reference ranges for thyroid tests

[Wendy7]

According to the AACE ( American Assn. of Clinical Endocrinologists ) as of January 2003 the TSH should be between 0.3-3.0.  Why is it that so many labs still go by the reference range .35-5.50?

[stella5349]

Dr Lupo is quite generous with his time here.

Some do have a fee and we are very much appreciate Dr. Lupo gives his time to to our community.

[Mark Lupo, M.D.]

There is still debate despite AACE's recommendations.  It is based on lack of clinical studies to show that treatment of a TSH >3 makes a difference.  Many of us use AACE guidelines despite what the commercial lab range states.....It must be based on the individual patient as clearly one size does not fit all.

[Thypatient]

Here's a response I gave on the other forum when this same question came up recently.  Perhaps the dr can speak on whether it's accurate or not:

"It’s a confusing subject. Which is a shame given TSH is a major aspect of the thyroid.

Here’s my understanding so far: The AACE lowered the range recommendation based on studies. But then those studies were thought to be incomprehensive, hence, controversial. That’s why many labs stuck with the previously determined range.

I had read (in one place) that the controversy came because some drs felt the said studies relied too much on determining if someone had thyroid disease by how they described themselves. This especially pertained to persons who had TSH readings between 3-5, the subclinical hypothyroidism area. In other words, it was too subjective. Given, you could ask someone how he/she feels and they will always say ‘awful’ but they might be healthy. Then the reverse could be true, you could ask someone how he/she feels and they will always say ‘great’ yet they could be harboring thyroid disease.

Maybe someone else has more up-to-date information, but the last thing I came across from the AACE is that until more studies are done they are sticking with their current lowered range. However, they do stress that diagnosis and treatment for readings between 3-5 should be determined by a qualified physician.

Given my personal experience, this seems like sound advice. I had a TSH range that fell within a healthy range (below 3) but the dr knew to pursue the situation further by doing an ultrasound. That u/s should [sic] quite a different story.

Good luck in the information you come across and in your own personal situation. But be careful, there is a lot of misleading information out there put together for the purpose of selling something or other.

Take care."


(Gee, I used to try to avoid contributing any responses over here because I had always thought folks were paying a fee on these "Ask a Doctor" forums.  I'm now told that's not true - no one's paying anything.)