TSH level

[tiredpoet]

what is the accepted "normal" range for TSH level?  
What is normal fluctuation?  For example if someone has symptoms with no other diagnosis and their TSH goes from 1 to over 3, even though they're still in the "normal" range couldn't thyroid still be off and causing the symptoms?  Or does the thyroid not cause symptoms until levels are outside of the normal range?  

I've asked this question before, but my posts seem to be disappearing somehow.  

[gimel]

TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate to use for the sole diagnostic for thyroid issues.  At best TSH is an indicator to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4 (not the same as Total T3 and T4).  

Since you daughter had a test that showed TPO ab to be 68, along with her symptoms, it is a good indication of the most frequent cause of diagnosed hypothyroidism, which is Hashimoto's Thyroiditis.  

For now, You really need to get her tested for Free T3 and Free T4, in order to see those levels and confirm that she should be on thyroid medication.  If the doctor resists, you should insist on it and don't take no for an answer.  

When test results are available, if you will get a copy and post results and their reference ranges, members will be glad to help interpret and advise further.

[laara160]

the fluctuations in tsh within the limit is a normal thing in children under 10yrs? my dd had 2.7 tsh in 4 months .. after that i tested her again at the age of 61/2 now..now her tsh is just 1.266.. what does it mean? inaddition her tpo antibody level is (tested for the first time) 68.. she is gaining  her wait easily and having protruded tummy,and also little bit slow... i couldn't give the food whatever she wants...but her endo  doesn't give any medication ..plz clear my confusion..

[CrohnieToo]

I'm not a medical professional, just a patient, but I say AMEN! to the advice Gimel has given. I raised dogs for 30+ years, we ran into some conception probems w/underlying thyroid problems. We had the entire kennel tested, the only two definitely HYPOthyroid via blood tests displayed HYERthyroid symptoms. One thing I learned working w/veterinarians was that the GOOD ones treated the SYMPTOMS when blood work was borderline "normal".

That being said, my blood draw done a week before my recent first FNAB for an enlarged right lob w/a complex, partially cystic/partially solid "lesion" in the mid pole and a more complicated lesion in the lower pole, also partially solid/partially cystic; showed a T3 Total of 173 with the Reference Range given as 60-181; T4 Free of 1.0 with a Reference Range given as 0.8-1.8 and TSH of 0.96 w/a Reference Range given of 0.35-5.50.

I always check the span of the reference range. For instance the TSH the range is 5.15 (5.50 minus 0.35) and my level is slightly less than 1. Doing this helps me get a better idea of just how "borderline normal" my levels may or may not be or how well w/in "normal range" they are.

[gimel]

The reference range currently recommended by the Amer. Assn. of Clinical Endocrinologists is .3 - 3.0.  It was recommended over 6 years ago, yet most labs and doctors are still using the old range of .5 - 5.0.  Even if TSH is within range, that does not preclude hypothyroidism.  TSH is a pituitary hormone that is affected by many variables.  It is inadequate as a diagnostic.  At best it is an indicator, to be considered along with more important indicators, which include symptoms, as well as the levels of the actual, biologically active thyroid hormones, FT3 and FT4.
Even test results within reference ranges for the free T3 and free T4 do not preclude hypothyroidism either.  The ranges for FT3 and FT4 are very broad and have not been adjusted like was done for TSH.  The result is that we hear from many patients with FT3 and FT4 levels just within the low end of their ranges, yet they have hypo symptoms.  
So, in my opinion,  the very best way to treat a thyroid patient is to test and adjust the levels of FT3 and FT4 with whatever meds are required to alleviate symptoms, without regard for the resultant TSH level.  The most difficult part of getting adequate treatment for being hypo is finding a good thyroid doctor that understands all this and is willing to treat your symptoms by adjusting your FT3 and FT4 levels.  Frequently we hear from patients that alleviation of symptoms requires FT3 in the upper part of its range and FT4 at least at the midpoint of its range.  Alleviation of symptoms is what it should be all about.

So for you, maybe the best place to start is to insist on being tested for FT3 and FT4 and confirm that they are, as I suspect, in the lower end of their ranges.  You should also discuss this with your doctor and see if he is going to be willing to treat you for your symptoms as described above.  If not, you will need to start looking for a good thyroid doctor that will do so.