Most labs and doctors are still stuck on the old reference range for TSH, which is .5 - 5.0. Over 8 years ago the AACE concluded that there were a lot of suspect hypo patient's data in their data base for TSH. After purging the data base, and recalculating, they recommended the new range should be .3 - 3.0.
Beyond this you should be aware that TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic for thyroid problems. At best it is an indicator that should be considered along with more important indicators, which are symptoms and the levels of the actual, biologically active thyroid hormones, free T3 and free T4 (not to be confused with total T3 and total T4).
If you haven't been tested for free T3 and free T4, then it would be a good idea to do so. FT3 is the most important because it is four times as active as FT4, plus FT3 correlates best with hypo symptoms. You might have to insist on those tests because many doctors resist running free T3 on the mistaken assumption that if they know FT4, then they can adequately estimate FT3. This is incorrect because people do not always convert T4 to T3 adequately. In view of the importance of FT3 why not just run the test and be sure?
If you are able to get those tests done, you should also be aware that just being in the low end of the reference range is frequently inadequate to relieve symptoms. Many members here report that symptom relief required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
Sorry if this is more than you really wanted to know. Just wanted to make sure you got your money's worth. LOL
Well I dont know if trl47807 didnt need all this info I sure DID!! I just got my results back and I wondered why he didnt run FT3 but after your explanation it makes perfect sense. I have Hashimotos thyroiditis and seem to have hypo-symptoms (i believe) My heart rate races a whole lot, my hair falls out and I;m always so tired. I have a chiari malformation which I have tons of problems with ..including the diagnosis it took 2yrs. but im trying to determine if its my brain giving me the heart issues (since they rulled out heart problems) or if its my thyroid. A lot of ppl tell me it's my thyroid but even w/a dx of hashis my endo doesnt treat me. I have a goiter and my thyroid is englarged. I had a nodule but its gone. My last tests read:
TSH 3.679, FT4 1.1, ANTIBODIES TG:20.00 and TPO 10.00
i must add my hormones are out of wack. They dx w/PCOS bc of hormone levels (not cysts) they gave me metformin which i never took so i went back to retest and they havent told me if PCOS is still a dx.
This is all so confusing to me. My doctor says her test is fine. UGH my TSH Level was 8, went down to 7, after raising my medicines again, it is now down to 4.5...hopefully she is doing something right? When I touch my neck in front sometimes I will come across a tender spot, should she be looking to see if it where my thyroid is? I'm a big gal, so looking for something may be hard visibly.
Well, your doctor obviously has the "Immaculate TSH Belief". It's pretty widespread, but that doesn't make it right. This is a good article that will give you some good info.
Has the doctor tested TPO ab and TG ab, to determine possible cause for needing thyroid meds? Do you still have symptoms of being hypo?
I think you are going to have to discuss all this with your doctor and change her mind about the testing and treatment. You may have to beat her up a bit and insist on the tests. Symptom relief should be all important, not just treating your TSH level. If you are unsuccessful with that, then you will need to start looking for a good thyroid doctor. By that I mean one that will test and adjust your FT3 and FT4 levels with whatever type of meds are required to relieve your symptoms, instead of treating your TSH level.
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