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  • What is "normal" TSH, anyway?

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    Old 02-18-2003, 08:56 PM   #1
    Lithiate
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    Question What is "normal" TSH, anyway?

    Hi all. I've been mulling the whole issue of hypothyroidism over in my head for about 6 years now. My family history is rife with the disorder (we're talking out of 10 of my closest blood relatives, 8 have hypothyroidism). My mom became hypothyroid in her 30's, with no weight gain. Her only symptom was depression and feeling cold all the time. When I was 19, she suggested I start getting tested for it. I'm 25 now, and I've had three TSH tests, all within "normal". But here's the thing... My latest TSH test came back with a reading of 2.3 and my doctor considers that no reason to suspect that I have anything to worry about (the lab considers anything between 0.5 and 5.0 as "normal"). HOWEVER... I've got the symptoms. Depression, anxiety, irritability, sensitivity to cold, low body temperature, fatigue, dry skin, the list goes on. Had my mom not been so insistant that I start checking my thyroid functioning, this probably wouldn't have even crossed my mind.

    What can I do? I want to see an endocronologist about this, but my primary care doc keeps insisting everything is peachy and I don't need a referal to an endo (but here's a prescription for prozac to treat the depression and anxiety). I guess I'm just venting about this because it's difficult not being taken seriously.

    Has anyone else here had a "normal" TSH test and was later proven to have a thyroid condition? How did you get the diagnosis in the end? I'm just so frustrated because it really feels like something is wrong, but there's not a whole lot I can do about it, it seems.

     
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    Old 02-19-2003, 06:58 AM   #2
    Daisy22
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    Hi,
    I completely understand. I started having hypo symptoms 4 years ago when I was 19, and my mom noticed my thyroid was enlarged. My dr. ordered bloodwork, but never even saw me. I was told my results were "normal", and I continued feeling horrible. I felt like I was in my 60s. The next couple years I got more and more fatigued, cold, and depressed. I finally went back to my dr to pursue it. My TSH was still "normal" at 3.3, but I had a multinodular goiter. I had an antibodies test which showed I have Hashimoto's Disease, and my dr. decided to start me on synthroid.

    I definitely have a thyroid disease, but my dr's aren't convinced I was hypo. But I know I was. My symptoms have gotten so much better since being on meds, I feel like a different person.

    New guidelines have come out that are restricting the range for TSH. Mine would have been high with the new ranges. Yours is probably too. Although some people would feel fine with your TSH, others might not. Many people like their TSH to be 1. I like mine at the very bottom of the range to feel best.

    If I were you, I would insist that you see an endo or that your dr perform more tests. You need T4s and T3s done, and the antibodies test. Make sure to get copies of your lab reports, too. If I wouldn't have fought to get more tests done, I would still be feeling bad.

    Good Luck


     
    Old 02-19-2003, 10:11 AM   #3
    ringbearer
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    Oh, don’t even get me started! My TSH was “normal” a year and a half ago (1.19). I was sent on my way and not even ASKED about any symptoms I was having. The things that I did complain about – weight loss, hair loss, and skin problems – I was told had nothing to do with my thyroid. Fast-forward a year, CT scan shows a nodule. Thyroidectomy reveals Hashimoto’s and papillary cancer. TSH at that time? 2.5.

    Can you have a normal TSH and still have a thyroid condition? Yes. Why they think that test is “the be all and end all” is totally beyond me.

    You can bet that I am going to be just like your mother with my daughter. They won’t make the same mistake with her if I can help it.

    If they had given me an ultrasound and an antibody test the first time I saw the endo, they probably would have found my problems. Keep looking for answers and good luck!

     
    Old 02-19-2003, 10:17 AM   #4
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    A few recent studies show that the most likely TSH score for a healthy adult with no thyroid risks or symptoms is about 1.5.

    What is "normal" and what is healthy for you may be two different things, though. Yes, the lab considers anything up to 5 to be "normal" but here's some food for thought:

    A few years ago, the American Associatoion of Clinical Endocrinologists published a paper suggesting that a TSH above 3 is suspect for hypothyroidism.

    In the same year in a British medical journal, a paper was published stating that a TSH above 2 is suspect for hypothyroidism.

    TSH is not always an accurate indicator of thyroid health as it is not even a hormone produced by the thyroid gland itself. Additionally, According the Thyroid textbook at [url="http://www.thyroidmanager.org,"]www.thyroidmanager.org,[/url] TSH varies daily up to 3 points over just the course of a day. How accurate cna that be as a diagnostic tool?

    My TSH when I was diagnosed as hypothyroid was 2.6, which is not signicicantly different from your test at 2.3, statistically speaking.

    My suggestion is get another opinion and have more than just TSH done. At a minimum, get Free T3, Free T4 and TSH done, but preferable be tested for Thyroid antibodies, too. Even with "normal" results on all the oters, if your thyroid antibodies are elevated, you may have symptoms that would resolve by going on thyroid hormones.
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    Old 02-19-2003, 03:06 PM   #5
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    I agree with Meep!
    I was disabled with hypothyroidism at a TSH of 2! I was very symptomatic. Read our stories here:
    Let's tell Our Stories [url="http://www.healthboards.com/ubb/Forum118/HTML/000045.html"]http://www.healthboards.com/ubb/Forum118/HTML/000045.html[/url]

    The Nov./Dec. 2002, American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism, vol. 8, no. 6:
    [url="http://www.aace.com/clin/guidelines/"]http://www.aace.com/clin/guidelines/[/url] [url="http://www.aace.com/clin/guidelines/hypo_hyper.pdf"]http://www.aace.com/clin/guidelines/hypo_hyper.pdf[/url]

    Some of the info in the report:

    The target TSH level should be between 0.3 and 3.0. Once the level is achieved, annual examination is appropriate. (The treatment must be tailored to the individual.)

    The diagnosis of clinical or subclinical hypothyroidism must be considered in every patient with depression. Treatment by thyroid hormone alone has not been proven to alleviate the depression.

    Treatment is indicated with the TSH level between 5 and 10 with goiter, (even if there are no symptoms)
    since these patients have the highest progrssion to overt hypothyroidism.

    With a TRH test, my TSH elevated into the twenties, and the doctor still did not want to treat me. Yet I had all of the symptoms of hypothyroidism.

    Search for the doctors in the know. They are out there!



    [This message has been edited by Tree Frog (edited 02-19-2003).]

     
    Old 02-20-2003, 08:52 AM   #6
    Lithiate
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    Thank you all for your suggestions and support. I'm begining to think that I may have to circumvent my HMO and seek out an endo in a private practice if I want to get this thing thoroughly checked out. The only problem is that I'm currently saving all my cash for my wedding in July, so it may have to wait a while...

    The only test I've had done was the TSH because (and I quote my dad's best friend who is head of the UC Davis student health program) "it's the most sensitive and realiable test available and it doesn't lie. Plus, you're too young to worry about thyroid problems." Don't get me started on that conversation. :P

    My first TSH test was done when I was 19 and it was 2.1, the second they never told me what it was and the third, which was done in December after I presented with a severe anxiety attack, was 2.3. It's not intollerable now, but it's not exactly a cake walk a lot of days. I just really wonder what would happen if I spent a month on thyroid medication...

    Sarah

     
    Old 02-20-2003, 11:08 AM   #7
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    Let me first begin by telling you, you find a doctor that will listen to your needs. I too found out the hard way I had thyroid problems. Im a mother of three under the age of 7. My doctor told me I was depressed get a job and go to therapy, long story short, I did all expect a job, staying home with my children is my job. Saw therapist for 5 visits, she told me to find a new doctor, I didnt need therapy, stop taking the prozac, which I took for 11 months, and I didnt need it. I went to a endo that I loved and I am on my way to feeling better, I also found out I had Hashimoto. Unfortunate but you have to do all the reseach and tell them! good luck, it gets better, beleive it or not
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