what does my high TSH score mean?

I am a 29 year old, healthy, active, happy man.  I just recieved my blood screening results from a voluntary test and am nervous about the results. My 'TSH, 3rd generation score is 19.5, says normal is .4-4.5.  My throat has felt a little swollen lately when I swallow.  Otherwise I feel good.  Do I need to worry?  Thank you!

[magpieannie]

Yes, this is high and need for some concern. Especially since you have the tight feeling in your throat. You need to get further thyroid blood testing and an ultrasound to know more. A visit to an endocrinologist is needed. You could have a goiter, or a nodule, or worse (not to scare you). Do you have any other symptoms of hypothyroidism? You need to have your availabe thyroid hormones looked at (freet3 and freet4) in addition to your TSH level and your TPOab and Tgab antibodies tested for hashimotos disease. Time for a referal to a "thyroid specialist"(not diabetes).

[gimel]

No need to worry, but I would go back for some followup testing.  TSH is a pituitary hormone that is affected by many variables, including the time of day when blood is drawn.  This makes TSH inadequate as the sole diagnostic for thyroid problems and medication; however the level of your TSH above the reference range is sufficient to do the additional testing to confirm thyroid problems.  

When you go back, I would insist on testing for free T3 and free T4 (the actual, biologically active thyroid hormones), as well as TSH.  Note that these tests are not the same as total T3 and total T4, which are somewhat obsolete and not every useful.  In addition you should request to be tested for  thyroid antibodies  by testing for TPO ab and TG ab.  These tests will indicate whether or not you have the most prevalent cause of hypothyroidism, which is Hashimoto's Disease.  

You may feel good now, but if it is the begining stages of Hashi's, then you will be facing a period of time during which your own autoimmune system produces antibodies that attack the thyroid glands until they are eventually destroyed and you need to compensate by taking thyroid meds while this is going on.  During the destruction phase, thyroid hormone levels fluctuate more than normal and make treatment more difficult.  Later in the cycle, treatment should be much more straight forward.

Many members here have had Hashi's.  The ultimate success of treatment is predominantly dependent on finding a good thyroid doctor that will treat you for your symptoms, by testing and adjusting the FT3 and FT4 level as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Don't accept treatment based only on  TSH testing.

[thelma201]

I know this may be a bit negative sounding, but be aware ( i was not ) finding a Dr. to test what needs to be tested..all the things, gimel hit on in above post, may be a little difficult! AND even if a Dr. tests for these things, they may not know how to best treat, or even tell you the tests are "normal"...i have had this happen for the last 4 years. Be sure you see , at the very least, Doc knows the new ranges for TSH ; 0.3-3.0....every Dr. i've seen still goes by the old lab ranges, including an Endo i saw.only tested TSH and FT4, left me hypo. If you're feeling well, no hypo symptoms other than what sounds like swelling, it may be temporary! Ask questions before you make an appointment..how much does the doc know about thyroid problems, how they treat, the labs they go by.and do they pay attention to YOU, not just the lab work!! Do seek help for this, and GOOD LUCK!!!