Should I be concerned? Please help.

[Freddy_fred]

My TSH levels from an ER blood test came back at .94. I've done a bit of google and youtube research and have read and heard that anything below 1.0 should be investigated. Should I be concerned?  

Thank you all

[Barb135]

Not a problem... While Hashimoto's is, typically, associated with hypothyroidism, early stages are often characterized by periods of hyperthyroidism that sometimes alternate with periods of hypo and/or normal.  Hashimoto's ultimately leaves the patient hypo and reliant on thyroid replacement medication.

Graves Disease is ALWAYS associated with hyperthyroidism and often results in thyroid ablation or removal, which, again, leaves the person hypo and reliant on thyroid replacement medication.

Another recommendation, at this point, would be thyroid ultrasound to determine whether or not you  have nodules on your thyroid.  Sometimes, the thyroid is working perfectly, but nodules can produce thyroid hormones independently of the thyroid and this hormone is not controlled by TSH or anything else.  This is another reason to get the FT3 and FT4, as well.  An ultrasound can also confirm/rule out thyroiditis/inflammation/swelling of the thyroid.

[Freddy_fred]

Thank you. I really appreciate you taking the time to respond.

[Barb135]

Things like that can be due to hormonal changes and it never hurts to get a thorough check up; however a TSH of 0.94 is, typically considered near perfect, since the recommended reference range is 0.3-3.0 - it's just that some doctors want to keep TSH in patients who are on medication at/near the 1.0 mark.  Your TSH of 0.94 does not indicate, either hyper or hypo.  TSH neither causes nor alleviates symptoms and should not be used as a sole diagnostic.  It should be coupled with actual thyroid hormones.

For peace of mind, you could request TSH, Free T3, Free T4 and thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab), Thyroglobulin Antibodies (TgAb) and Thyroid Stimulating Immunoglobulin (TSI)...

The Free T3 and Free T4 will tell you what your actual thyroid hormone levels are.  The TPOab and TgAb will confirm/rule out Hashimoto's Thyroiditis and the TSI will confirm/rule out Graves Disease.  

That would be my recommendation, at this point.

[Freddy_fred]

Thank you for your thoughts. I went to the ER due to a sudden and bizarre panic attack that changed my entire mental and physical well being. From one moment to the next, I experienced a shift in consciousness where I detached from my sense of self and my connection to reality. Something went very wrong. I was diagnosed with Depersonalization about two weeks later. Been like this ever since.

After some research, I've heard that this can be caused by a hormonal imbalance. Sooo, I noticed that my TSH was a tad low and want to find out if I need a full panel blood test.

[Barb135]

"I would not consider TSH of 0.94 anything to be considered with" - sorry - I meant "concerned" with...  my fingers aren't working well this morning... lol

[Barb135]

Whether or not that result is a concern would depend on the reason for your visit to the ER.  Was the visit to the ER thyroid related - as in, due to thyroid related symptoms? Was TSH the only thyroid related test that was done?

The doctors should have ordered Free T3 and Free T4, which are the actual thyroid hormones, while TSH is a pituitary hormone.  Unless you have symptoms of a thyroid condition, I would not consider TSH of 0.94 anything to be considered with, since the recommended reference range is 0.3-3.0, even if that's not the one used by the lab that did your test.

[Freddy_fred]

Im 27 and male btw.