Hypothyroidism???

[AndreaDawnV]

I recently had my TSH levels tested and I came back with 5.67. I spoke with a friend of mine who is a doctor and he advised me that I should speak with my primary care doctor about getting started on some medication. When I was able to speak with my primary care doctor (I go through Kaiser and so you always have to wait to speak with someone) she argued with me. She stated that my level was normal and that since these things take time she wanted to just wait and retest me in 6 weeks. I was finally able to get her to agree to putting me on some low dose thyroid medication to see if it would help me (I am experiencing all the normal symptoms but they're accompanied by nearly constant nausea (yes, I've been tested, I'm not pregnant)). They use a range of 0.320-5.500 uIU/mL therefore I'm not necessarily out of their range.

Is 5.67 particularly high? Should I be on medication? Or was my doctor right in just making me wait 6 weeks?

I appreciate it in advance and look forward to your comments.

Thanks again!

[Shastacovich]

Hello. Here is my last lab:

fT3: 2.9 in 2-4.4
THS: 1.18 in 0.27-4.2

I think the reason my T3 has improved is that I take iodine (one drop of 2% Luggol's on skin 3 times a week). Have not been taking dessicated thyroid for a while. Even though it gives me energy, it makes me anxious and irritable.  Doctor suggested I take synthroid which is milder than desiccated thyroid but I've not started it yet. I have terminal insomnia which I'm thinking may be caused by hypothyroidism.

[dee3368]

you may want to see another doctor i was told by my gyn after my brother told me to get tested cause he had (graves)

[gimel]

I realized that I forgot to mention that many doctors are reluctant to test for FT3, on the (mistaken) assumption that if they just test for FT4, they can estimate FT3 levels.  This is frequently not the case because many people do not convert T4 to T3 very well.  Also, when on thyroid meds, it seems to slow the conversion.  So my feeling is why not just do the test and be sure since FT3 is so important.  FT3 is four times as active as FT4, plus FT3 has been shown to correlate best with hypo symptoms.  In that same study, FT4 and TSH did not show any significant correlation to symptoms.

[gimel]

Over 8 years ago the Amer. Assn. of Clinical Endocrinologists recommended that the ref. range should be changed from .5 - 5.0, down to .3 - 3.0.  The rationale behind this significant change was that the TSH data base apparently included lots more hypo patient data than they originally had assumed, when limits had been established.  So they purged the data base of suspect hypo patient data and recalculated a new reference range.  Unfortunately, most labs and doctors still cling to the old range.

More importantly, TSH is a pituitary hormone that is affected by so many variables, that it is totally inadequate as a diagnostic, by which to treat a thyroid patient.  At best it should be used as an indicator, to be considered along with more important indicators, such as symptoms and the levels of the actual, biologically active thyroid hormones, free T3 and free T4.

Since you mentioned having hypo symptoms, and your TSH also indicates the possibility of being hypo, I suggest that you go back and request testing for FT3 and FT4 as well as TSH.  You should also request testing for the most prevalent cause of hypothyroidism, which is Hashimoto's Thyroiditis.  Tests for this condition would be TPO ab and TG ab.  If your doctor has a problem with doing these tests, then you will need to insist they be done.  After all, you are the customer.  Don't take no for an answer.

After the tests, get a copy of results for future reference.  Doctors are required to provide a copy upon request.  It is a good idea to also note on the copy how you are feeling with those results and what meds you are taking at the time, if any.  If you will get the lab report copy and post here, our many experienced members will be glad to help interpret.  

In my opinion, a good thyroid doctor will test and adjust FT3 and FT4 levels with whatever type of medication is required to relieve symptoms, without being constrained by TSH levels.  Symptom relief should be all important, not TSH level.  If your doctor has a problem with treating your symptoms with this approach, then you may as well find out and start looking for a good thyroid doctor that will do so.

  

[xrvlms731]

Thank you for the very clear information you provided here. Very informative, accurate and helpful!!!