TSH at 5.65, RE says it's only "slightly elevated"

[jmaew]

I was diagnosed last year with Hashimoto's by my primary care doctor. She put me on 100mcg synthroid and we never followed up.

Recently, my husband and I have been trying to conceive with no luck. I went to the ONLY reproductive endo in our area last week and he drew labs. He left me a voicemail a few days ago saying, "The only thing I saw was that your TSH was just a little bit elevated. I might increase you to 112mcg of Synthroid, but I want to recheck you first."

I went in today and had them draw blood again. The lab tech said my TSH last week was 5.65 and that normal is 5. Every single thing I've read says that normal is 1-3, and that a woman should be at 1-2 if trying to conceive. Why would the doctor say I was only a little bit elevated? Would would the 12mcg increase make a big enough difference to bring my TSH down to 1-2? If so, how long might this take? "Little bit" is so subjective, so I'm a little upset that he wasn't more specific. To me 5.56 is significantly elevated from 1-2.

Thanks for your help!

[redheadaussie]

Hi. It depends where you live! Here in Australia they would tell you the same thing, that you are slightly elevated, yet in USA you would be classified as Hypothyroid! The reference ranges are totally different!
Do you have symptoms of being hypo? If not then for you your levels might be fine. Some people feel great around 4 whilst others are totally debilitated and need help.
   It would be good if you have your Free T3 and Free T4 done too. The TSH on its own is not the way to diagnose any thyroid disorder. If you already have them, post them here. Also look at the reference ranges next to your results and post them too.
  Yes, 12mcg can be just the ticket in bringing the levels down. It may not bring it down to 1 -2. Every person is different.  It can take up to six weeks for you to feel any effect, but as I said earlier, if you have no symptoms and feel fine (apart from not conceiving) then it may actually bring it down too much. Sadly there is no cut and dried answer in this. You will need to take the extra 12mcgs and see how you go.
  Good luck!
   I

[gimel]

For general info, about 6 years ago, the Amer. Assn. of Clinical Endocrinologists recommended that the TSH range be changed from .5-5.0 down to .3-3.0.  Unfortunately most labs and doctors still use the old range and many hypo patients are left under medicated and still suffering with hypo symptoms.

This is because, in addition to the problem with the reference range,  TSH is a pituitary hormone that is affected by many variables, so that it has only a fair correlation with T4 and T3 levels in the blood, and  a very poor correlation with thyroid symptoms.  Much of the biological activity in the body is dependent on free T3 and free T4 (free meaning not bound up by protein).  Free T3 is the most important because it is four times as potent as free T4, and correlates best with hypo symptoms.

If I were in your shoes, I would try to get the doctor to treat you by testing and adjusting free T3 and free T4 levels as required to alleviate symptoms and get you into what I call the "sweet spot", by which I mean neither hypo nor hyper symptoms.  Sometimes, this will mean that the TSH is suppressed to the  low end of the reference range or even below, even though  free T3 and free T4 are still well within their ranges.  A suppressed TSH shouldn't automatically define you as hyperthyroid.  In my opinion, a patient's hyper or hypo status should be defined and treated by symptoms, not TSH level.

[Cassie737]

I was recently hopitalized for my thyroid, and my doctors said that the normal TSH level is anywhere from 2 to 5 so I wouldn't be too worried, my TSH level was 699 which is unheard of and I'm still trying to recover. Years ago my level was higher than yours and I conceived 3 children, so hopefully this will give you hope.