What are the normal ranges for the TSH level?? and will levothyroxine help aid weight loss?

[Sleighty]

I was just put on levothyroxine .05 mg. This whole thing is new to me. I'm not an overweight person by any means, but noticed i've put on about 10 lbs, and I'm extremely exhausted everyday. Last summer my TSH was 5.99, Sept of this year it was 6.06, which then prompted my DR to ask for another blood test, and last week it was 7.43.

I just want to know what is a normal range for the TSH? I've done some research, and looks as though its better to be between .3 and 3, and some Doctors will go as high as 5 for a normal range. What is normal???

Should I follow any particular diet/exercise plan? Will I be able to lose this extra 10 lbs I've gained?

Thanks!

[gimel]

It's true that many labs and doctors still use the old reference range of  .5 - 5.0, or something similar.  However, over 8 years ago the AACE came to the conclusion that there were a lot more hypo patients than predicted by their old reference range.  When they went through their data base and purged suspect hypo patient data and recalculated the range limits, they recommended it become .3 - 3.0.  

In addition to that, TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a sole diagnostic by which to treat a thyroid patient.  Studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not.  I have done extensive searching and have yet to find a statistically valid study that shows that TSH even correlates well with FT4, much less FT3 or symptoms.  

I feel the same as Dr. David Derry expressed in this quote from him.    "Why are we following a test which has no correlation with clinical presentation? The thyroidologists by consensus have decided that this test is the most useful for following treatment when in fact it is unrelated to how the patient feels. The consequences of this have been horrendous. Six years after their consensus decision Chronic fatigue and Fibromyalgia appeared. These are both hypothyroid conditions. But because their TSH was normal they have not been treated. The TSH needs to be scrapped and medical students taught again how to clinically recognize low thyroid conditions."

This quote was taken from this article, which you might find very interesting.

http://www.thyroid-info.com/articles/david-derry.htm

[Migueleto]

According to my medical report, the normal range for TSH is 0.35 - 5.5. I suggest you verify this from your doctor.

[gimel]

Make sure that the thyroid antibodies tests are requested on the sheet.  Then I think I would call the doctor's office and say that people with thyroid problems and low energy frequently seem to have low Vitamin D and B12 and ferritin.  Also, when you looked at the sheet you noticed that those tests were not included and you were wondering if those tests could be run as well, just to verify if they are okay.    

[Sleighty]

Unfortunately my next blood test isn't until Nov 17 and I'll be getting results at an appointment on Dec 2. But I already have the lab test sheet pre filled so I can't just add those other tests on it myself, or can I? I think right now its only testing for tsh, free t3 and free t4 and I think antibodies. Can I add those other tests myself?  Otherwise I'll have to wait till January :(    

[gimel]

Let's hold off on that question until you get results from further testing.  Then the explanation can be better focused.

[Sleighty]

I appreciate all your help and advice. I can't believe at 27 I've been diagnosed, when I'm not over weight, and I try to be healthy as much as possible. What causes the thyroid to do all this anyways?

[gimel]

It would help if you could post the lab's reference ranges for the FT3 and FT4 tests.  Results vary from lab to lab and they can have slightly different ranges.  

In the interim, basing it on ranges I see  frequently, the answer is yes, your FT3 and FT4 levels are low in their ranges and therefore consistent with being hypo.   Although TSH is a pituitary hormone with limitations I listed above, yours is high enough to be an additional indicator of being hypo.

You should plan to go back for followup testing in about 6-8 weeks.  It takes that long for the meds to reach full level in your body.  Also don't forget to request the TPO ab and TG ab tests to determine if there is an autoimmune system related cause.  Many hypothyroid patients also experience low Vitamin D, B12 and also ferritin, so those are worth testing as well.  

As you go forward, keep in mind that many members here report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.   Symptom relief should be all important.  If your body is not converting T4 to T3 adequately, it can cause an imbalance that requires a source of T3 to be added to your meds to bring up the FT3 level.  If your doctor is not going to be willing to treat you clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, then  you will need to find a good thyroid doctor that will do so.

[Sleighty]

So I called my Doctor for the results of the Free T3 and T4 levels. I remember the requisition sheet saying Free and not Total. The result for the T3 was 4.5, and the T4 was 14. And of course my TSH is 7.43.........

I have to go back in 6 weeks for blood work, and see what it is then, and I'm hoping this won't be an ongoing thing every 6 months to check my levels.

The thing concerning me is the weight lose, even though its not too much, but I'm hoping the pill will kick in quickly, and get my body working properly! Should I follow any particular diet from now on? Should I stay away from anything in particular?

I also was planning on getting pregnant within the next 6 months, but I must hold off now due to possible complications. I guess they need to get the thyroid levels regulated before that can happen. Such bad timing......

My thing is that my doctor won't bring my tsh levels down to a normal range. Because she is only a general practitioner, I'm questioning whether she'll know exactly what is normal and what is normal high, and low.......What do you suggest are normal levels for the TSH, T3 and T4? Do my T levels seem really out of range?

Thanks!

[gimel]

If the blood testing done last week was for total T3 and total T4, then you still need to be tested for free T3 and free T4.  Knowing the levels of FT3 and FT4 and your symptoms will allow adjustments to be made as necessary to relieve symptoms, which is the real objective.  

As far as getting your energy back quickly, the answer is that it probably won't be as quick as you would like.  the half life of a T4 med is about 7 days.   So it takes about a week for 50 % of the amount of your meds to show up in blood levels.  Thus it takes about 4 weeks to achieve over 90 % of full effect.  And that is just the effect on blood levels.  Symptoms can lag behind the changes in blood levels of the thyroid hormones, dependent on the severity of the hypothyroidism and the length of time at that condition.  So the answer is some patients report feeling the effects of the meds short term, but most take longer.  

As far as weight, I would expect that once you get the FT3 and FT4 levels high enough to relieve symptoms, then your increased metabolism will allow you to start seeing benefits in weight reduction, consistent with your eating habits and physical activity.

[Sleighty]

Thank you for your quick response. This is all totally new to me. In the last blood work I did last week, they tested the T3 and T4. I didn't know to ask for those results, so I will call in to my Doctor today, and get those. Unfortunately I had to see a different doctor when my results came in as mine was fully booked, so I'm going to call today to make sure what he prescribed was correct. I will also get those other results.

Thank you for telling me about the other things to test for. I think they may have tested for antibodies, I remember seeing something of the sort, but next blood work, I'll make sure to test for TPO ab and Tg ab.

Once I start taking this pill today, do you think I'll gain some energy back quickly? Also, do you think I'll be able to lose this extra 10 lbs a bit more easily?

Thanks!

[gimel]

Fatigue and low metabolism are two of the most common symptoms of hypothyroidism.  The range currently recommended for TSH is .3 - 3.0, but you exceeded even the old, higher range.  You should be aware that TSH is a pituitary hormone that is affected by so many variables, including the time of day when blood is drawn, that it is totally inadequate as the sole diagnostic for thyroid issues.  At best it is an indicator, to be considered along with more important indicators such as symptoms and also levels of the actual, biologically active thyroid hormones, which are free T3 and freeT4 (that is FT3 and FT4, not total T3 and total T4).  

FT3 is actually the most important test because FT3 is the most active and studies have shown that it correlates best with hypo symptoms, while TSH and FT4 did not correlate. For all these reasons, it is my opinion that the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with meds as required to relieve symptoms, without being constrained by resultant TSH levels.  

So, I suggest that you should go back and request testing for free T3 and free T4, along with TSH.  If the doctor resists, you should insist and not take no for an answer.  Remember that you are the customer and the doctor is providing a service.  While ther you should also ask  to be tested for the thyroid antibodies, TPO ab and Tg ab, to assess for the  possibly of  Hashimoto's Disease, which is the most prevalent cause of hypothyroidism.  

If your doctor has a problem with treating your symptoms, as I described above, then you will need to find a good thyroid doctor that will do so.