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What is the normal TSH range to exclude or diagnose Subclinical Hypothy...
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What is the normal TSH range to exclude or diagnose Subclinical Hypothyroidism?



Hello. I have had some serious health problems since childhood, such as: mental fog, problems with concentration, hipersomnia, heavy constipation,  cold feets&hands...After couple of years I added loss of libido, dysthymia, and hair thinning  to the list of symptoms.  
BUT when I checked my TSH level for the 1st time (8 years ago) it was 3,29 µIU/ml, so my Family Doctor told me there is nothing to worry about (even though I told him about the symptoms!!!!)..
3 years later I checked TSH for the 2nd time: it was 4,9....and my FD told me I am simply hypochondriac....
2,5 years ago TSH was 6,8...still the answer was the same....
Finally , when I  checked my TSH couple days ago and it was 10,33...my Doc suggested I should visit Endocrynologist... but now I have some doubts.: All of the classical hypothyroidism symptoms are constant,  regardless of TSH level, and existed even when the level was "normal", so can it all be blamed upon thyroid malfunction? Or maybe it is something else?
maybe there are some hidden somatic problems that cause both: changes in TSH and symptoms mentioned above?? ( I also have Testosterone, and Prolactin above the range, and ACTH close to the upper limit, is it somehow connected with TSH level?).
i would really appreciate opinions, especially from professionals :)
Thank You.
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649848_tn?1357751184
None of us on this forum are medical professionals; we're all patients trying to help other patients.  In order to get a professional opinion, you would need to post on the expert forum, but I'll give you opinion, anyway.  

The American Association of Clinical Endocrinologists recommended a new range for TSH, nearly 10 years ago, but many doctors and/or labs don't go by it.  

The "new" range is 0.3 - 3.0, so even your first TSH at 3.29 was higher than it should have been.  While TSH is considered to be the "gold standard" in thyroid testing and treatment, even more important are the Free T3 and Free T4, which are the actual thyroid hormones, with Free T3 being the one actually used by the individual cells.  I strongly recommend that you get those tested.

It's not unusual for symptoms to appear long before blood tests indicate a thyroid issue (though your TSH did indicate that).  The fact that your TSH has been steadily rising, indicates that you may have Hashimoto's Thyroiditis, which is an autoimmune thyroid disease that gradually destroys the thyroid.  As the destruction progresses, healthy tissue is "killed" off and the thyroid produces less and less hormones, until finally it will produce none.  

The tests you need to determine if you have Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).
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649848_tn?1357751184
None of us on this forum are medical professionals; we're all patients trying to help other patients.  In order to get a professional opinion, you would need to post on the expert forum, but I'll give you opinion, anyway.  

The American Association of Clinical Endocrinologists recommended a new range for TSH, nearly 10 years ago, but many doctors and/or labs don't go by it.  

The "new" range is 0.3 - 3.0, so even your first TSH at 3.29 was higher than it should have been.  While TSH is considered to be the "gold standard" in thyroid testing and treatment, even more important are the Free T3 and Free T4, which are the actual thyroid hormones, with Free T3 being the one actually used by the individual cells.  I strongly recommend that you get those tested.

It's not unusual for symptoms to appear long before blood tests indicate a thyroid issue (though your TSH did indicate that).  The fact that your TSH has been steadily rising, indicates that you may have Hashimoto's Thyroiditis, which is an autoimmune thyroid disease that gradually destroys the thyroid.  As the destruction progresses, healthy tissue is "killed" off and the thyroid produces less and less hormones, until finally it will produce none.  

The tests you need to determine if you have Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).
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4371075_tn?1353547067
Thanks, well.. maybe You are not an expert, but You answer is really helpful. :-)) I didn't know that the standards of TSH range has changed.

Of course I did also fT3 and ft4 test, but they were always within average range, (although T4 was always low)...that's why I didn't mention it in the post.
The tests for antibodies showed TGab 4 times higher than expected limit, but TPOab were ok, so my FD told me it doesn't prove any thyroiditis, while many factors can affect TGab, and value of this test is rather low to a clinician..

I am curious whether anybody has (or had ) similar symptoms with TSH close to the statistical range, and has been diagnosed with endocrine disease?

You know.... I have feeling that doctors are sometimes void of any empathy, they stick to the 'standards' so passionately, and forget that each patient is an unique individual.... :-/

P.S. For years I believed I am a Narcoleptic ( I happen to fall asleep in various places)  :) but nobody seemed to take it serious. My endocrine system is deteriorating, that's for sure, but nobody seems to understand it.


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649848_tn?1357751184
Just because FT3 and FT4 are "in range" doesn't mean they are adequate for YOU, and the fact that your TSH was higher than normal, along with all your symptoms, indicates that.  When I was diagnosed, my TSH was 55+, but my FT4 was in range, though low and my doctor refused to test FT3.  Shortly after diagnosis, my FT4 actually dropped below range and when I finally got an FT3 (different doctor), it, too was below range.

Could you please post your actual FT3 and FT4 results, so we can get a full picture of your situation?  Be sure to include reference ranges, as those vary lab to lab and must come from your own report. Also please post the result and reference range for the TGab.

I beg to differ with your FD, regarding the TGab.  TGab is one of the main diagnostics for Hashimoto's.  Some people have only TPOab, some have only TGab and still others have both.  One is not required to have both in order to be diagnosed with Hashimoto's Thyroiditis.  I was diagnosed with Hashi's on the basis of high TPOab.  TPOab can be present in other autoimmune diseases, at low levels, but TGab is most indicative of Hashimoto's.

"I am curious whether anybody has (or had ) similar symptoms with TSH close to the statistical range, and has been diagnosed with endocrine disease?"  Yes, many people are diagnosed with an endocrine disease, when their levels are close to the range.   Many doctors refuse to treat patients whose TSH is under 10, but there are many more, who will treat at a much lower level, based on symptoms, and the FT levels.

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649848_tn?1357751184
Sorry, MedHelp is acting up this evening and wouldn't let me post my comments in their entirety, so I'm having to do it in 2 posts.  

"For years I believed I am a Narcoleptic ( I happen to fall asleep in various places)"  So did I, when I was really hypo.  I'd pull up to a stop light and pray that the light would stay red longer so I could nap; I'd fall asleep sitting at my desk or even at the dinner table; I couldn't be a passenger in a vehicle for more than a mile or two without nodding off. I still tend to get drowsy if I ride for long distances (though I'm okay if I'm driving).

If your doctor won't take you (your symptoms and labs) seriously, you might have to look for a different doctor, in order to get the necessary treatment.
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4371075_tn?1353547067
My  results:

TSH: 10,329 µIU/ml.(ref: 0,27 - 4,7)
fT4: 11,89 pmol/l. ( ref. value: 10,6-19.4)
TgAb: 448,3 IU/ml (ref.: below 115)
Testosterone: 7,40 pg/ml  (ref.: 0-4,1 pg/ml).
Ultrasonography:  medium sized Thyroid gland, right echo, without inflammations.

So as You can see the results are rather ambiguous, while the symptoms are rather certainly thyroid inflicted.
I am going to meet Endo next monday, maybe I will finally get an answer :)
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Avatar_m_tn
Barb is 100 % correct about those lab ranges, I had so many MD's tell me I was wacky and my symptoms were all in my head, well maybe I am a little wacky, but I did have Hashimoto's and the symptoms, these MD's don't have a clue sometimes, all they know is the ranges and do not care one bit about the way you feel, no one knows more about your health than you do. When you feel something is not right and you don't feel normal, than 9 out of ten times there is something going on, and for some clown pretending to be a doctor to say its all in your head is absurd. Listen to yourself, and if the MD don't, then its time to find a new MD. Good Luck FTB4
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649848_tn?1357751184
Your TGab indicates that you have Hashimoto's; your TSH and FT4, also indicate that you could be quite hypo.

You can have Hashimoto's without having the inflammation that characterizes thyroiditis.

What was your FT3 level?
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4371075_tn?1353547067
I havent done it this year ( but I was told to do it, by my Endo).

So today I have been enlightened- My endo diagnosed me with Hypothyroidism  (she also mentioned Thyroiditis.. but didn't name it) and she told me I might have been treated for years, since my TSH was around 4 ( I knew it!).
I have been prescribed Eurythox 50 (the lowest dosage just for start) and Dostinex.

But as I read opinions about Eurythox I am starting to have doubts, it is apparently harmfull for eyesight (!!!) and I already have huge Myopia :-((
What is more it causes swelling and weight gain in many cases. :-/
I am scared of possible side-effects, but I guess I have no other option...

At least I know that I am not crazy :) and my problems have real 'organic' reason :) somehow (I know it sounds strange) I feel relieved...

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4371075_tn?1353547067
Euthyrox I Meant ;-p I guees I am eurocentric ;p
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649848_tn?1357751184
The active ingredient in the Euthyrox is identical to what the body would  make, if it could.

The harm to eyes, would only take place if you took so much that you became very hyper, which can cause thyroid eye disease.  The weight gain is a symptom of hypo, not a side effect of the medication.

Also keep in mind, that it's not unusual for patients to have worsening symptoms after starting on medication, as the body adjusts to having the hormones again.

It's good that your doctor started you on a low dose; much better to start low and work up slowly, than to start too high and risk reaction to the medication.  Keep in mind, that you will, most likely need periodic adjustments in your dosage.

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