Thyroid Disorders Community
TSH 0.67
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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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TSH 0.67

Hi , I have had Hashimotos for 17 years and feel best when my TSH is between 1 and 2 .My recent bloodwork for TSH was 0.67. I have very bad leg pain, cramping spasmS, RLS, could this be related ?
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Avatar_m_tn
Of course, there can be other causes for some of those symptoms; however, with Hashi's, a hypo patient frequently needs increasing levels of thyroid meds, as the thyroid gland is gradually being destroyed by the thyroid antibodies.   So your thyroid hormone levels may be too low.  

In addition, TSH is a pituitary hormone that is affected by so many things that it is totally inadequate as the sole diagnostic by which to medicate a thyroid patient.  Although TSH supposedly accurately reflects levels of the biologically active thyroid hormones, Free T3 and Free T4, TSH cannot be shown to correlate well with either, much less with symptoms, which are the most important consideration.  In addition, TSH is frequently suppressed when taking thyroid meds, and thus becomes even less valuable as a diagnostic.  So targeting a TSH level frequently leaves a hypo patient under medicated and symptomatic.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

If you haven't been tested for Free T3 and Free T4, then you should request those each time you go for followup tests.  If the doctor resists, you should insist on them and don't take no for an answer.  They are that important.  Also, since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin you should request those as well.

When test results are available please post results and their reference ranges and members will be glad to help interpret and advise further.  



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Avatar_n_tn
Just got results back doc. Only ordered TSH again now 0.973, t3 uptake 37 and total t4 12.1. I thought he was going to do total profile.
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Avatar_m_tn
Your doctor ran tests that are somewhat outdated and not nearly as revealing as the ones I suggested.  From that I suspect that your doctor is also out of date and does not understand how to test, diagnose and treat a hypothyroid patient.  

Did you insist on tests for Free T3, Free T4, Vitamin D, B12 and ferritin and the doctor refused?  If so, that is another reason for you to drop that doctor and find a good thyroid doctor.  If you will tell us your location, perhaps a member can recommend a good thyroid doctor, like you need.
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