Avatar universal

Tests are so confusing

I have been treated for Hypothyroidism for 3 years and I need help because I am not sure my GP is treating me correctly. She runs different test every time and has me all over the place on my meds. Any advice would be great. Here are the bloodwork results I could find. btw, I was on meds during all tests.
Feb 14 - TSH (.671)
Sep 14 - TSH (.034)
May 15 - TSH (4.71), Triiodothyronine, Free (2.6), T4 Free (.73)
Dec 15 - TSH-ICMA (5.6)

On minute she tells me I am great then high, low. What am I? I go in to talk soon and need to understand what I can say to her.
4 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Apparently your doctor is medicating you based on TSH, which just doesn't work.  TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered during initial evaluation, along with more important indicators such as Free T4 and Free T3.  When already taking thyroid med, the TSH test is basically useless.  

A good thyroid doctor will treat  a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  You can get some good info from this link written by a good thyroid doctor.

You should make sure they always test for both Free T4 and Free T3 every time you go in for tests.  If the doctor resists, just insist and don't take no for an answer.  The only time you were tested for FT4 and FT3, even without knowing the reference ranges for that specific lab, I am very sure your FT4 and FT3 are in the very low end of their ranges, which is often associated with being hypo.  So you need to find a good thyroid doctor that will treat clinically, as described.

Also hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Have you tested for those?  Also, what symptoms are you having at present?
Helpful - 0
Avatar universal
Symptoms I always have are..... cold, sore throat, itchy, gained more weight again (avid hiker), tired all the time.  

Do you know what the difference is between the TSH and the TSH-ICMA tests are? Is a High result in them mean I am taking too much med or not enough? Even researching it on the internet I can't seem to understand.

Thank you.
Helpful - 0
Avatar universal
The ICMA means Immunochemiluminometric assay.  It is just the technique used for the test.  Different labs call it different things.  Other aliases for the test are as follows:
High Sensitivity-Thyroid Stimulating Hormone
HS-TSH (High Sensitivity Thyroid-Stimulating Hormone)
S-TSH (Sensitive-Thyroid-Stimulating Hormone)
Sensitive TSH (Thyroid-Stimulating Hormone)
Thyroid-Stimulating Hormone-Sensitive (S-TSH), Serum
TSH (Thyroid-Stimulating Hormone)-High Sensitivity
TSH Hypersensitive
TSH, 3rd Generation
Ultra-Sensitive TSH (Thyroid Stimulating Hormone)

When you see the doctor you should mention that from what you have read a TSH test compared to a group based reference range is inadequate to diagnose thyroid status and that the biologically active thyroid hormones, Free T4 and Free T3 need to be tested every time you go in for tests.  Then you should mention that symptoms are even more important for diagnosing hypothyroidism and that you have a number of those.  Also ask if the doctor is willing to treat you clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Also ask if the doctor is willing to prescribe T3 meds such as Armour and Cytomel.  If either answer is no, then you are wasting your time with that doctor.  I already suspect that is the case, and if you will tell us your location, perhaps we can suggest a doctor in your area that has been recommended by other thyroid patients.  
Helpful - 0
Avatar universal
I also meant to mention that a high TSH means that the pituitary is calling for more output of hormone from the thyroid gland.  A high TSH is frequently associated with the main cause for diagnosed hypothyroidism, which is Hashimoto's Thyroiditis.  To check for the antibodies associated with Hashi's, two tests are required:  Thyroid Peroxidase antibodies and Thyroglobulin antibodies.  The tests are often shown as TPO ab and TG ab.  You should ask for those also.  
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
Avatar universal
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.