tsh of 4.7 and 4.2 three tests in the last couple years. I am sick of the docs telling me that is normal. It seems after what I have read that I should be on synthroid. I don't want to be on it, but I have all the symptoms of hypo thyroid, including fatigue, hair loss, very cold extremities, a bit of weight gain, but not bad, dry flaky skin, depresssion etc.
I am asking ....is 4.2 tsh and 4.7 tsh normal or not?
Taken along with those symptoms, no it is not. Over 8 years ago the AACE recommended that the reference range for TSH should be changed to .3 - 3.0. Unfortunately most labs and doctors have yet to adopt the new range. Much more importantly, TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as a diagnostic for thyroid problems. At best it is an indicator, to be considered along with more important indicators, which are symptoms, and also levels of the biologically active thyroid hormones, free T3 and free T4. Note that FT3 and FT4 are not the same as total T3 and total T4, which the doctors test much more frequently.
FT3 is the most important of these tests because it largely regulates metabolism and many other body functions. Scientific studies have also shown that FT3 correlated best with symptoms, while TSH and FT4 did not correlate very well at all.
A good thyroid doctor does not rely primarily on TSH as a diagnostic and to medicate a thyroid patient. In my opinion a good thyroid doctor will treat a patient clinically, by testing and adjusting FT3 and FT4 with medication as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results.
So, the first thing I suggest is to request testing for free T3 and free T4 (not total T3 and total T4), along with TSH. If the doctor resists, then you should insist on it and don't take no for an answer. Remember that you are the customer. In addition you should ask to be tested for the thyroid antibodies, TPO ab and TG ab, in order to check for the possibility of Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism. Since many patients who are hypo also have low Vitamin D, B12 iron/ferritin, and selenium, at some point you will want to have those done also. While with the doctor, you should also find out if the doctor is willing to treat you clinically, as I described above. If not, then eventually you will need to find a good thyroid doctor that will do so.
When you get this testing done, if you will get a copy and post results and reference ranges shown on the lab report, then members will be happy to help interpret and advise further. I think you might also like to read this link, written by a good thyroid doctor. This form letter is sent to the primary doctor of patients consulting with the author of the letter. It provides guidance and direction for clinical treatment as I've described above.
Great information. Thank you. I just got my test results back. My TSH is 5.014 and the doctor wanted me on thyroid med. I have no symptoms of hypo at all. I asked to have my Free T3 and Free T4 done. The numbers came back as follows: Free T4 is 1.04 and Free T3 is 2.6. From what I understand from reading online these are both in the normal range which would explain my lack of symptoms. I am 44 years old (female) and feel great, I don't want to go on medication if I don't need to. Anyone have any opinion regarding my Free T 3 and 4 numbers? Or any advice? Thank you!
Since test results and the calculated reference ranges can vary from one lab to another, it is important to always compare results to their reference ranges shown on the lab report. Please post reference ranges for the Free T4 and Free T3 results.
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