What to do with high TSH levels as a relatively healthy adult male?

[Tiger26]

I recently had labs done for an appointment with the VA.  One thing that the lab mentioned was that my TSH levels were high at 6.2 for a normal range of 0.27 - 4.2.  The test that I took about 5 months prior was at 3.080.  It was at 2.820 the year before and 4.1 the year before that.  What is causing this?  I am a pretty healthy active 31 year old male, and I do not use tobacco.  I do drink some but not on the level where it is a problem.  Lately I've had some unexplained weight gain, lack of energy, and trouble sleeping.  The VA generally tries to push us out the door instead of explaining things, and I only get blood tests during yearly check ups so I am trying to look into this on my own.  Is there cause for concern here?

[gimel]

The TSH being over its reference range is indicative of the need to do more tests to evaluate for the possibility of an autoimmune system disorder called Hashimoto's Thyroiditis.  There are two tests required to confirm/deny Hashi's.   Those tests are Thyroid Peroxidase antibodies (TPO ab and Thyroglobulin antibodies (TG ab).   Most of the time Hashi's shows with the TPO ab  test, so the TG ab test is needed only if the TPO ab test is negative.  

With Hashi's the antibodies attack your thyroid gland and over an extended period the gland is destroyed.   As this happens, the output of thyroid hormone diminishes and the pituitary starts increasing output of TSH in an attempt to stimulate more production of thyroid hormone.  

In assessing a person for possible hypothyroidism, the most important consideration is always symptoms that occur more frequently with hypothyroidism.   You have several of those.  Next in importance is biochemical tests for the biologically active thyroid hormones, Free T4 and Free T3.   Free T4 should have been automatically tested since your TSH was above range, but since it is the VA, you might have trouble getting all the needed tests.   Since hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin you should also try to get those done, and then supplement as needed to optimize.   Vitamin D should be at lest 50, B12 in the upper end of its range and ferritin should be at least 100.

If your Free T4 and Free T3 test results are in the lower half of their range, you will probably be told that they are in the "normal" range and therefore no problem.  That is incorrect.   With your symptoms if Free T4 and free T3 are in the lower half of their ranges it is a strong indication of hypothyroidism and the need to be treated with thyroid medication adequate to relieve symptoms.

If you are totally dependent on the VA for diagnosis and treatment you are likely to be facing difficulty getting the testing, diagnosis and treatment needed.  If you will try and insist on getting those tests done and then post results and reference ranges here, we will be happy to help interpret and advise further on what you need..