TSH levels?

[rombou]

Hi,
I had been feeling tired, battled weight gain and just not feeling right for years. My grandmother had goiter in her early 20's had surgery and has been on thyroid meds ever since. I had been tested over the years and was always told I was borderline hypothyroid but they never wanted to treat just told me to eat right and exercise. Finally after gaining 100 lbs, feeling disorentated at times losing concentration, puffy face and basically falling asleep in a middle of a conversation, my doctor check my results again and told said we needed to treat. For the last two years my dose has been increased every 8 to 12 weeks. I finally asked if theres any other treatment and was told that my tsh is slightly improving each teat. I'm now on 200mcg and my level was tsh 7.47 previous 9.17 at .175. I still don't feel any better.I'm tired of being tired. What else can I do at this point?

[gimel]

The first thing I would want to do is to get tested for the actual, biologically active thyroid hormones free T3 and free T4, along with the TSH.  TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic for thyroid medication and dosage.  At best it is an indicator to be considered along with more important indicators such as symptoms, and also levels of free T3 and free T4 (note that is FT3 and FT4, not total T3 and total T4).  FT3 is the most important because it is the most active and it largely regulates metabolism and many other body functions.  Studies have also shown that it correlates best with hypo symptoms, while FT4 and TSH did not correlate.  

In my opinion the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever meds are required to relieve symptoms, without being constrained by resultant TSH levels.   Symptom relief should be all important, not TSH levels.  Many of our members report that symptom relief for them required that FT3 was adjusted to the upper part of its range and FT4 adjusted to at least midpoint of its range.  If your doctor is unwilling to treat you clinically (for symptoms), in this manner, then you will have to find a good thyroid doctor that will do so.  

Many members report finding that even when taking substantial dosages of T4 meds, their body was not converting T4 to T3 adequately, and their FT3 level was lower than necessary.  So it is very important that you get the FT3 test done.  Members also report that along with having low FT3 and hypo symptoms, they also had low Vitamin D, B12 and iron/ferritin, all of which can contribute to being tired.  So those should also be tested.  Since the most common cause of becoming hypo is Hashimoto's Thyroiditis, you should also ask to be tested for the thyroid antibodies, TPO ab and TG ab, to see if it is autoimmune system related.  

When test results are available, I suggest that you get a copy and post results and reference ranges for each, and members will be happy to help interpret and advise further.  

[rombou]

Thanks

I know that they do a full panel when they do a blood test but She only lets me know what she thinks is adnormal so on Monday I'm going to ask for all my results since I just came across thisforum
Thanks

[Barb135]

I totally agree with everything gimel said and might add that a thyroid ultra sound might be in order, as well, to see if you have nodules on your thyroid.

Please keep in mind that there are also people whose TSH remains higher than "normal", but if their FT levels are good, this isn't always a bad sign.

Your doctor is doing you a great disservice by prescribing and dosing based solely on TSH.  This is usually disastrous and will keep you ill much longer than necessary.

[vishal_agrawal]

Hi I have a similar concern. My report is following:
T3 1.01
T4 6.62
TSH 7.47

All my blood counts are perfect.

Doctor has told me that he would start medication from tomorrow. Should I consult some other doctor?

[gimel]

Please post the reference ranges shown on the lab report for those test results.  Also, what symptoms do you have?