Acceptable range for TSH?

[Tempitis]

My TSH has almost doubled since last year from 1.79 to 3.29.  

My other numbers - T4 (6), T3 uptake (34), free T4 (2) - are relatively stable.

Should I be concerned?  

I'm exhausted - stressed and depressed.  My GP says my numbers are normal.  A few years back I suffered a thyrotoxicosis that left me slightly hypothyroid.  30/mg Armour thyroid/day had me feeling better.  I've read that TSH over 2 is now considered indication of hypothyroidism.  Is this true?

[Tempitis]

I agree - I need to see another doctor, one who understands thyroid function in greater detail.  I'm looking for one.  My stress is circumstantial and not likely to resolve itself any time soon.  

Thanks for sharing what you know!

[flyingfool]

Find another Dr who does use and test T3.  You will likely stay sick otherwise!  In MY OPINION, any Dr who is treating a patient with a T3 medication (which Armour is) and not testing for Free T3 is bordering on malpractice.  T3 can be very touchy and to treat with T3 and not monitor the blood levels just makes no sense what so ever!

Hypo can have symptoms of depression and certainly fatigue.  Also stress can have an effect on thyroid. In particular it can increase the amount of Reverse T3 that is produced during conversion of the T4 into T3.  Reverse T3 is useless to the body.  In fact one theory says that the reverse T3 "looks" so identical (it is the mirror image of Free T3) to the body's cell receptors that the receptors will accept the Reverse T3 (RT3) and essentially "plug" them up.  Or take up the vacancies and thus there is no room for the actual Free T3 that IS biologically active and the ONLY thing your body's cells use from having a receptor to do its job.

Bottom line is that when stress is high either emotionally, physically through exercise or dieting or injury recovery etc the body can make more RT3 and thus less Thyroid is actually getting to your cells.

It is IMPOSSIBLE to determine this without testing for Free T3.  RT3 can be tested but it is very expensive from what I understand and most Dr's will not do it unless a last resort.  So reduction of stress may very well help but it may not be the complete fix.

Above you state that you are taking Armour which has a T3 component which is good.  The ONLY way reverse T3 is made is from the conversion of T4.  The T3 in the medication is available immediately.  So at least your cells have some T3 to work with.

However in MY OPINION, any Dr who is treating a patient with a T3 medication (which Armour is) and not testing for Free T3 is bordering on malpractice.  T3 can be very tricky and to treat with T3 and not monitor the blood levels just makes no sense what so ever!

[Tempitis]

Thank you, flyingfool -

My main symptom is lack of energy.  I'm active, but I can get very tired.  I'm positive for certain EBV markers, an indication is of past infection.  I suffer from depression.  I'm aging.  My life is particularly stressful just now.  My GP attributes my symptoms to stress but, based on life experience and what I've read, I feel the need to investigate further.

The lab my doctor uses doesn't measure free T3.

[flyingfool]

TSH is a screening test/tool at best.  The "real" test for your thyroid health is the two FREE tests.  Not free in terms of cost. Rather it denotes that the hormone molecule is "free" from being attached to a protein molecule.  Once a protein attaches itself, the hormone becomes unusable.

So you really want to get tested for BOTH the Free T4 AND the Free T3.

In addition the two antibodies TPOab and TGab. (to determine if you have Hashimoto's).

Many people have found they need in order to feel well to be significantly up into the ranges of both Free T4 and Free T3.  In fact the better target seems to be:

1) Free T4 to be in the middle of the range (50%) or slightly higher. Your test indicates that you are only at 21.7% of its range.  So plenty of room for improvement.

And- that means in addition

2) Free T3 to be in the UPPER 1/3 of the range (66.7%).  You were not tested for Free T3 so you don't know where you're at.

Free T3 is the ONLY hormone that your body uses at the cellular level.

Even though TSH is not a good tool, many Dr's believe that they will treat in order to get the TSH result to be between 1 and 2.  Yours being over 3 would also indicate that you may be Hypo.

What symptoms do you have currently?

[Tempitis]

Thanks, Barb135.

The lab describes the range for their free T4 index as 1.5 - 3.8.

I don't have many of the symptoms for Hashimoto's Thyroiditis tho I doubt I've been tested for the specific markers.  I do have inactive EBV in quantities great enough to surprise my doctor.  Judging by what I've read on the web this morning, there is a relationship between hypothyroidism and auto-immune dysfunction.  Makes sense to me.  Further research required, by me and the medical community.  

Thanks for connecting the dots!

[Barb135]

Approximately, 10 years ago, the AACE set the range for TSH at 0.3-3.0; however very labs and/or doctors go by the "new" range.  Some (very few) doctors do consider anything over 2 as being somewhat hypo, but TSH is not a good indicator of actual thyroid function. Far more important are the Free T3 and Free T4.  Total T4  an T3 uptake are considered obsolete and of little value.

What was the reference range for your Free T4?  Those ranges vary lab to lab and have to come from your own report.

Do you know if you have Hashimoto's Thyroiditis?  With Hashi's, it's not unusual for symptoms to be present before lab results show a problem that doctors are willing to deal with.