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A ? about TSH (thyroid)
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A ? about TSH (thyroid)

I have heard that a person can have a thyroid problem, despite "normal" TSH?

In other words, TSH is within normal range but the T3s & T4s may be abnormal?
Is this correct?

As I understand it (and from my own experience), most doctors simply check for TSH without looking into the others.
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7 Comments
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Avatar_n_tn
Hey, I ahve had problems like that with my doc.  She only wanted to test TSH.  She would say TSH in normal range - but normal for some is not normal for others.  After reading alot on the thyroid forum, I see that a good area for most is around 1.0.  Mine has been, in the last few years 5.0 - 8.0.  Last one was around 4.8 but I still feel bad.  Even though I have been hypo for several years, I am ashamed to say that I haven't done as much research on this as I'd like but I can tell you that Grave's Lady, who posts here and on thyroid forum, was very helpful to me - she seems to be very knowledgable about all of it.  Try posting there or reading some.  It will help.  The doc answered on of my ? that I posted to someone there.  That was great to finally get an opinion from an MD in endocrinology.  Hope this helps - take care!
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Avatar_f_tn
Some Dr.'s will treat for "subclinical" hypo or hyper thyroidism. This just means that you are borderline, but the Dr. is willing to try treatment to see if your symptoms improve. Your best bet is an endocrinologist.
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125112_tn?1217277462
>She would say TSH in normal range - but normal for some is not normal for others.<

This is exactly what I had read in a book written by a compassionate Dr. who herself has been the patient. The book is called, "Screaming To Be Heard. Hormonone connections women suspect...and doctors still ignore"

I haven't read the book page for page. Simply have it as a reference.

I have many symptoms of hyper but before I consider requesting a thyroid test (and now think to request a free t4 with it), need to be first checked out for another reason.
Last August, the doctor ordered a TSH (alone) and my TSH was 1.56
In Decemeber, I was seen for allergies/tonsils and a different doctor ordered a TSH (again, alone)and it was 1.13
In January is when I felt the worst.
Neither cases did I request it or have any thought about thyroid.
In April, I had my tonsils out and the Anethesiologist after awakening suggested I have my thyroid checked. Prior to the surgery, I had a EKG and strip because the nurse didn't like seeing my heart rate bounce around like a ping pong ball. Tachardia and I was not anxious.
Finally, it was then I looked into thyroid conditions. I was clueless.
If anything, it would be interesting to see if my TSH is continueing to decline and what the t4 reads.

As for TSH lab results. I have read that prior to 2003 most labs normal values were between .5 - 5.50
Today, most labs are reported to use .3 - 3 as their normal values.
Our lab must be behind the times. lol

So, I am wondering if you are not being treated for hypothryoid: is it because your lab is using the "old" values?

As for posting on other forums, with the exception of family practice...I never can post in the other forums. Always to capacity.

Thank you Charley for the response.

myproblem:

I for one am not keen on medications but it would be nice for doctors not to be solely hung up on lab results. A good idea (for certain!) but if other conditions are ruled out, a consideration for low dose medications and strict monitoring. To at least see if symptoms improve.

As for any specialized doctors: all of this needs to be done outside of my community (small community located on a island in Alaska) and it's the absalute pits!
The time, expense, exhaustion and only having one real shot at a doctor (due to time and expense): makes matters worse if the consideration is that a different opinion is needed either by the same kind of specialist or different specialist altogether. Ugh, aggravating! However, what must be done...has to be done.

Thank you for your response, myproblem.

Appreciate your both having taken the time to post.

~Kate


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Avatar_n_tn
LOL!!! That was a funny thought!!!
I am interested in reading that book.
What is the authors name?  Sounds like
it has some good info.  Thanks
Charley
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125112_tn?1217277462
>In April, I had my tonsils out and the Anethesiologist after awakening<

Oh lol...that would be after *I* woke up...not her. Sounds like she liked her own "juice." <Big grin>
Frightening thought, waking up on the operating table only to find the anethesiologist laying on the floor with the gas mask over *her* face. ;-D
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125112_tn?1217277462
The author is: Elizabeth Lee Vliet, M.D.
There's Ebay! (-= and to "Look inside" the book feature, Amazon:
http://www.amazon.com/gp/product/0871319144/sr=8-1/qid=1153444197/ref=pd_bbs_1/102-6943134-7116139?ie=UTF8
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Avatar_f_tn
This might not answer your question but perhaps it will give some insite to the thyroid tests.

Serum FT4 measurement is a more reliable indicator of thyroid status than TSH when thyroid status is unstable.

When thyroid status is stable and hypothalamic-pituitary function is intact, serum TSH measurement is more sensitive than free T4 (FT4) for detecting mild (subclinical) thyroid hormone excess or deficiency.

TSH relates to whether a person is hypo or hyper. The TSH acts as a running average of actual thyroid hormone levels.  TSH measures much tinier distinctions more accurately so doctors rely heavily on it and is considered much more reliable than looking at actual blood levels of thyroid hormone.

T4 test generally aids in the diagnosis of hypothyroidism or hyperthyroidism and usually is ordered in response to an abnormal TSH test result.

F/T-3 is used mainly to help diagnose hyperthyroidism. T3 is not usually helpful if your doctor thinks you have hypothyroidism.

Thyroxine (T4) and triiodothyronine (T3) are controlled mainly by thyroid stimulating hormone (TSH)
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