TSH results and treatment

[jeanettr]

I have had symptoms of hypothroidsm for years. Never dx.  In the past 2 years my TSH has gone from 2.937 to 3.576.  Even though I have told different doctors about how tired I am, total lack of interest in anything, and the list goes on,  they keep saying there is nothing wrong.  Finally about a month ago I went to an Endo that put me on 50 mg of synthroid.  He did not test free T3, or free T4 and said my T4 (14.6) and T3 (20) was not realiable because I take a hormone replacement.  He told me to come back in 3 months.  Should I see another doctor for more testing, or just wait out the 3 months?  I am not feeling any better.

[GravesLady]

Yes, but for already diagnosed and treated patients.  

I think you are misinformed with out dated information.

AACE 2006 amended guidelines,  the US Government 2004 Guidelines and UK 2006 Guidelines.  And I am in the process of finding more.

quote - TSH 2.5 - 4.5: May be due to minor technical problems in the TSH assay, circulating abnormal TSH isoforms, or heterophilic antibodies; normal individuals with serum TSH concentrations in this range would be misidentified as having hypothyroidism

TSH of 4.5 to 10:  No routine levothyroxine treatment for patients with TSH levels between 4.5 and 10 mIU/L, but thyroid function tests should be repeated at 6- to 12-month intervals to monitor for improvement or worsening in TSH level. Early levothyroxine therapy does not alter the natural history of the disease,.........

TSH Higher Than 10 mIU/L Hypothyroidism Levothyroxine therapy is reasonable.

Data do not confirm clear-cut benefits for early therapy compared with treatment when symptoms or overt hypothyroidism develop. - unquote

So you are lucky to find a doctor who treats by symptoms alone.  TSH of 3.576 is not considered hypothyroid for treatment, per the above.

[jeanettr]

I don't think this is a good TSH level.  From what I have been reading the closer to 1 and below 2 is the new levels. The Endo himself said the .35 - 5 is outdated.

[GravesLady]

How do you know your symptoms are thyroid.  Thyroid symptoms are so non-specific.  In other words, a lot of other health conditions have the same symptoms as thyroid, it is very difficult to distinguish where the symptoms are coming from or which health conditions are the cause.

You are lucky you got a doctor to treat you by symptoms alone with such a good TSH.

If you are estrogen by whatever reason, Ts are not reliable, however the FTs are, very reliable.

You better stay with this doctor because the next may not treat you with such a good TSH level.  Your TSH  does not request or relate the need of other test, however that is up to your doctor.