TSH levels down

[ncpatti]

TSH levels:  2011 -  3.15; 2012 - 3.61; 2013 - 3.84; 2014 -- 1.870.  Because I have a cyst on my thyroid and an enlarged thyroid, I asked my doctor to do further testing.  My T4, Free (Direct) in 2014 was 1.02.  I've noticed that my TSH levels have gone down since 2011.  Can you tell me anything about these numbers?  I know they fall in the normal range, but I was wondering if they were getting too low?  

[ncpatti]

That's what I've read so I'll make sure I cover that issue if the ENT can't help.  I'm hoping I have fluid in my ear.  We'll see!!!

[gimel]

Tinnitus is a well known symptom of hypothyroidism also.  

[ncpatti]

In 2011, D was 22.5.  In 2014, it's up to 59.5 so that's good.  I'll look into the B12 and ferritin.  I have an appt with an ENT tomorrow for the ringing in my ears.  I've also read that B12 deficiency can cause ear ringing.  Once I'm done with the ENT, I may go to an endocrinologist instead of my physician.  

[gimel]

Please include ferritin for testing also.  Vitamin D is recommended to be 55-60.  B12 in the upper end of its range, and ferritin about 60 minimum for females.

[ncpatti]

Thanks for the information.  My D was low but that is back up.  I haven't been tested for B12.

[gimel]

Just having thyroid test results that fall within the so-called "normal" range does not mean that is adequate for you.  First, the ranges are far too broad due to the erroneous method used to establish them.  Everything is based on the wrong assumption that TSH results are a good diagnostic.  That is not correct.  Second, the ranges for FT3 and FT4 are established for a large data base of test results, that are screened only by TSH results.  Thus patients who have secondary hypothyroidism (relatively low TSH, with low FT4 and FT3) are included in the data base.  This skews the data and calculated reference ranges tremendously.  As a result, the lower half of the ranges for FT4 and FT3 are basically suspect.  You can read more about it in this link written by a good thyroid doctor.  

http://www.hormonerestoration.com/Thyroid.html

In the link, note the statement, "Thyroid tests must be interpreted in relation to the patient's symptoms. The FT4 and FT3 tests must be interpreted in relation to each other. A relatively high FT3 may compensate for a relatively low FT4. If the FT4 is below the middle of the 1 to 1.6ng/dL range, the FT3 should usually be greater than 3.5pg/ml to assure thyroid sufficiency (range 2 to 4.4pg/ml)."

So, all this means that you really need to get tested for both Free T4 and Free T3 each time you test.  You also need to review this with your doctor and find out if he is willing to treat you clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms.  If the cyst is found to be affecting thyroid hormone output, then of course that will have to be addressed also.

Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, I also suggest getting those tested as well.  

[ncpatti]

Tired, difficulty sleeping, more hair loss than usual, ringing in ears.  The ringing in the ears is what brought me to this site.  I had not associated the ringing with a possible thyroid condition.  I never discussed my thryoid results with my doctor because they were mailed to me as being in the normal range.  

[gimel]

TSH is a pituitary hormone that is affected by so many things that, at best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4.  So, you should always make sure they test for both Free T3 and free T4 in the future.   Since thyroid test results and calculated reference ranges can vary from lab to lab, it is also important to compare lab results to reference ranges shown on the same lab report.  

If your Free T4 is in the lower half of the range, that is lower than optimal for many people.  If your Free T3 is also in the lower half of the range, that is a good indication of symptoms being hypothyroid related for many people.

So tell us about any symptoms you are having.