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Thyroid

I am a 36yr old male that has had two recent general labworks done and they have shown a TSH of 5.12 and then 3.75 a week later. My primary care MD says that these are "Normal" and nothing to be concerned about. I do have some mild hypo symptoms however..tiredness, brain fog, high cholesterol. Is it likely these are coincidental or is it possible they are related and I should see an endocronologist?...thank you
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Avatar universal
Over 8 years ago the AACE recommended that the range for TSH should be revised from .5 - 5.0 down to .3 - 3.0.  Unfortunately most labs and doctors still have not adopted the change.  Beyond that TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid.  At best it is an indicator,  to be considered along with more important indicators such as symptoms and  also levels of the biologically active thyroid hormones, which are Free T3 and Free T4 (not Total T3 and Total T4).  FF3 is the most important because it largely regulates metabolism and many other body functions. FT3 has also been shown to correlate best with hypo symptoms, while FT4 and TSH did not correlate very much at all.  

Based on your symptoms and the TSH test results, it seems likely that you are hypothyroid and you need some further testing.  I would suggest that you need to be tested for Free T3 and Free T4.  Results in the lower end of their ranges would be further indication of being hypo.  Just because results fall within the so-called "normal" ranges does not mean that they are adequate for you.  The ranges are far too broad for that to be the case.   The ranges should be considered as guidelines within which to adjust FT3 and FT4 as necessary to relieve symptoms.

Since Hashimoto's is the most common cause of hypothyroidism, you should also be tested for the thyroid antibodies, TPO ab and TG ab.  

You do need a good thyroid doctor.  That does not mean it has to be an Endo.  Frequently they seem to be the most rigid about diagnosing and medicating based solely on TSH .  That does not work.  A good thyroid doctor will treat a patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can read about the clinical approach in this link, written by a good thyroid doctor.
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Avatar universal
Thank you very much for the response! Any thoughts on how to track down a good thyroid doctor in the Boston area?...outside of a simple google search
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Avatar universal
I have been making a list of doctors recommended by Forum members, but don't have one for the Boston area.  You can have a look at this site and see if there are any doctors that look like prospects for you.  I have had fairly good success with recommending doctors from this list.  I pay careful attention to the patient feedback and I also look to see if there is evidence that they treat for symptoms, not TSH.  Also if there is an indication that they are willing to prescribe meds other than just T4 types, that is a good sign.  

http://www.thyroid-info.com/topdrs/massachusetts.htm

I saw one that looked like a good prospect.  I will forward name by PM.

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Avatar universal
Perfect. I really appreciate your help!
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Avatar universal
Sorry, I looked back and noticed that I left off the link I mentioned.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

Please let us know how things go for you and how things work out with the new doctor.

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