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Old 08-11-2003, 08:18 AM   #1
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kael HB User
Wink Hey Meep - TSH Question!

When I posted my last lab values, it was obvious (as you said) that my TSH was too high at 9.839 (at least part of the reason why I feel like crap!) But get this. I've been really sick, so they've poked me so many times lately. I just went back and chronologically listed my TSH since last December and I couldn't believe (or understand) the huge fluctuation. What's the explanation for this?

12/13/02 1.73
6/6/03 3.22
7/9/03 14.913
7/16/03 5.26
7/24/03 9.839

Are there some lab errors in there? I know I've read you to say that TSH can vary by 3 points in 24 hours (did I get that right?) Can you help me out here? Very confusing!!!

Is there a specific time of day -with meds, no meds, etc. to get the most accurate reads on a blood panel?

Thank You Sir
You're the Best!
Hugs,

Kael

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Old 08-11-2003, 09:03 PM   #2
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bumping up
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Old 08-13-2003, 07:08 AM   #3
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bumping up again

thanks

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Old 08-13-2003, 07:44 AM   #4
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Yours is varying more than what I woudl think due to just circadian fluctuation woudl account for. Have you been tested for Graves, TPO antibodies and Thyroglobulin antibodies?

Any of those alone or in combination could cause you to have fluctuations like that.

Alternately, a pituitary tumor could cause weirdness like that too, though that is VERY unlikely.

As for the time of day that it is best to have TSH measured, supposedly, healthy people with a "normal" schedule have a surge of TSH starting about 9pm which peaks about 1am. In practice, though, we are all different. Some people have this peak in the afternoon and some in the morning, too.

Since TSH is released in several pulses once a day, it depends on when you get your pulse of TSH as to what you should do regarding meds, if all you are measuring is TSH.

I prefer not to rely on TSH, but to look at Free T3 and Free T4 to track my thyroid levels, just due to the daily fluctuations. If you are going by Free T3 and Free T4, I like to keep at least 8 hours between when the meds were taken and when the blood is drawn. If you have your blood drawn in the morning, take your meds after the blood is drawn. If your meds are drawn in the afternoon, schedule the draw as late as possible and take your meds as early in the morning as possible.

My advice may be contrary to what many doctors will recommend, but it is sound and is based on repeatable scientific evidence.
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Old 08-14-2003, 07:47 AM   #5
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Smile

Meep -

Thank you once again. What my test shows is that the antibodies that are elevated are thyroid peroxidase antibodies. I will post a separate message because this brings up all kinds of questions!!!

Kael
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Old 08-14-2003, 07:56 AM   #6
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...and I assume a tumor in my pituitary gland would have shown up on an MRI, right?

K

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Old 08-15-2003, 12:45 PM   #7
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Quote:
Originally posted by kael:
...and I assume a tumor in my pituitary gland would have shown up on an MRI, right?
Most likely, assuming that they were looking for that on the MRI...(i.e. they imaged that part of your brain where the pituitary is located.)

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