Thyroid/TSH confusion

[yearofadventure.livejournal.com]

Alright, so I went to my gyno for my annual and requested to have my thyroid tested. I have some of the symptoms of hypothyroid, but really, they are so vague that probably 90% of the population would endorse them. Just figured I'd have it checked out.

Well, I have a copy of the results, which says my TSH level is 5.11, with a reference level of 0.34-5.60 mIU/mL.

I've talked to my doctor, who says the standards vary by lab, and that that isn't high enough to be treated. However, from comments on here, and from poking around the internet, I've noticed most sites cite 3 or 4 as the cutoff for normal/abnormal. She knew nothing of this, and just said it all depends on the lab.

Is this true?

I'm not one to question my medical attention typically, but I currently live in a small town and have seen/heard too many things get messed up. I just want to verify that this is correct. She offered to retest my TSH and get the T3 and T4 levels, but she seemed to think it wouldn't be necessary. Any advice?

Comments

[archangelbeth]

You are correct -- THS 5 is hypo. You can also check out thyroid for even more elaboration on that... (which I'd do, but am on phone to my mom... O:> )

Edit: Okay, off the phone now.
http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm -- that's the National Library of Medicine and the National Institute of Health's site. Note the...
Normal values are 0.4 - 4.0 mIU/L for those with no symptoms of abnormal thyroid function.

However, those without signs or symptoms of an underactive thyroid who have a TSH value over 2.0 mIU/L but normal T4 levels may develop hypothyroidism in the future. This is called subclinical hypothyroidism (mildly underactive thyroid) or early-stage hypothyroidism. Anyone with a TSH value above this level should be followed very closely by a doctor.

If you are being treated for a thyroid disorder, your TSH level should be between 0.5 and 3.0 mIU/L.

Now that even lets you go up to 4 without symptoms, but go to http://www.aace.com/newsroom/press/2003/index.php?r=20030118 -- the American Association of Clinical Endocrinologists said, in 2003, "Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.04."

Question your doctor. TSH 5 is way high enough to be treated. O:>

My doctor keeps me at TSH 1.

[frolicnaked.livejournal.com]

From my understanding, it's a recommendation from the American Association of Clinical Endocrinologists (http://www.aace.com/newsroom/press/2003/index.php?r=20030118), not an "it varies by lab" thing. Additionally, according to that recommendation, even "older" guidelines topped off at 5.0mIU/mL.

If it were me, I'd present the info -- the AACE rec and your symptoms -- to your doc and see what her recommendation is then. I also think getting a second opinion, from another GP or from an endocrinologist, wouldn't be a bad idea if it's one you'd be inclined to do.

[ihatemostthings.livejournal.com]

it is true...my hypothyroidism went unknown and untreated for many years because whatever lab I was tested at had standards like this.

I was finally diagnosed by a holistic doctor recommended by the Broda Barnes foundation (http://www.brodabarnes.org/) with a simple basal temperature test.
Using a non-digital thermometer, take your temperature in your armpit when you wake up - lay still for 10 minutes while the temp reads, then check it. If it is below the average of 98.6, particularly if it's by more than a degree below, you likely have a thyroid deficiency.
Sounds stupidly simple, but I was diagnosed this way and treatment with Armour Thyroid made my wide array of symptoms disappear, including many that I had no idea were related to thyroid function.

[twisty-mirror.livejournal.com]

i would see an endocrinologist. i have a hypothyroid, and there is no way he would let my levels be that high. like others said, get your T3 and T4 (both free numbers) checked.

[disturbedme.livejournal.com]

Yes, 5.11 is hypo. My TSH level was about the same... it was 5.98 or somewhere around there but a couple of my doctors poo-poohed it saying that it was fine and not really hypo.

I've heard and agree that most people feel their best having a TSH between 1 - 2. You need to see a different doctor about this if your doctor believes it's nothing to treat...because it is.

[southbr.livejournal.com]

Old post, but still incredibly relevant.

Thanks for all the contributors.

Max