tsh level and need for medication

[karendave56]

I recently got a tsh completed and my results came back at 3.890 my dr is suggesting I go on LEVOTHYROXINE  25 MCG daily and recheck my tsh in 8 weeks. I just turned 40. I was wondering I cant find actual lab data that gives you the range for a  normal tsh. Should I even at this point need a medication for that result?  

Thank you
Karen

[gimel]

From your posts it sure sounds like there is a need for some kind of medicine.  Seems to me the only issue is what kind and how much.  LOL

So,  do suggest that you should get those tests done that I mentioned above.  I would also include Vitamin D, B12 and ferritin, as a start.  If you will get those tests done and post results and their reference ranges shown on the lab report, members will be better able to assess your status and advise further.

[karendave56]

I didnt even go into this appointment with the intention of having a TSh it was just a routine physical and she tested my TSH, I am low in vit d the test came back at 21.68 and she told me to start taking 2000 InternationUnits of D3, My main concern was that I have been feeling nausous for the past couple of months and didnt know if I had h-pylori again but my blood test for that came back showing I had had it in the past but dont have it now or if it could be my gallbladder seems my hyda scan came back as my gallbladder only working at 16%, . I dont believe she did a free t3 and a free t 4 I think it was just a thyroid function test. she didnt mention that in any of the labs just the tsh. I do feel fatigued but summed that up to just working and a family, I sweat alot right before my period only when sleeping though I wake up drenched that I have to change my clothes drenched. Im always cold but have been for years.  I just dont want to take medication or start medication if theres no need for it.

[gimel]

The old range for TSH was .5 - 5.0 in most labs.  then about 10 years ago the AACE recommended that the range should be reduced to >3 - 3.0, which was a huge change.  Although most labs and doctors still are not up to speed on that change, apparently your doctor is.  However, TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as 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, which are Free T3 and Free T4 (not the same as total T3 and T4).  Of these tests Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with symptoms, while Free T3 and Free T4 did not correlate at all.

So, my question is what symptoms do you have that might relate to being hypothyroid?  Also, if you haven't been tested for Free T3 and Free T4, that should be done each time you go in for testing.  Since hypo patients are frequently low in other areas as well, you should also test for Vitamin D, B12 and ferritin.  If you haven't been tested for the possibility of having Hashimoto's Thyroiditis, then you should also get the tests for thyroid antibodies, which are TPO ab and TG ab.  If you will tell us about your symptoms, and also get these tests done and then post results and their reference ranges shown on the lab report, members will be glad to help interpret and advise further.

Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance, after an initial first hand evaluation and testing.  The letter is then sent to the participating PCP to help guide treatment.  

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