below mid range, which is too low for most of us and your FT4 is at the very bottom, which is generally not acceptable. Most of us need to have FT4 at least mid range and FT3 in the upper 1/3 of it's range.  Your TSH is also near the high end. I would not consider you Euthyroid.

I'm sorry, what is ND - 1.03 Hypothyroid? and 2-11.4 Hyperthyroid?  
and NTI 0.8-1.9?
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