Tsh...what is a normal range??

[bugaboo52]

I have posted in other places and have not really gotten a clear answer on TSH.  Last year in april my tsh was 1.36 and in january 2010 it was 4.12. (0.5-5.50) I realize the lab says it is normal but I have read online that that is not an optimal range.  My dr requested the free t4 but our medical plan only pays for the test if she marks it as a special case...which she did not.  My Dr is a big believer in not looking past the TSH if it comes back normal. Is it normal to jump that much in 9 months? Apparently it can jump around on the same day but would it jump to 4 if all was normal?I have many symptoms of hypthyroidism, cold hands and feet in a warm house, dry skin,brain fog, dizziness, recurrent sinus infections, fatigue(serious fatigue) heavy periods that have gotten worse and then better and then heavey again,gained weight and hard to lose,rosacea, cracked heels that are turning yellow(what is that about).  Last year I had an unexplained period of weight loss(and I did nothing to lose it), heart palpitations and night sweats and sweating. I have a maternal Aunt  with graves.  I have some positive tests for autoimmune disease but it has not been diagnosed. I   have a sore throat (quite severe pain at times) that comes and goes with no sign of infection. For the last 2 years I have a choking feeling in my throat where I feel like I am being strangled (cannot even wear a scarf or seatbelt), but that comes and goes as well.I have found that after the birth of my 3 children at around 3-5 months I have gotten really bad.  Does this sound like thyroid at all in conjuction with the TSH? I need information that I can give to my dr that is credible or she will continue to dismiss all this.any help would be so appreciated, this has been going on for 10 years.

[bugaboo52]

HI there, I should have clarified that I am up in Canada and we have the medical services plan for everyone in our province. They would pay for it if my Dr made it a point to call it a special case.  I have a feeling that our medical plan will only pay for further testing if there is good reason-perhaps family history, physical symptoms that are so obvious you cannot ignore them...high TSH.  I think it has a lot to do with keeping the cost of testing down but then it also keeps people that dont have a high TSH sick.  Every time my Dr has sent me for a TSH (and that has been at least 4 times in 8 years) that is all she has requested, except for this last time and the lab didnt run it anyway.  So frustrating when I have so many symptoms. However the family history information is very new to me and may help with my argument for further testing.  

[annamae26]

can i ask what insurance won t cover a ft4 test- im in an hmo and its all covered so i don t understand who wouldn t cover it  thanks  just really curious   its the old case manager kicking in i guess

[goolarra]

Yes, doctors can be unbelievably stubborn.  Sometimes there's just no way around firing them.

Ask your rheumy to test free T3, free T4 and TSH (again) in the same blood draw.  T3 and T4 are the actual thyroid hormones an much more important than TSH.  You might also want to ask for the thyroid antibody tests, TPOab and TGab.  These will inticated if you have autoimmune thyroid disease (Hashimoto's thyroiditis).  It's the most prevalent cause of hypo in the U.S.

Joint pain is common with hypo.  Being hypo tends to exacerbate any condition that you might have.  If you have arthritis, it will aggravate that, old injuries, etc.

Find someone who will order appropriate tests and listen to your symptoms.

[bugaboo52]

thank you for your answer and your specific reference. I believe that my TSH is too high but when your dr  cannot get past the lab's ranges then I am out of luck. I am going to try and broach this subject with the rheumatologist I have just started seeing. I have not been tested for thyroid disease(other than tsh) but had a positive ANA and ENA...which indicates non-specific autoimmune disease. I do not have all the markers for lupus though that has been thrown out there.  I believe this is hypothyroidism
and it has been going on for so long and I keep trudging to my dr and giving her one more symptom and it is never dealt with:(
I also have muscle and sporadic joint pain that seems to move about hips, shoulders and hands and knees.  Is that a thyroid thing?

[goolarra]

According to the American Academy of Clinical Endocrinologists (I think that's the name...I've been using the acronym, AACE, for so long I'm not sure!) the range was redefined eight or nine years ago to 0.3-3.0.  Many labs and doctors are still using an obsolete range. 4.12 is high and indicates hypo.  It can change that much or more in a few weeks, let alone months.  Your symptoms also sound very hypo.

Have you tested positive or an autoimmune thyroid disease?  Having one autoimmune disease makes you much more vulnerable than the general population for developing a second.