Is Your Thyroid Doctor Using the Old TSH Lab Standards?

What is TSH? TSH (thyroid stimulating hormone) is a thyroid test to diagnose thyroid disorders. High TSH is diagnosed as hypothyroidism, low thyroid problems.

Most conventional doctors rely on TSH as the gold standard to measure thyroid functioning. Many mainstream doctors do not run a full thyroid panel that should at least include Free T4, Free T3, Reverse T3, and thyroid antibodies. Unfortunately TSH alone does not provide a complete picture. If doctors are going to rely on TSH alone, however, they should at least give consideration to the controversy over the TSH normal reference range and consider this when diagnosing patients. Right? We are more than a lab number. It’s up to us to take control of our thyroid health and insist our doctors treat us the patient and not this controversial TSH lab number, even if they look at us like we are CRAZY for questioning them!

The thyroid gland is a little butterfly-shaped gland at the base of our necks. TSH stands for Thyroid Stimulating Hormone, a hormone produced in the pituitary gland in the brain that tells the thyroid how much thyroid hormone to make.

Typically, if there is a low level of thyroid hormone in the body, the pituitary will increase production of TSH to stimulate the thyroid to produce more thyroid hormone. Therefore a high TSH level suggests an underactive thyroid (hypothyroidism), while a low TSH indicates too much thyroid hormone in the body (hyperthyroidism).

In my post “Miscarriage in New York City…Be Thyroid Aware”, I outlined the TSH ranges for pregnancy and provided trimester-specific ranges. In this post I would like to discuss the normal TSH lab standards for non-pregnant adults.

Thyroid Stimulating Hormone

For many years, most mainstream doctors have considered TSH level >10 mIU/L evidence of overt thyroid failure, and levels of 5-10 mIU/L evidence of mild or subclinical hypothyroidism. Many doctors refuse to treat hypothyroidism if a person’s TSH is less than 5 mIU/L even when the patient presents with classic hypothyroidism symptoms. This strict reliance on 5 mIU/L has left many hypothyroid people suffering with debilitating symptoms and yet their doctors refuse treatment.

For over a decade there has been considerable debate about the correct upper limit of the reference interval for TSH. According to the old standards 5.0 mIU/L is the upper limit. This upper number is critical in determining who is diagnosed with hypothyroidism and who is not.

Modern medicine continues to argue within itself on the proper upper limit of the reference range for TSH.

One of the largest studies of thyroid problems in a population is the Whickham Survey, which studied the thyroid levels of 2,779 randomly selected adults living in the town of Wickham in England from 1972-1973 and subsequently followed for 20 years. Data from the twenty-year follow-up published in 1995 demonstrated an increased risk for the development of hypothyroidism once TSH exceeds 2.0 mIU/L.1

The third National Health and Nutrition Examination Survey (NHANES III) screened 17,353 subjects from 1988 to 1994 and excluded those with diseases or factors known to affect thyroid function. In the resultant ‘normal’ population of 13,344 subjects, 95% had TSH levels that fell between 0.3 and 2.5 mIU/L.2,3

These findings supported the establishment of a narrower TSH reference range and a lowering of the upper limit of the range.

The National Academy of Clinical Biochemistry (NACB) in 2002 recommended that the upper limit of the reference range be lowered:4

The recent follow-up study of the Whickham cohort has found that individuals with a serum TSH >2.0 mIU/L at their primary evaluation had an increased odds ratio of developing hypothyroidism over the next 20 years, especially if thyroid antibodies were elevated.

In future it is likely that the upper limit of the serum TSH reference range will be reduced to 2.5 mIU/L.

In 2003, the American Association of Clinical Endocrinologists issued a press release in support of lowering the upper limit of the reference range:5

Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now.

However in 2012, the Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association Of Clinical Endocrinologists and the American Thyroid Association recommended 4.12 as the upper limit of normal for TSH.6 (Wait! What happened to the AACE’s press release in 2003 to reset the TSH level to 0.3 to 3.0? Do you see the craziness of all this?)

Thyroid Advocacy To Lower The Upper Limit of TSH

Thyroid advocates and many integrative physicians are fighting to narrow that range. Thyroid doctor Dr. Weston “Wiggy” Saunders posted this important message on his Dr. Wiggy Thyroid MD Facebook page.

Dr. Wiggy TSH 1.5

Thyroid advocate Mary Shomon, from the About.com Thyroid Disease website, shared this important list of recommended lab tests and optimal ranges on her Thyroid Support Facebook page. Note the optimal TSH range listed.

Mary Shomon optimal thyroid lab ranges

When I was initially diagnosed with hypothyroidism after the birth of my first son in 2006, I listened to my doctors unquestioningly. I assumed that my doctors were the experts and that they knew everything there was to know about this disease. My doctor was using the old 0.5 to 5.0 TSH lab standard and kept telling me my TSH was normal falling in this range, yet I felt awful. Under my doctor’s care my TSH levels rose to 10.0 mIU/L.

At a TSH of 4.0 I felt sick and tired. By the time my TSH rose to 10.0, I felt like the walking dead struggling to make it through each day.

I even had one doctor who said she only treated a person for hypothyroidism when their TSH rose above 10.0 otherwise it was unnecessary. WHAT?!! I couldn’t function at a TSH of 10. I couldn’t get up from my bed to take care of my young son.

What Should You Do?

What if you have many symptoms of hypothyroidism, but your doctor is testing TSH only and your TSH is “normal”. What should you do?

What if you are being treated for hypothyroidism but you still suffer symptoms and your doctor is insisting your treatment is fine because your TSH is “normal”. What should you do?

Don’t just accept “your thyroid is normal” from your doctor. Insist on a full thyroid panel not just TSH but also Free T4, Free T3, Reverse T3 and thyroid antibodies. Get a copy of your lab results and check your scores yourself, even if your doctor acts like you are crazy (because you are NOT)!

If your doctor won’t do the additional tests and insists on relying on TSH while you suffer symptoms, find a new doctor. Find a doctor who understands you are more than a lab number. There are good thyroid doctors out there. Here is a list of resources to help you locate a great thyroid doctor in your area.

Do NOT settle.

References:

  1. Vanderpump, M.P., Tunbridge, W.M., French, J.M., Appleton, D., Bates, D., Clark, F., Grimley Evans, J., Hasan, D.M., Rodgers, H., Tunbridge, F. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995 Jul;43(1): 55-68
  2. Hollowell, J.G., Staehling, N.W., Flanders, W.D., Hannon, W.H., Gunter, E.W., Spencer, C.A., Braverman, L.E. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002 Feb;87(2):489-99
  3. Lee, S.L. When is the TSH normal? New criteria for diagnosis and management. Lecture presented at 12th Annual Meeting of the American Association of Clinical Endocrinologists (AACE), San Diego, CA, May 14, 2003 (thyroidtoday.com)
  4. National Academy of Clinical Biochemistry 2002. Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease. Retrieved from: http://www.aacc.org/sitecollectiondocuments/nacb/lmpg/thyroid/thyroid-fullversion.pdf
  5. American Association of Clinical Endocrinologists (January 2003 Press Release). Over 13 Million Americans with Thyroid Disease Remain Undiagnosed. Retrieved from: www.hospitalsoup.com/public/AACEPress_release-highlighted.pdf
  6. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association Of Clinical Endocrinologists and the American Thyroid Association. Retrieved from: https://www.aace.com/files/hypothyroidism_guidelines.pdf

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About Dana Trentini

Who knew that little butterfly-shaped thyroid gland at the base of my neck could affect my life so completely? I founded Hypothyroid Mom in memory of the unborn baby I lost to hypothyroidism. Winner of two 2014 WEGO Health Activist Awards: Health Activist Hero & Best In Show Twitter. *Hypothyroid Mom includes Affiliate links. Connect with me on Google+

Comments

  1. Dana Trentini says:

    Thank you to “Health & Fitness Update” for including this post on your site. Much appreciated.

    http://health.newzogs.com/?p=39

    • Lakshmi says:

      Hi Dana,

      Really appreciate the work you have done here. It’s really informative.
      I had my first TSH diagnosis done recently and my TSH level was 4.46 ,free T3 -2.11 and free T4 -1.17. I’m 20 weeks pregnant with my first child ( that’s when I had my test done). My doctor has put me on thyronorm 25mcg. I have hair loss and no other symptoms which I have noticed of hypothyroid ( I’m assuming that from what I have read ). I have read that low maternal thyroid can affect unborn child. Please could you shed some light on the matter. Most articles I read deals with TSH 10 and above no where around my range. Pls help… First child and really worried..
      Thanks..

      • Dana Trentini says:

        Hi Lakshmi,

        Congratulations on your pregnancy. I am happy your doctor did this testing. I’ve attached here the American Thyroid Association guidelines for pregnancy that recommend:

        RECOMMENDATION 2

        If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

        So bring a copy of the guidelines to your doctor and be sure to have your levels retested because in second trimester according to the guidelines that TSH should be less than 3.0. The good news is that your doctor already tested you and put you on medication, now it’s about making sure your doctor has the guidelines. So bring a copy.

        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

    • marianne schilling says:

      I need to find a Dr in Corpus Christi TX that uses your standards. Can u help me

  2. I am curious what your TSH was at first diagnosis. What if it’s .01 TSH? Is it not good for pregnancy? I have Hashimoto’s and that’s what mine was at my last blood draw a couple weeks ago. We really want to have a baby!!

    • Dana Trentini says:

      Hi Clara, Is your TSH .01 on thyroid drug treatment? What type of medication are you on? I ask because at first glance that TSH is low, however at the same time we are each unique in terms of what TSH is ideal for us. For many people receiving medication such as natural desiccated thyroid brands like Armour, Nature-throid and Westhroid, for some of us our TSH is suppressed (lower than normal) while on these medications and our doctors are dosing us based on our Free T4, Free T3 and Reverse T3 levels. Since I don’t know enough about your situation, it is hard to say. Are your Free T4, Free T3 and Reverse T3 optimal for you, do you suffer hypothyroid or hyperthyroid symptoms? How do you feel? It is important for a doctor to treat the patient and how they feel first before the lab numbers. How does your doctor feel about your TSH level? Also, many people with Hashimoto’s cycle up and down with TSH going up and down between hypo and hyper. Does your TSH level change normally? Welcome to Hypothyroid Mom!

      • Hi Dana, like Clara, I have also been trying to get pregnant with no success for over 3 years now. I’m 35 and have Hashimoto’s, and my TSH for the last year or so has been at 0.01. My Free T4 = 0.9, Free T3 = 3.3, TgAb <20, and TPO = 443. I take 105mg of Armour and a bunch of supplements. I have issues with acne, low estrogen/progesterone, low basal body temp (ranging from 96.5 – 98), cholesterol on the high side of normal, gluten sensitivity, and an extra 25 lbs that I haven't been able to lose, but I don't feel other symptoms of hypo or hyper. I am on day 4 of a 30 day autoimmune paleo protocol, so I hope that helps, but if you have any other suggestions on how to heal better, I would appreciate it! My husband and I would love to have a baby! =)

        • Dana Trentini says:

          Hi Lily, Infertility is a very real issue for thyroid sufferers. I am sorry for your struggle. There is hope to have healthy babies. It’s about being as thyroid healthy as possible prior to trying to conceive. First, would you look at the lab results sheet and check the normal reference ranges for Free T3 and Free T4 because each lab may use different units of measurement. Thyroid advocate Mary Shomon wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2 — in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentil of the normal range.” Now many of us have TSH lower than 1 when on natural desiccated thyroid like Armour however not the Free T4 and Free T3 ranges. Are yours in that range, if not speak with your doctor about your dosage.

          Also there are many potential underlying issues for Hashimoto’s that should be tested and treated if needed: sex hormones, gluten intolerance (going gluten free to see if it helps), food sensitivities, adrenals, iron including ferritin, D3, B12, magnesium, zinc, selenium.

          http://hypothyroidmom.com/hypo-like-a-rock-star-hashimotos/

          There is hope to have healthy beautiful babies.

          http://hypothyroidmom.com/hypothyroid-moms-story-of-hope-her-miracle-babies/

      • My tests from May were as follows: TSH 0.011 (range 0.400-4.00), FT4 1.54 (range 0.54-1.51), T3F 5.8 (range 2.3-4.2), TPO 912.6 (range 0.0-60). I am on NatureThroid. My ND who prescribed the thyroid meds hasn’t really said much about the TSH numbers. She’s just looking to get the TPO down. Now when I saw my primary doctor she didn’t like the numbers at all!! She said I’m really hyper and that can cause many problems. I did a little research and one problem can be no ovulation, which I haven’t been for many months. I lowered my dose and feel much better. I didn’t realize that the shakiness I often felt was thyroid related but have noticed now that I don’t have it. My TSH has been in the hyper range for 6-7 months. Any thoughts? Clara

        • Dana Trentini says:

          Hi Clara,

          For all of us on thyroid medication we need to be on the watch for symptoms of hyperthyroidism due to over-medication including heart palpitations, insomnia, weight loss, shakiness, nervousness. Absolutely hyperthyroidism is just as dangerous as hypothyroidism so I am so happy your doctor lowered your medication. How are you feeling now?

  3. What could be wrong if my TSH level is 1.54 and I am still exhausted, foggy brained, weak, muscle weakness, dry mouth, chronic constipation, rigged fingernails, very tired eyes, hooded eyelids? I am on 50 mcg of levyothyroxine. My dr recently upped me to 88 mcg and after 2 wks on it I realized it was to much, was having trouble sleeping but other things were improving, especially the sleepiness (obviously) and the constipation. He wasn’t in, so the other DR dropped me right back to 50 mcg and now all the symptoms are back.

  4. Francesca Thomas says:

    Does your doctor use the new TSH lab standard 0.3 to 3.0 mIU/L?
    Here in Canada, most labs still use the old range – 0.5 to 5. And most doctors will do NOTHING if your TSH is within that range.

    Do you know your TSH level? Is it in this range?
    My TSH was 3.4 in January. My husbands TSH is 3.01. BOTH of us have Hypothyroid symptoms.

    How do you feel when your TSH is less than 3.0? 3.0 to 5.0? 5.0 to 10.0? Above 10?
    We feel horrible when our TSH is above 2. We will probably be dead if the TSH ever went above 5.

    • Dana Trentini says:

      Hi Francesca, I was born and raised in Toronto before moving to the US with my husband in 2000. I love having Canadian followers on Hypothyroid Mom!

      Thyroid advocates have been pushing for a narrowing of the TSH reference range for years and unfortunately in most countries the 0.5 to 5.0 is the range still used. However there are great thyroid doctors who understand that this range is too wide and that at TSH ranges of 3.4 in your case and 3.01 in your husband’s case you suffer hypothyroid symptoms and need help. You must find a new doctor.

      There is a natural dessicated thyroid called “Thyroid” created by Erfa in Canada. I haven’t tried it personally but I’ve read good reviews on it. Try calling all your local pharmacies and ask for doctors that prescribe this drug or other natural desiccated thyroid drugs like Armour and Nature-throid because the doctors that prescribe these types of drugs tend to be more open-minded about thyroid treatment.

      Thyroid Advocate Mary Shomon includes a list of doctors in Canada so check it out too! Best of luck to you and your husband.

      http://www.thyroid-info.com/topdrs/canada.htm

  5. Marcia Carson says:

    I have been suffering extreme fatigue for over a decade now. I have looked back through the tests my doctors have ordered and see no TSH. ????? What the heck? On my last visit to my GP once again, I told him about my fatigue. I have just looked at the tests he has ordered for me this time and a TSH is among them. Believe me, I have emphasized this fatiguq to him or his PA many, many times. It seems no one had been listening to me. All I can figure is this. On previous visits, until the last 2 times, I have always worn makeup. I am somewhat of an expert at makeup application and know it covers up a lot of flaws and tireness, but never considered the fact that even though I told my doctor as many times as four times per year for a number of years about my fatigue, that because I “didn’t look sick” he chose not to test my TSH during all that time. Of course I am not a doctor and did not know about the TSH test and did not know to ask for it. The last few times I’ve been in to see this doctor for three month check ups, (I go every three months to monitor my lipids and blood sugar) he finally did notice that perhaps I was a tired as I said I was. The fact was, I didn’t wear any makeup to those appointments. Both times, he made a point of asking me if was fatigued or getting enough sleep. I could just pull out my hair, which by the way is considerably thinner than it was a few years ago. So this guy really was not lilstening to what I was saying and merely going on appearances. Well, at last I will have the TSH test and perhaps some insight as to why I am barely dragging myself around.

    • Dana Trentini says:

      Hi Marcia,
      You must be a great makeup artist! I look less tired with makeup too. The key for you is no makeup when you visit your doctor so they see your fatigue on your face. It’s sad really because it should be enough for you to say you are tired and for you to be taken seriously. Here is an article with a list of recommended lab work to ask your doctor to test.

      http://www.stopthethyroidmadness.com/recommended-labwork/

  6. suvarna jyothi raju says:

    im suffering from hypothyroidism from 8yrs.im using 50mg tab dialy &now ihave got TSH levels 67.23 7 & i had all the symptoms what should i do?pls help me

    • Dana Trentini says:

      Hello Suvarna,

      What has your doctor recommended? Your TSH at 67.23 is very high and needs to be lowered. Has your doctor recommended an increase in medication or further testing? The first step is you need to be sure to have testing of your Free T4, Free T3, Reverse T3, thyroid antibodies (TPO-Ab, TgAb, TSI), adrenal function, iron and ferritin, sex hormones including ferritin, vitamin B12, D3, magnesium, zinc and selenium. This is your first step Suvarna. Please contact your doctor about your high TSH and ask for these tests. You should not be left with a TSH this high.

  7. Valerie says:

    Hi,
    Thank you so much for your article! I am a mom to a 9 month old baby girl and 5 yr old son. I went in 2 weeks ago for a routine blood draw and my TSH came out at 6.49. My doctor asked me to come in again for another TSH and FreeT4 blood draw. My 2nd TSH level was 4.46 and my FreeT4 was 1.20. She stated that this was normal, when I asked about the guidelines, I was told this is what they follow. There was also no answers to what could cause such a fluctuation in a week’s time, apparently something is going on. I was told many things, but nothing specific. I would like to find a doctor in the Chicago area who won’t think I am crazy when I have the chronic fatigue that wears me down and help me find the right medication/treatment for me. Any suggestion s or recommendations?

    Thanks!! :)

  8. Gabriella says:

    I have been experiencing hair loss for a few years and my doctor just told me that my TSH of 3.09 is high and optimal levels would be less than 2. Is that true? What causes this to happen? Also is there any connection between hypothryroid and low iron ferritin levels? Thank you for helping me sort out this mystery

    • Dana Trentini says:

      Hi Gabriella,

      Thyroid advocate Mary Shomon wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2 — in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentil of the normal range.” So yes a TSH at 3.09 while in the normal range may not be ideal for you and may be the reason for your hair loss.

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      Low iron is an issue for hypothyroidism sufferers and should be checked and treated especially for those with hair loss.

      Mary Shomon wrote a great book about hair loss as well as a great article.

      http://www.thyroid-info.com/articles/hairloss.htm

  9. hi my TSH level is 10.35 and MY TYROXINE (FREE) IS 11.23

    HAVE I GOT HYPO OR HYPER THYROID ..PLEASE HELP I HAVE PUT ON 20KG IN THE LAST FEW MONTHS….AM I OVER ACTIVE OR UNDERAVTICE.

    THANX FOR YOUR TIME.

  10. Hi I’ve been trying to concieve for 2yrs now went to fertility clinic and all they can find was my tsh was about 3 they put me on levothyroxin 0.05 and now my levels are 2.5 is this good or should it be lower to concieve?

    • Dana Trentini says:

      Hi Tanya,

      The American Thyroid Association issued guidelines for pregnancy in 2011. Bring a copy to your doctor so that they too are aware of the guidelines.

      ■ RECOMMENDATION 15

      Treated hypothyroid patients (receiving LT4) who are planning pregnancy should have their dose adjusted by their provider in order to optimize serum TSH values to <2.5 mIU/L preconception. Lower preconception TSH values (within the nonpregnant reference range) reduce the risk of TSH elevation during the first trimester.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

  11. laurie becker says:

    Hello Everyone,
    I just had a recent TSH draw. 18.59. Yikes. About 6 months ago I was diagnosed with Hasimotos. My levels have been wildly fluctuating for awhile now. My GP will not send me to a specialist. Just has me test every few weeks. Long before I was diagnosed with hypothyroidism, I spent 8 years trying to conceive and now knowing what I know its obvious that my thyroid was likely the cause then as well. Out of pure and desperate want and a Divine miracle, I finally became pregnant and after the first, pre-eclampsia, it was discovered my thyroid was low. I was able to have two more children after being stabilized and never had any difficulties until my last pregnancy when I became hyper. It still amazes me that the standard list of symptoms is a far cry from what I suffer everyday and trying to get the doctor to understand its all thyroid related is almost impossible. She has tested me for everything including Lyme disease and I know I have never been bitten by a tick. Right now I am going on an elimination diet to try and cleanse my system because I feel that it is up to me to feel better and help to heal my own body. The medical care leaves me feeling like a guinea pig. I even had a nurse scold me for researching Hashimotos on the internet because she said patients read all kinds of stuff and misdiagnose themselves and that we should only use our doctors advice. So for now all the medical community does is increase my medication. It is truly maddening. So to all you trying to conceive, I know how heartbreaking it can be but please don’t give up hope.

  12. I have been hypothyroid since 1979. Now I am also diabetic, type 2 with insulin. just had some blood work done and my TSH is 0.69. Have been feeling horrible lately and thought it was all due to the diabetes but maybe it is both!!!

  13. Hi dana i am 32 years doing my post graduate in nursing.recently i got married in nov.2012 and planning to have my baby after completing my course in sept. For my frequent stiffness and joint pain i have shown to a neurologist and he also adviced for tsh test and it comes out 4.45.he said its within the normal range but i dont feel its not within the normal if i am planning for pregnancy.please advice.thanks

    • Dana Trentini says:

      Sana,

      The American Thyroid Association issued guidelines for pregnancy recommending a TSH less than 2.5. Bring a copy of the guidelines to your doctor.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

      ■RECOMMENDATION 2

      If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

      ■RECOMMENDATION 15

      Treated hypothyroid patients (receiving LT4) who are planning pregnancy should have their dose adjusted by their provider in order to optimize serum TSH values to <2.5 mIU/L preconception. Lower preconception TSH values (within the nonpregnant reference range) reduce the risk of TSH elevation during the first trimester.

  14. Suzette says:

    Hi Dana,
    I have been battling Hashimoto’s for at least 20 years now. As is the pattern, I could tell I was starting to slip again, and I was right. . .
    My recent lab results are: TSH – 9.49; T4 – 7.7; T3 Uptake – 27; Free T4 Index – 2.1; T3 – 86; and TPO – 283. Also, my Cortisol levels (at least the AM levels) are high.
    I currently take 137 mcg of Synthroid (used to be Levoxyl, but just had to recently switch brands) and 5 mcg of Cytomel.
    I will be going to the ND to discuss these results soon, but I’m interested in what your thoughts on this might be. Any idea of how big a boost in meds I might need to feel normal again?
    Thanks!

    • Dana Trentini says:

      Hi Suzette,

      Your TSH at 9.49 is high so that would explain the symptoms you are feeling. We are all different in terms of what dosage is right for us with thyroid medication. Thyroid advocate Janie Bowthorpe includes a list of recommended lab work to ask your doctor about.

      http://www.stopthethyroidmadness.com/recommended-labwork/

    • I would ask my doctor to change me to Armour thyroid as it’s closer to what humans have and not synthetic.

      • Dana Trentini says:

        Hi Beth,

        I’m on a natural desiccated thyroid called Nature-throid and doing great. It’s sad the number of readers not feeling well on Levothyroxine drugs like Synthroid. They don’t know there are options and I hope with my blog I will empower them with knowledge to know to insist on other options including NDTs like Armour and Nature-throid.

  15. Hi Dana: )
    I am 46. I have had several symptoms such as fatigue,obvious swollen tongue and neck, swollen eyelids, I have lost half (literally) of my hair, dry skin, lost the hair at the edge of my eyebrows, extreme sensitivity to cold, tired and when I go to sleep for 7-8 hours, I feel like I have only been asleep for 30 min. I went to the doctor and she would only test the TSH and T4. T4 level was 0.9 and the TSH was 2.47. She stated this was all in normal range and that my iron level was normal as well as kidney and liver function from the blood that was drawn.
    Her only advise was to see my gynecologist. That these were symptoms of menopause.
    She will not give me a referral to see an endocrinologist but did say I could seek a second opinion. Please give me any advice you can and who should I see next?

    Thanks so much!

  16. Hello, I checked my TSH level and it come 0.39 I want to know is it dangerous or something? and why then my neck is little swelled and how I can cure it through which medication? My age is 26.

    • Dana Trentini says:

      Hi Anita,

      TSH does not give a full picture of your thyroid condition. Do you have hypothyroid or hyperthyroid symptoms? Please ask your doctor to also test your Free T4, Free T3, Reverse T3, thyroid antibodies, adrenals, ferritin and D3 at a minimum. There is hope to live well despite a thyroid condition so should you have this health issue there is great hope to be well again. Please speak with your doctor about these additional tests.

  17. Susan Friedman says:

    Hi Dana. I cannot get anyone where I live (SW FL) to use the newest standards for measuring TSH levels. Both my daughter and I have all the classic signs of low thyroid (the worst of it has been severe hair loss for both of us and extreme fatigue). Not certain what to do? All of the endocrinologists we go to see, insist that the old standard of measuring TSH is proper. should we resort to seeing a Naturopathic doc instead? Thanks!

  18. mam,i feel very tierd..and i got weight gain…. so i consulted a doctor… mam can u tell me what are all the causes of the TSH of 73.3..but my T3AND T4 levels are normal only…
    i need the effects of this TSH in my body mam…. what should i do for this level to reduce…

    • Dana Trentini says:

      Gowri,

      Your TSH at 73.3 is so very high and that would explain your fatigue and weight gain. What has your doctor recommended to reduce your TSH. What thyroid medication has been prescribed? Thyroid advocate Mary Shomon wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2 — in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentil of the normal range.” Bring this article to your doctor.

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

  19. mam,i feel very tierd..and i got weight gain…. so i consulted a doctor… mam can u tell me what are all the causes of the TSH of 73.3..but my T3AND T4 levels are normal only…
    i need the effects of this TSH in my body mam…. what should i do for this level to reduce…

  20. Hi Dana, after reading what you wrote about TSH and how it’s not necessarily the best test for many people, I am wondering if I should push my family doctor for a full thyroid blood panel. I am experiencing hair loss and hair thinning as well as fatigue and pronounced forgetfulness, I have Raynaud’s disease and my toe nails are ridged. When I first got a blood test done for the hair loss last October my TSH was 2.54 and nothing else was done about it, since it was in the normal range. I have a hard time telling the doctor all the symptoms that I have because he just looks at me like I’m being unreasonable for asking anything more of him. I did get another blood test done last week and my new TSH was 2.15. But I am still experiencing the same symptoms… I am not sure if it is worth it to convince him that I need further thyroid testing, Dana. But the hair loss and forgetfulness is worrying me quite a bit. I appreciate any advice you can give me. Thanks.

    • Dana Trentini says:

      Mary,

      Absolutely push for comprehensive thyroid testing including at a minimum Free T4, Free T3, Reverse T3, thyroid antibodies for Hashimoto’s (thyroid peroxidase antibodies and thyrogloblin antibodies), adrenals, full iron panel including ferritin, and D3. I’ve read that Raynaud’s may be associated with autoimmune conditions which makes testing your thyroid antibodies particularly important.

      http://hypothyroidmom.com/hypo-like-a-rock-star-hashimotos/

      Hair loss is such a common symptom of hypothyroidism that advocate Mary Shomon wrote an entire book on hair loss for thyroid patients. Until I was optimally treated my hair would fall out in handfuls that clogged my shower drain regularly.

      http://www.thyroid-info.com/hair/index.htm

      The normal ranges are very broad so your TSH can fall in the normal range but still not be optimal for you. Further testing will at least give a clearer picture of your thyroid health.

      http://hypothyroidmom.com/top-5-reasons-doctors-fail-to-diagnose-hypothyroidism/

  21. Dear Dana,
    My Thyroid result is 3.15mclU/ML
    I feel tired alL the time (want to sleep constantly ) and have constipation too, my doctor insisits that the normal range is till 5 mclU/ML , plus I have to train , which I do for 40 minutes treadmill 6kph every day
    on a tough diet but losing so little every month, thus Im sensitive to air conditioning , all the above symptoms are new to me, yet the doctor is not convinced that I have a thyroid issue.

  22. Susan Friedman says:

    How does one go about finding a doctor that uses the new standard for diagnosing thyroid issues? I’ve now been to see at least 5 physicians where I live (FL) and none of them uses the new standard!!! When you tell them it isn’t the new standard they either: get rid of you as their patient or make up some lame excuse. I know that I have thyroid issues, as I have ALL of the symptoms and really feel lousy all of the time!!!!! My hair loss over the past few years has been significant, but all of my former physician’s simply blame it on ageing or menopause.

    I was diagnosed a few years back with a goiter, and then put immediately onto a moderate dose of Levothyroxine. That made me very ill, so I was switched to Armour Thyroid. The Armour made me itch all over, so my physician at the time switched me to Natur-Thyroid. My last (and 5th physician) felt that, I didn’t have a thyroid condition and promptly removed me from all of my meds ( I also discontinued taking my BHRT as the combination of the thyroid med and the BHRT made me swell up and gain a lot of weight).

    The highest my TSH had been was 2.53 (on no meds). The lowest was 1.0 (on no meds). How can one’s thyroid have such wild swings up and down??? One of the physician’s said I had low thyroid, but that there was no treatment for that (I would have to live with it). I even went so far as to get tested for chemical poisoning (they found large traces of arsenic and cadmium in my blood) and also discovered that when I was taking my BHRT I had Estrogen Dominance issues, and adrenal problem and also had insulin resistance due to having PCOS. Once again, even though these tests showed issues, no physician would treat me for them. How can a medical community be so incompetent?

    My mother had Hashimoto’s and it took her ages to get a proper diagnosis. Prior to my complete hysterectomy, I had full blown PCOS. It’s my understanding that, even though the organs have all been removed, the PCOS symptoms will remain. This has also caused issue with my thyroid and NO ONE will recognize this fact. I am 61 yrs. old, have no ovaries and my Testosterone levels are off the charts – 75-120!!!

    Would love to find a decent physician who can treat my symptoms and get me feeling better!!!! I live in SW Florida (Ft. Myers area)….whoever reads this website, could you recommend someone that knows what they are doing? It doesn’t have to be an endocrinologist. Thanks!

    • Dana Trentini says:

      Susan,

      As soon as I read about your PCOS and your mother’s Hashimoto’s your story all came together. Hashimoto’s, a thyroid autoimmune condition considered the number one cause of hypothyroidism in the US, can come with swings up and down in TSH. Given your family history, you are more vulnerable to develop it too. I have read a great deal connecting PCOS and Hashimoto’s. You must be sure your thyroid antibodies are tested both thyroid peroxidase antibodies and thyroglobulin antibodies.

      http://hypothyroidmom.com/hypo-like-a-rock-star-hashimotos/

      I compiled a list of the top 10 resources I could find to help readers find good thyroid doctors in their area. I hope you will find a good doctor near you even if it means meeting 10 different doctors until you find the one that helps you.

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

  23. I had my thyroid stimulating hormone tested with my blood work my tSH came back at 0.72 is this okay please let me know I am over weight and my hair has been falling out to a point of very little on top. I am 44.

  24. Hi my levels are according

    TSH – 1,895
    F3 – 2,89
    F4 – 1,22
    DR said he wants to put me on throxine, T4 for a period of two months. According to my research, my levels are normal. Can you assist me? Thanks

    • Dana Trentini says:

      Hi Lorraine,

      How do you feel? Do you have hypothyroidism symptoms? Each lab uses different units of measurement so for your Free T3 and Free T4 check to the right of your scores on your lab results for the normal reference ranges. When you wrote TSH 1,895, I assume you meant 1.895. Technically that is in the normal range but we’re all different in terms of where in the ranges we feel best.

      If you are feeling well then I hear why you would not want to go on medication. Speak with your doctor more about why he/she recommends Thyroxine.

      • Thanks Dana for your reply, I did go to him due to fatigue, weight gain, heavy periods monthly but then I do have low Iron/Ferritin levels as well so now I am confused as I don’t want to start T4 pills that he prescribed to ‘jump start’ my thyroid as he put it. I have heard once you start these pills, you have to continue for the rest of your life? So, now I am starting research on a natural form, iodine and diet along with supplements just to boost my thyroid – if that will help?

        • Dana Trentini says:

          Hi Lorraine,

          If I could rewind time when I was first told about my hypothyroidism, I wish I had done my research and made sure all the right tests were done and that I tried every method possible to try to improve my thyroid condition before I started medication. So absolutely address your low iron levels because that is closely connected to thyroid health. Be sure to have also testing for your adrenals, sex hormones, D3, B12, magnesium, zinc, selenium, food sensitivities especially gluten. Try going gluten free for 3-4 weeks, add coconut oil and fish oil and probiotics. Eliminate soy. Improve your diet, reduce sugar and dairy. There are so many things to try first to see if you can heal yourself.

  25. How about kids? What is the normal range to be either hypo or hyper? I would like the updated guidelines. I read all kids of thing besides the actuall range for kids of various ages.

  26. This site is so informative! Thank you! I think I might have some thyroid issues going on. I’m in the “normal” ranges, so my doctor says everything is ok. TSH on my most recent test was 3.3. Previous tests during the last couples years show an up-and-down pattern: 3.3, 4.2, 2.3, 3.6. My hair is falling, not too bad, but enough that my hairdresser asked me if I was pregnant (I’m not) and I cannot seem to lose those 10-20 pounds no matter what exercise or diet I do (after being thin most of my life). Also, my mom was diagnosed with hypothyroidism a couple years ago (in her late 50s). Lastly, I would like to have kids in the near future too, so that’s an added concern too. I’m just starting to research all this and I’m so lost! What do you think of all this? Any help or advice is appreciated.

  27. The problem with the 2002 revised lab levels is that while they capture a lot more potential hypothyroid patients, they also lets down and miss a lot more hyperthyroid patients. Our medical professionals are so caught up with worry over “obesity in America” that they are stereotyping (hyper can be overweight too) and ignoring a large percentage of women suffering from hyperthyroidism (Graves). Patients are being left to needlessly struggle with their symptoms. A range is just that, a range, work with your doctor until they find the right spot in the range where you not only are out of danger, but feel good.

    • Dana Trentini says:

      Hi Terry,

      So true what you are saying. I wish doctors were not so focused on these TSH ranges. They are just that ranges. We are all individual in terms of where we feel our best. I encourage my readers to find doctors who treat them the patient and not their lab numbers. As your message says so well, the TSH range misses so many thyroid sufferers, hypothyroid and hyperthyroid. I wish doctors would throw out the TSH range.

  28. Hi Dana,

    Below are my TSH Levels along with range values. I am too scared to start harmonal preparations as me & my husband are planning for a baby. i ve heard that once you start any harmonal thyroid preparation you need to take them life long. I was a normal girl i dont know how come this thing had happened to me suddenly… there is no family history as well

    I am very scared dana please put some light here i request please… Also, let me know if there is any natural way to deal with this problem without taking any harmonal preparation???

    Free T3 3.07 pg/ml (Range : 2.5 – 4.3)

    Free T4 0.76 ng/dl (Range : 0.93 – 1.7)

    TSH 36.83 uIU/ml (Range : 0.27 – 4.2)

    Prolactin – 39.71 ng/ml (Range-non-pregnant : 4.79 – 23.30

    • Annie, did your doctor talk about checking if you have a tumor on your pituitary gland, with your high prolactin numbers? It’s not dangerous to have one but can cause the high numbers.

    • Dana Trentini says:

      Hi Annie,

      Your TSH at 36.83 is very high. First, I notice your prolactin level is elevated. What did your doctor say about this? I don’t know a lot about prolactin levels so I looked it up and noted causes listed in this link. Please see your doctor about this to better understand why your prolactin is high because whatever the cause of it may be also causing your high TSH.

      https://en.wikipedia.org/wiki/Hyperprolactinaemia

      Also there are other tests you should have done including testing included in thyroid advocate Janie Bowthorpe’s article attached.

      http://www.stopthethyroidmadness.com/recommended-labwork/

      Depending on the underlying causes determined in that testing treating those things may help your TSH level.

      One thing to try is to go gluten-free to see if it helps your condition. There is a lot written about the connection between gluten and hypothyroidism so well worth trying to see if you can bring your TSH down by diet.

      http://chriskresser.com/the-gluten-thyroid-connection

      Add coconut oil to your diet.

      http://articles.mercola.com/sites/articles/archive/2003/09/13/coconut-oil-part-three.aspx

      You don’t want your TSH as high as 36.83 too long so be sure to see your doctor right away about this additional testing to see what next steps are needed. Best wishes to you.

      • Hi Dana,

        Your help is much appreciated, after reading a lot on your page i decided to go for antibodies test and the results are given below:
        Anti Microsomal Antibody : 14.48 IU/mL (Range : Upto 5.61)
        Method : CMIA)
        Anti Thyroglobulin Antibody : 108.81 IU/ML (Range : 0 – 4.11)
        Method : CMIA)

        Free T3 : 3.15 pg/ml (Range : 1.71 – 3.71)
        Method : CMIA)
        Free T4 : 1.01 ng/dl (Range : 0.7 – 1.48)
        Method : CMIA)
        Ultrasensitive TSH,Serum : 11.2005 uIU/ml (Range : 0.35 – 4.94)
        Method : CMIA)

        I am now much scared as the values shown are way beyond normal. Just dont know how to cope up with it. Doctors wants to put me on lifelong harmonal preparation. :(

        It would be great to hear back from you on the above results…

  29. hi mam,

    I have a test yesterday for TSH and the result is 1.17 mclU/ML, i just worried if this is a normal or not for hypothyroidism? because my feeling like nervousness, tremor, rapid heart rate and weight loss?

    Regards,

    rad

  30. Diane Allen says:

    Hi Dana.
    I have had a under active thyroid for ten years. I take 150m grams of thyroxine. My blood test results have come back as 0.03. Does this mean it is lower than it has been?

    Many thanks Diane

    • Dana Trentini says:

      Hi Diane, I assume the blood test value of 0.03 refers to TSH. Normally the reference range for TSH is around 0.5 to 5.0 but thyroid doctors have been debating these numbers for years. 0.03 is lower than “normal” however TSH does not give a full picture. You should speak with your doctor about testing your Free T4, Free T3, Reverse T3, and thyroid antibodies. I personally have a suppressed TSH (lower than normal) but I feel good and I don’t have any signs of over-medication such as anxiety, insomnia, heart palpitations, racing heart, weight loss, sweating, trembling etc. My doctor bases my dosage on my Free T4 and Free T3 levels. So the most important question is how do you feel?

      • Diane Allen says:

        Hi Dana,

        Thank you for your quick reply. So if my TSH is 0.03 will my doctor lower my Thyroxine? I take 150mg which is obviously to much. How can my Thyroid go over active after 10 years? Thank you for your time.

        Many thanks Diane

        • Dana Trentini says:

          Hi Diane,

          Every person on thyroid medication can become over-medicated with too high a dosage of medication and result in hyperthyroid symptoms like insomnia, weight loss, heart racing and palpitations, sweating, shakiness, anxiety, etc. However while the normal range is generally 0.5 to 5.0 thyroid advocates have been debating this range for TSH for years. Really the best doctors are the ones who listen to the patient and their symptoms rather than on the lab results. So what I am saying is that TSH alone is not enough to decide whether to change your medication dosage or not. It’s about discussing with your doctor if you are experiencing hyperthyroid symptoms, as well as doing additional testing. We’re all different in terms of what TSH level is best for us.

          • Diane Allen says:

            Hi Dana,

            Thank you for all your help and information. I am talking to my doctor tomorrow and hopefully will get some answers as to what to do.

            Many thanks Diane

          • Dana Trentini says:

            Hi Diane, best of luck with your doctor appointment. Have a good weekend.

  31. Hi Dana,

    I’m 21 years old and I’ve been feeling sick for 2-3 years now, and I didn’t really understood why. I was eating healthy, being physically active and overall taking care of myself. These last years I had several colds, and my throught was constantly sore. I easily catched the flu, and I was feeling a bit tired. I needed minimum 9 hours of sleep for me to feel awake the next day. I’ve also had Atopic dermatitis since I was little, and my doctor told me lately that I will keep having it (75 % children that have Atopic dermatitis improves when they get older, but unluckily for 25 % continue to have this skin condition through adulthood). This last half year, I got sick every month and I also started to get infection in my private part and in my breasts. I also was not able to concentrate at uni as much as I wanted. My breasts were sore, had some lumps on the side, my nipples were itchy and I also got nipple discharge. All this really concerned me, and I went to the doctor and told him all of this. I took several tests, and found out that my TSH was 3.97. This means that I have Hypothyroidism, and that my thyroid gland is underactive. The scale that my doctor used was 0.40 – 3.50, so it sounds reasonable to what scale you are refering to. He concluded that I’ve been so much sick lately because of this, because my body was not able to defence itself. I’ve also been taking some scan of my neck, that I will receive next week. I’m on antibiotics right now for my breast infection, and I’ll be on thyroxine after that.
    Did you have similar symptoms? And how are you going now? Do you have any tips?
    Thanks for the article!

    Regards

    Ingrid

    • Dana Trentini says:

      Hi Ingrid,

      Infections are a classic symptom of hypothyroidism. I’ve suffered from chronic infections my whole life until I was finally diagnosed and treated for hypothyroidism. Normally the range is around 0.5 to 5.0 that doctors use but this range is too broad and thyroid advocates have been pushing to narrow this range. You are fortunate that your doctor uses a narrower range. Sounds like you are a more open minded doctor. I personally take a natural desiccated thyroid and feel great. Now I don’t get chronic infections, colds and flus like before. I hope the same for you.

      http://hypothyroidmom.com/thyroid-hormone-replacement-drug-madness/

  32. Just got myself a little workup. Due to objective symptoms of an eye twitch for 17 days, and I’m bradycardic with a heart rate between 48-60 most of the time. Subjectively, I feel awful. Tired all the time, headaches, etc. Had a thyroid US that only showed two tiny nodules, too small to classify. Today, these are my labs… they seem fine, don’t they? TSH 1.99 (Ref range is .35 to 4.01), Free T4 is .80, Free T3 is 3.2, all within normal limits. I’m thinking I’m not hypothyroid now. Maybe just my low iron is to blame. By the way, this blog is great!

    • Dana Trentini says:

      Hi Amy,

      While your labs are technically “normal” they are not necessarily optimal for you if you have symptoms. I personally don’t feel well when my Free T4 and Free T3 are as low as yours. Thyroid advocate Mary Shomon wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2 — in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentil of the normal range.”

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      It would be helpful to also have tested your Thyroid Antibodies, Adrenals, full iron panel (including ferritin) and D3.

      Get a second medical opinion.

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

  33. Dana,
    I am so lost and confused right now. I have about three quarters of all the hypothyroid symptoms i’ve read about, my TSH is at 2.6. I feel awful — foggy, depressed, poor memory, can’t concentrate, constapation… the list goes on. I pushed for a thyroid test, and my doctor prescribed me Prozac. I don’t know what to do from here, I feel like a hypochondriac the way he looked at me when I pressed the issue. I’m in Canada and I feel like no one is going to listen to me here.

    Am I crazy? Why do I feel this terrible when my TSH is “normal”?

  34. Hello,
    I ‘ m 21 weeks pregnant and 33 yrs old and this is my 2nd pregnancy (have 1 daughter almost 8 yrs old) and my thyroid profile says : T3 – 2.23 pg/ml
    T4 – 1.08 ng/dl and TSH – 2.40 ulU/ml

    I feel low on energy , week and exhausted at times. I ‘m confused weather i need medication for thyroid or not. Pls advice.
    Many thanx

    • Dana Trentini says:

      Hello Shikha,

      Congratulations on your pregnancy. I am sorry for the delay in responding. I’ve received hundreds of comments, emails, Facebook messages from Hypothyroid Mom readers that I finally now got to yours. How are you doing now? Is your T3 listed FREE T3 or total T3? If it is Free T3 than it is low in the normal range (which would be listed to the right of your score on the lab results) and would explain your fatigue. What ranges are optimal for each of us is different but the fact you are experiencing this fatigue it would be worth it to get a 2nd medical opinion to be sure you’ve heard multiple points of view. I’ve put together resources to help readers find a good doctor in their area.

      Be particularly watchful of yourself postpartum. Which is a time when women are particularly vulnerable to worsen an existing thyroid condition or trigger a new one.

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

      http://hypothyroidmom.com/your-postpartum-fatigue-could-be-a-sign-of-thyroid-problems/

  35. When I had bloodwork done with my routine physical two years ago, my TSH was 4.09. My doctor didn’t said it was normal.
    Today I went to a doctor’s appointment for unusual fatigue, and she mentioned that when last tested, it had been “borderline high”.
    Now it sounds like it may not have been normal-but-borderline-high, but, actually high. I had another blood test done today, and am waiting for results.
    :(

    • Dana Trentini says:

      Mcc,

      Thyroid advocates have been trying to push for a narrowing of the TSH range as you can see from this article. Thyroid Advocate Mary Shomon writes: “More innovative doctors are beginning to believe that a TSH of around 1 – 2.” Your TSH at 4.09 is high by these standards. I personally feel terrible at a TSH that high. Thyroid testing should also include Free T4, Free T3, Reverse T3, thyroid antibodies, adrenals, full iron panel and D3 at a minimum.

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      http://hypothyroidmom.com/top-5-reasons-doctors-fail-to-diagnose-hypothyroidism/

      • Thank you so much for everything you’re doing to help inform people.
        I requested more tests, and got them back. My TSH had gone down from 4.09 to 3.09.
        My T4 came back normal, and my “t3 uptake” came back slightly low (20%). My iron also came back low. I did not test positive for thyroid antibodies.
        That was all the info that was included in the thyroid panel that I requested, unfortunately.
        My doctor says this means that I definitely do not have hypothyroidism. I’m wondering if you think this is correct. I do have the symptoms of it.
        Thank you so much again.

  36. Dear Dana Trentini,
    My TSH is more than 10. Please suggest me what I can do now and in this time if i want to be pregnant is there any problem?

    Tania.

  37. Hi
    I have just been diagnosed with hypothyroidism, and my TSH levels were 8.86. I know this is well above normal range. How long will it take before the meds start to have an effect.
    I am exhausted all the time…I have all the obvious symptoms of hypothyroidism: weight gain, dry skin, feeling cold, tired all the time, moody, no libido etc etc etc…I think my husband had all but given up on me every having energy again.
    How high is my TSH? Trying to understand how badly I have hypothyroidism???
    Thanks

    • Dana Trentini says:

      Hi Nicky, TSH of 8.86 is high. You are hypothyroid. You can see from this article that on average the TSH range is considered 0.5 to 5.0 so even by that standard your TSH is too high. However thyroid advocates have been pushing to narrow that range. Thyroid advocate Mary Shomon from the About.com Thyroid Disease website wrote, “More innovative doctors are beginning to believe that a TSH of around 1 – 2.”

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      The main issue is that Levothyroxine drugs like Synthroid are the drug of choice by mainstream doctors but they don’t work for all of us. If after several weeks you still don’t feel well, go back for retesting and if despite dosage changes you still don’t feel well then speak to your doctor about the other drug options. Be sure your thyroid testing includes Free T4, Free T3, Reverse T3, Thyroid Antibodies, adrenals, full iron panel and vitamin D3 at a minimum.

      http://hypothyroidmom.com/which-is-the-best-thyroid-drug-for-hypothyroidism/

  38. Hello! I was diagnosed at 17 with hyperthyroidism (the one where you gain weight). Its been 11 years and I have had my gallbladder removed since then and although tests show normal according to doctors things have not been right. I recently have been getting frequent hive like bumps and itchy skin. My current test results are: tsh 0.57 and t4, free, non-dialysis 0.9. Is that normal? Thank you!

  39. Thank you so much for everything you’re doing to help inform people.
    I requested more tests, and got them back. My TSH had gone down from 4.09 to 3.09.
    My T4 came back normal, and my “t3 uptake” came back slightly low (20%). My iron also came back low. I did not test positive for thyroid antibodies.
    That was all the info that was included in the thyroid panel that I requested, unfortunately.
    My doctor says this means that I definitely do not have hypothyroidism. I’m wondering if you think this is correct. I do have the symptoms of it.
    Thank you so much again.

    • Dana Trentini says:

      Mcc,

      I’m not so sure you don’t have hypothyroidism based on a TSH of 3.09. The most important question is do you have hypothyroidism symptoms. Thyroid advocate Mary Shomon from the About.com Thyroid Disease site wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2.”

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      • I am not sure either, but I do have the symptoms. I told my doctor that I was really tired a lot, especially in the afternoon. She told me that maybe I wasn’t sleeping enough. But I’d told her that I sleep between 8-9hrs/night. She is not a great listener.

        One thing I have a question about is: why did my TSH go down from the last time they tested it, from 4.1 to 3.09? What causes it to fluctuate like that? Because if I have hypothyroidism, my understanding is that it wouldn’t just go away on its own, right? But my doc seemed to say that while 4.1 might be a bad sign, 3.09 is not.

        Another question I have is: is there any harm in the doctor just giving you the medicine to see if it helps? Is it dangerous to do this? When you have the symptoms and the #’s are unclear, I don’t see why they don’t just try if it isn’t dangerous to do so. But I’m not sure how to research that question.

        • Dana Trentini says:

          Hi Mcc,

          TSH can fluctuate during the day and also depending on stress levels and weather changes (believe it or not our thyroid condition can be worse in stressful times and in colder weather). Also if you haven’t had your thyroid antibodies tested for Hashimoto’s please do because people with Hashimoto’s often swing up and down in TSH. It is considered the number one cause of hypothyroidism yet thyroid antibodies are not routinely tested. Insist on it.

          http://hypothyroidmom.com/hashimotos-your-body-is-not-supposed-to-destroy-itself-right/

          There is more to the story than just TSH. Testing should include Free T4, Free T3, Reverse T3, and thyroid antibodies at a minimum. Your symptoms are just as important and in many cases even more important than blood test results and yes there are doctors who base on how a person feels. These blood tests tell how much thyroid hormone is in the blood stream but there is no way to know by these tests how they are being used inside the cells and why these tests can be misleading. Find a new doctor.

          http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

    • Dana Trentini says:

      Mcc,

      I’m not so sure you don’t have hypothyroidism based on a TSH of 3.09. The most important question is do you have hypothyroidism symptoms. Thyroid advocate Mary Shomon from the About.com Thyroid Disease site wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2.”

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      Get a 2nd medical opinion.

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

  40. Before 6 months my thyroid reports are:
    TSH is 25.54 U/ml(0.2-4.2)
    T3 is 114 ng/dl(70-200)
    T4 is 5.7 gm/dl(5.5 – 13.5)
    Doctor suggest me to take Eltroxin 100 mcg 1 tab at every morning in empty stomach.Then she told me to take another test in after 2 months but i took test after 6 months. The reults are
    TSH is <0.01 mlU/L(0.30-4.00)
    Free T3 is 7.1 pmol/L(3.0-6.5)
    Free T4 is 20.0 pmol/L(10.0-20.0)

    please help me .

  41. Hi Dana,

    Thanks do much for all the information on this site- it is so helpful!

    I’m 32 and I have been shedding hair for the past year and absolutely no doctor from the many I saw had any explanation for it besides stress. I had a strong feeling it had to be something more than just stress. My TSH was 2.1 and after a few month 2.69 so no one (including me) suspected my thyroid could be the cause. Finally, I went to one endocrinologist who despite of my “normal” TSH values asked about my family history of thyroid disorders. My mom and my older sister have Hashimotos (and my grandma had it too) . She ran an antibodies test on me and I have a TPO of 230, but my TSH for some reason is 1.49 now. The doctor said she thinks my TSH is fluctuating because I have Hashimotos and that’s causing the problem. She referred me to a thyroid specialist which I will see soon.

    I’m a bit scared because I don’t know what kind of treatement I’ll get if at all (as my TSH is not high now) and Iv’e heard that Synthroid can cause more hair loss. How do I know if I’m getting the right treatment? What questions and tests should I ask for? I want my hair to stop shedding so badly. I also intend on becoming pregnant soon and after reading all the problems Hashimotos can cause I’m concerned about that too…

    Thanks for your help!!!

  42. Thank you so much for having this site. I am in the process of figuring out what I should do. Back story: I am a 29 yr old man. I have been exhausted, and I mean feeling like a zombie from the time I wake up in the morning to the time I go to bed. I have had a “lump in my throat” feeling as well. It has been like this for almost three months. I eat very healthy, organic, etc I get 8-10 hrs every night and I was working out but have had to stop because I have been too tired to do anything. Hyperthyroid runs in my family. My maternal grandma, my mom and my uncle all had it. Yet when I had my levels checked it came back at 1.18. I am going to get a second opinion. Is it just that each individual is so different that different levels mean different things for each person. It is hard not to feel defeated. I was positive my thyriod was the problem. Thoughts? Thank you so much!

    • Dana Trentini says:

      Hi Kade,

      TSH is often the only test run to diagnose thyroid conditions however this one test does NOT give a full picture of thyroid health. Testing should include at a minimum Free T4, Free T3, Reverse T3, Thyroid Peroxidase Antibodies & Thyroglobulin Antibodies. Since you have a family history of Graves which is hyperthyroidism be sure they also run antibodies for Graves too. The thyroid gland is located in your neck so the fact you have a lump in your throat means your doctor should physically check your neck and have a thyroid ultrasound. Even if your doctor won’t do these tests, insist or find another doctor who will run the tests in particular the antibodies.

      http://hypothyroidmom.com/top-5-reasons-doctors-fail-to-diagnose-hypothyroidism/

      Here is how you can also check your neck yourself for any growths or inflammation.

      http://thyroid.about.com/library/howto/htthyroid-check.htm

  43. I have been having all the typical symptoms:fatigue,constipation,cold,weight gain, ect. I was referred to an endo. they did some blood test, said everything is normal? After doing some research and finding out they did not test the free T3 I pushed for it so they did it and again said it is normal? but I don’t feel normal! My results: free T3-2.60 ref range 1.70-3.70, TSH-0.65 ref range 0.30-5.00, free T4-0.9 ref range 0.8-2.2, antibody-68 ref range <5.61. I have no idea if these are acceptable levels are not since all I can get from the endo is that they are normal. Should I get a second opinion? Any guidance would b greatly appreciated.

  44. Thank you so much for your response! I find this site so helpful.

    I have been to a thyroid doctor today and am quite confused. She did say I have Hashimotos and did an ultrasound which revealed a swollen gland (I will have a biopsy done too), and she did take blood to check T4 and T3 (total and free), and of course- antibodies again. However she said that because my last TSH was normal (1.49) the hair loss may not be related to this condition (as this TSH indicates that the thyroid is still producing normal hormones despite of it being attacked by the immune sytem). This is really confusing because of 2 reasons- first, Iv’e been searching for an entire year for a cause to my shedding and went to many doctors and none could identify a trigger for the hair loss but did say it is diffuse and temporary(if the cause is fixed). Second, from all Iv’e read people do have hypothyroid symptoms even if their TSH is normal, especially if they have a swollen gland and high antibodies. Do you know what is responsible for these symptoms if the thyroid is still producing hormones?

    The doctor said she may give me treatment to reduce the size of the gland but she doesn’t know if it will help the hair. Not sure what to do.

    She also said that it’s problematic to treat patients with normal TSH because then they could become hyperthyroid.

    What do you think?

    Thank you so much I can’t tell you how revealed I am to find this site.

  45. My TSH were 5.04 and 4.67.

    Could you go into how you feel now and what you take and the side effects? I am very sluggish and fatigued. It has gotten worse since my son was born. I am a 36 year old male.

    Thank you.

    • Dana Trentini says:

      Hi Todd, At a TSH of 8 even at 5 I was unable to function and keep myself awake. We’re all different in terms of how severely it affects us but I also had hair loss, constipation, heavy menstrual periods, high cholesterol, high blood sugar, kidney stones, loss of my eyebrows and eyelashes, dry itchy skin especially my scalp, chronic infections including constant colds and flu. Now thanks to proper treatment my cholesterol and blood sugar reduced to normal, I haven’t had another kidney stone, my hair is less dry and less itchy, my hair is falling out less and my eyebrows are filling in a bit more, and I’m not constantly sick with an infection. I have much more energy although I can’t say I’m as energetic as my most energetic friends but I’m 90% better than where I was so yes it’s affected my whole body.

  46. Hi, I have in the past couple of months dizziness, hand tremors, pale complextion, tiredness, feeling of a lump in my throat, feeling cold all the time with the odd few hot flushes/sweating, especially cold extremities (blue fingernails), heart palpatations.

    I have seen 3 drs. I have had a TSH result of 0.39 which I was told was boarderline but normal. 4 weeks on I have had another result of 0.56 this time which I was told was now nicely in the normal range!? I sure don’t feel normal. I pushed for a T3 T4 test but was told that unless my TSH fell below the range they wouldn’t do that and that they couldn’t as the primary care order it…it was done only at the hospital. I did however manage to get them agree to refer me to the hospital for a Ultra sound scan of my thyroid. Will this show anything and if it doesn’t…then what? 3 different drs were pretty adamant that they would not and indeed could not test for T3 and T4….any advice would be appreciated. Also…is it possible i’m hyperthyroid based on the info I have just written?

    • Dana Trentini says:

      Hi Aeo,

      With your symptoms especially the lump in your throat yes please keep pushing for more testing or find a new doctor. It’s good at least they will do a thyroid ultrasound because the thyroid is located in the neck and so any unusual symptom in the neck/throat area is suspect and should be checked. If your doctor won’t test Free T3 and Free T3, ask them if they will test your thyroid antibodies for Hashimoto’s (there are 2: Thyroid Peroxidase Antibodies and Thyroglobulin Antibodie) and antibodies for Graves (TSI).

      http://hypothyroidmom.com/hypo-like-a-rock-star-hashimotos/

      Here are resources to help readers locate good doctors in their area.

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

      • Hi Dana,

        Just to give an update. I was sent to the hospital to see cardiology to check my symptoms weren’t caused by my heart (I knew they weren’t but I went anyway). I am glad I did. The consultant I saw took one look at my notes and examined my neck and said he thought I was Hyperthyroid. As he is a consultant he was able to order the tests I have been trying so hard to get, T3, T4, free T3 and T4, Thyroid antibodies and calcium. I am so happy I could cry (kind of strange wanting to be diagnosed with something I know, but I just want answers). I also have a Thyroid ultra sound on the 12th. I’ll let you know what happens

        Thanks

        • Dana Trentini says:

          Hi Aeo, So great your doctor ordered your thyroid testing and ultrasound. This may explain symptoms you’ve been experiencing including heart related. Best wishes.

  47. I have been diagnosed with Graves disease and have been on methimazole now for nearly a year. My thyroid has been resistant and my dr. now has me on 20 mg per day.
    My te4sts were all normal as of 6 weeks ago,my TSH was 1.34. I had my blood tested yesterday and just found out my TSH is at 37.6, yes that is correct 37.6. My dr. has taken me off of my medication for 7 days and then wants me to go back on at 10 mg.
    Does this sound right, should I be worried about the 37.6 TSH? You can only imagine how rotten I feel. I thought I was just working too hard, but I guess that isn’t the answer. I can hardly stay awake. I had to pull off the road on my way to work because I couldn’t stay awake. Can there be immediate or long lasting effects from this high of a TSH level? Thanks, I am enjoying your site, it is hard to find anything other than generic symptom sites.

  48. Hello! Thank you so much for your hard work and dedication to this disease. I am 9 weeks and terrified as having suffered a miscarriage before. My OBGYN called indicating my TSH is less than 0.5 (too low) and free T4 is normal at 0.9. It seems I am within normal according to the new guidelines? Am I completely misinterpreting my values? She said my TSH is too low which scares me. Thank you so much for your time. RAVEN OF INDIANAPOLIS

    • Dana Trentini says:

      Hi Raven, Happy to hear your thyroid has been tested and you are being monitored in pregnancy. Congratulations on your pregnancy. There are TSH ranges specific for pregnancy so bring a copy of the American Thyroid Association guidelines for pregnancy. Which states:

      ■ RECOMMENDATION 2

      If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

      The most important question is always how do you feel? Are you suffering hypothyroid or hyperthyroid symptoms at your current level?

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

  49. Hi I am so glad that you did this I was begining to think that it was all in my head.
    I just came from being in the hospital for two days. .since after the birth of my son in 2003 I started having rigors (chills shaking and feeling cold) at night but I never got or
    had a fever and I would usually be fine the next day, but for the last two years I noticed that the next day it would be difficult for me to get out of bed my head hurts and all my muscles hurts.
    Now for the past few months the headaches are different its feels like my is ten times the Normal size and it’s more like a pressure a constant pressure I had my blood tests done and my tsh was 4.75 so the said that I had hypertyroidism and was prescribed eltroxin but that made me feel worst so I went back to the doc but was unable to see the same doc as before so the new doc said that I should stop taking the eltroxin so I did and I had one my episodes (rigors) and write to see the doc she referred me to the hospital where I stayed for 2 days while I was there I was told that I shouldn’t have been given the eltroxin in the first place so I am there not knowing what to think I still haven’t been diagnosed and I have to join a clinic could you please shed some light I confused THANKS ALOT

    usually be

  50. Hi Dana,

    I recently got my my Thyroid checked because of excessive weight gain. They told me that i am suffering from hypothyroid.

    My T3 is 86.0(ng/dl)
    T4 is 7.1 (ug/dl)
    ans TSH is 9.32 (ulU/mL)

    I want to know if I start taking medicines will i be able to lose weight.And if yes how much time will it take to get back to normal weight.

  51. Hello, I hate to see people sick, hope you feel better. God bless you.

    • Dana Trentini says:

      Hi Elena, I hate to see people sick too. The good news is that there is light at the end of the tunnel. There is hope to be well despite hypothyroidism but it’s about the person learning all they can and being an advocate for themselves.

  52. Hi,
    I recently went on routine physical checkup. In that I came to know that my TSH is 4.46. Asked me to wait for 1 month to have labtest again to start medication. Meanwhile I was planning for 2nd baby. So can I go ahead or we need to wait for 2nd labtest? Is it okay to get pregnant while TSH is 4.46? Is it okay to get pregnant when we have this problem? is it going to effect unborn baby?

  53. Christine says:

    I just had routine blood work done after battling low iron for two plus years! (I think I’ve gotten use to be tired and out of breath!) I was surprised by a phone call from my doctors nurse saying my blood work came back and I had to make an appt. to talk to him about the results.. huh?! Never had that call before. I requested a fax of my full blood work and here’s what I see- TSH normal range 0.450 – 4.500 my reading is 4.750, also EOS (white blood cells) normal being 0-5 I am a 10 and EOS Absolute, normal being 0.0 – 0.4, my reading is 0.8. Not sure what all this means. I’ve never had an abnormal reading on thyroid before, but from my own research I’m finding this can also cause low iron which has been a big problem for years. Help, any insight is appreciated. My Doctor appt. is tomorrow.

  54. Wrong and misleading information: the author of the blog is stating that your doctor may be using the older range. well, I have news for you. It’s NOT the doctor, it’s the state or country’s medical body and legislation that indicates what the normal ranges are. doctor’s dont have time to remember what the ranges are. that’s why the blood work results show if the levels are out of range. the out of range values are also bolded for the physician. in fact, in many cases the physician cannot order more tests if for example the patient’s TSH is normal. He can’t order a Free T4 in that case. If he does it won’t be covered by the insurance company.

    • Is this true?? That the insurance won’t cover the FT4 tests if the TSH one is “normal” ?

      • L, that is not necessarily true at all and is, as Hmm would say, “wrong and misleading information.” Just as it is wrong, misleading and frankly ludicrous for Hmm to have written “doctor’s dont have time to remember what the ranges are.” If you have a doctor who “doesn’t have time” to remember ranges, it is time to seek a new doctor.

        What insurance will and won’t cover in any given situation will vary by company, of course, but I’ve never heard of an insurance company denying a Free T4 test. They’re not inordinately expensive and anyone who is insured and studies their explanations of benefits after claims have been processed will quickly realize that while blood work is very expensive on the surface, the negotiated rates that insurers pay are generally quite low.

        If a doctor ever refuses to run a Free T3 or Free T4 test for you, make sure to press them on the reason. It will usually have everything to do with the doctor’s own antiquated way of doing things and nothing to do with your insurance.

  55. This is my nightmare, new standards with an old family Dr. *shudder* – Just one more thing to bring up at my next appointment!

    ~~Fay

  56. Hi, Thank you for your post. What do you do if your doctor doesn’t accept the 3.0 guidelines? When I was pregnant (Baby is now 4 months old) I was feeling many hypo symptoms and my doctor did some tests and my TSH was 3.87. She of course said that was normal but now I am still having many symptoms that seem to be getting worse. I had the blood work done again yesterday and my TSH is 3.01, T3 3.06 and T4 1.01. When I said that I have read that the TSH level has changed, she said the drug companies are responsible for that so she doesn’t go by that number. I had an ultrasound of my thyroid because it is large and has been since my son was born in september 2011. I asked to have my antibodies tested as well and those results have not come back.

  57. Is the post from Jan 12th true? That the insurance won’t cover the FT4 test if the TSH one is “normal” ? Thanks!

  58. Hi! My TSH levels were tested a few months ago and were 3.38. I’ve learned from this site about the new standards, but realize that even with the new standards, a 3.38 still isn’t that high. The problem is that I feel absolutely awful lately. I’m 37 and realize that I’m getting older, and a lot of people say it’s just the weather…but I’m wondering if you think my thyroid could possibly be making me feel this bad. I have put on a little weight and my periods have gotten much heavier and painful. I also stopped taking the birth control pill though, so I’m thinking that it could be related to that. I’ve also gotten pretty crabby at times, which just isn’t like me. I haven’t noticed hair loss, but I have really thick hair normally so I don’t know if that would be real noticeable. I’m literally tired all day long, and don’t feel like doing anything. What are your thoughts?

  59. Hi Dana,

    I just got lab results today and all seems great with T3, T4, and anti-TG. TPO is a bit higher 201.90 U/mLand also my TSH is low, for the first time since I was diagnosed. It’s 0.242 mU/L. So my doctor said that I got hyperthyroid and I should lower my Euthyrox dose from 100mgr to 75mgr. I’ve been on 100mgr for more than three years now and I’ve been feeling very well. So now I don’t know what to think about it as I don’t feel “hyper” ;) I actually have been feeling a bit tired for the last few weeks. What do you think about it? I’d love to hear your opinion! Thanks a million!
    Micah

  60. Hi Dana, Thank Goodness for your article. I’ve been fighting this disease for almost 3 years now. Right after my first baby. I notice my symptoms I started feeling really fatigue depressed and losing Crazy amounts of hair! I have changed Doctors twice and I still haven’t seen any improvements on my health. I’am Currently on synthroid .25 . I have horrible chest pains heart palpitations, my hair is thinning out like crazy yet my endocrinologist does’t think it has to do with my thyroid or medications. I absolutely believe the opposite I do believe it has to do with my medication. and everything you say in your article is completely right doctors never run a completely thyroid blood panel. I’ve only been tested for free T4 and TSH. I asked my doctor why was’t freeT3 tested and her answer was that “hypo” patients don’t typically get tested for T3. WOW!! really..
    Any ways Thanks a million for your article.

  61. I don’t want this to come across as spam because it’s not. I’m 38, I’m a mother of 6, and I suffer from hypothyroidism and have for 5 years. I’m currently on 30 mg of Armour Thyroid because I wanted something more natural. Even with all my thyroid meds….i still had symptoms. I was still tired, I had no libido, my moods were horrible, and I had no motivation. I too felt like many women on here and prayed for help. Finally a friend told me about these natural supplements that will help me with my energy issues. I decided to give it a try. I’ve been using Le-Vel Thrive for 12 weeks now. Not only are my thyroid symptoms almost gone, so is my GERD, my panic attacks, my joint pain, and I’ve lost inches. I’m again not spamming this site, I just know how I feel and really want other women to feel the same. Friend me on facebook. http://www.facebook.com/kristenmaxine

  62. Hi,

    My Thyroid test report is as follows:
    Free T3: 4.70 pmol/L
    Free T4: 16.14 pmol/L
    TSH: 3.38 UI/ml

    My doctor said it is totally normal. But I am confused. Please suggest if I should take any further tests or these results are infact normal.

    Thanks
    Deepa

  63. Ok hi. Im concerned bacause i have symptoms of hyperthyroid. Heart beat high. Im 5’9″ and weigh 105 pounds. Yet in 2005 and 2012 i had TSH of 7.72 and 6.416 respectively while my t3 and t4 were well normal. My T4 in 2005 was 8.2 and in 2012 is was .96 while t3 was 1.46. I have moles that may be skin cancer. I have a lymp not below my adams apple but on it. Right before my cycle started my throat went soar, the front swelled, and after my cycle the left side of my throat was tender. My throat appears to be getting better. Im holistic so i started taking myrhh this morning. My doctor told me to stop soy but ow says its fine, but i think im being misdiagnosed. Im having panic attacks and anxiety and i dont think its a mental problem but a manifestation of something physically wrong.

  64. Ok hi. Im concerned because i have symptoms of hyperthyroid. Heart beat high. Im 5’9″ and weigh 105 pounds. Yet in 2005 and 2012 i had TSH of 7.72 and 6.416 respectively while my t3 and t4 were well normal. My T4 in 2005 was 8.2 and in 2012 is was .96 while t3 was 1.46. I have moles that may be skin cancer. I have a lump not below my adams apple but on it. Right before my cycle started my throat went soar, the front swelled, and after my cycle the left side of my throat was tender. My throat appears to be getting better. Im holistic so i started taking myrhh this morning. My doctor told me to stop soy but now says its fine, but i think im being misdiagnosed. Im having panic attacks and anxiety and i dont think its a mental problem but a manifestation of something physically wrong.

    • Laura Ann, please get a second medical opinion. Your symptoms alone suggest you may not be properly diagnosed or treated. Resources to help you locate a good doctor:

      http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

      • You are right. I got my blood tests and the tsh and t4 are normal but he did not even read the t3. I am going to let him run a stool test and urine but im going back to my original internal medicine doctor to talk to him because the blood test also shows my White blood cell count at 3.6. The thyroid and immune system are connected. Even when i had cancer my white cell count has never been low. My parents are clueless and my father thinks im malnurited bc im vegan. I eat. I can eat an entire container of hummus if given the chance. What we are doing to ourselves medically irks me. Doctors shoud know but they don’T. Im sorry but something is wrong and i feel like money is the only thing anyone carws about. My doctor is costing and others wont run trsts i may need because im not wealthy. I wish we had our priorities straight, love friendship, laughter, fun, peace, joy.

        • Ok i had anultrasoubd done by a throat doctor. I have nodules on my thyroid and my thyroid appeared swollen. .it seems to act up right before my cycle. I get a choking sensation. My doctor says it could be a virus but he denied at first i had a problem. I have hyperthyrodism. He says its not likely cancer. I have stopped eating Soy. My face breaks out horribly riggt before my cycle to and i get the sensation of choking. I dont know what to do and i found i tested in 2008 with high thyroid anti bodies.

  65. Mary Atkinson says:

    My thyroid was removed in August,2012 b/c of cancer. After removal of thyroid and 14 lymph nodes (the cancer had spread), 2 rounds of RAI and 2 body scans, I am cancer free but feel horrible!! When I share how I feel w/ my Dr., he stares at his computer and tells me that my TSH levels r good–0.127 and he refuses to listen to how I feel and will not adjust my Rx-100mcg. 6 days, 50 mcg.-1 day. No energy, not sleeping, 20 lbs. weight gain, weepy all the time, cannot concentrate on anything!! Something tells me that all he is concerned about is that my TSH levels are where he wants them—forget how I am feeling!! I am very frustrated; but not sure what to do since I am now at the mercy of his calling the shots on my dosage of Synthroid. Is there anything you can suggest I do at this point? I almost wish I would have never had my thyroid removed! Not sure I would have felt any worse than I do now. My quality of life is horrible and my Dr. could care less!!

  66. Thank you for this article, from the bottom of my heart. Just today, I left my doctor’s office in tears with nothing but a prescription for antidepressants in my hand. He completely blew off my concerns about my thyroid and blamed all of my weird symptoms on depression. He said my 6.0 TSH is considered “normal” (even though it was 3.0 last time it was checked months ago) and “there’s no reason to worry about it until it gets to 10.” No additional tests – I didn’t even know what to ask for, because I hadn’t found this article yet – and he wouldn’t even feel my neck (where I’ve been having the sensation of swelling for months now). I actually cried in disbelief, right there in his office. I came home and started searching the internet for information; I found this article. Thank you so much, for giving me hope and arming me with specific information to ask for.

  67. Thank you for this article, from the bottom of my heart. Just today, I left my doctor’s office in tears with nothing but a prescription for antidepressants in my hand. He completely blew off my concerns about my thyroid and blamed all of my weird symptoms on depression. He said my 6.0 TSH is considered “normal” (even though it was 3.0 last time it was checked months ago) and “there’s no reason to worry about it until it gets to 10.” No additional tests – I didn’t even know what to ask for, because I hadn’t found this article yet – and he wouldn’t even feel my neck (where I’ve been having the sensation of swelling for months now). I actually cried in disbelief, right there in his office. I came home and started searching the internet for information; I found this article. Thank you so much, for giving me hope and arming me with specific information. At least now I know to ask for a “full thyroid panel.”

  68. I have hypothyroid from last 5 years. My numbers were never stable, it always fluctuate. one year back my dr. changed it to branded meds Synthroid, after that it was stable for few months than again went up. he increased the dose now I am taking 175 mcg daily. My new numbers are:
    tsh: 0.61
    t4:1.4
    Total T4: 9.7

    But still I dont feel great, always tired, gaining weight. What should I do?

  69. Valerie McGee says:

    Boy was I glad to find this page. Thank you for all your hard work. Does low Thyroid run in families/ My son was recently diagnosed though he has had severe symptoms for years with repeated TSH test, finally one came up at 6.2. Enough for the Dr to start treating though on a low dose of medication. My daughter has also been having severe problems though different from her brothers, like Rheumatoid Athritis, Sleep Apnea, Severe Fatigue, and extreme Hair Loss. She also has several other symptoms on your lists, I will talk to my Dr about running a full panel, thanks to you. Also is trouble getting to sleep a thyroid issue, my son has several nights that he just cannot fall asleep. Thank you again for your help. Valerie

  70. Valerie McGee says:

    Boy was I glad to find this page. Thank you for all your hard work. Does low Thyroid run in families/ My son was recently diagnosed though he has had severe symptoms for years with repeated TSH test, finally one came up at 6.2. Enough for the Dr to start treating though on a low dose of medication. My daughter has also been having severe problems though different from her brothers, like Rheumatoid Athritis, Sleep Apnea, Severe Fatigue, and extreme Hair Loss. She also has several other symptoms on your lists, I will talk to my Dr about running a full panel, thanks to you. Also is trouble getting to sleep a thyroid issue, my son has several nights that he just cannot fall asleep. Thank you again for your help.

    • Hi Valerie, Yes thyroid conditions can run in families so have your daughter tested too. You mentioned that your daughter has Rheumatoid Arthritis, which is considered an autoimmune condition. You should have her tested for her thyroid antibodies for Hashimoto’s as well as your son. When a person has one autoimmune condition like RA they are more vulnerable to develop others such as the thyroid autoimmune condition called Hashimoto’s (which can run in families too). Hashimoto’s is considered the leading cause of hypothyroidism in the US yet thyroid antibodies are not often tested. Here’s more on Hashimoto’s:

      http://hypothyroidmom.com/hypo-like-a-rock-star-hashimotos/

  71. nasrin says:

    im 26 year old and female. my tsh is 7.5(0.3-5.5) and my t3 an t4 are normal, my doctor said i have hypothyroeed . what shoul i do? should i have tablets? but some doctors say it is normal to 10 (for tsh ) so what should i do???

  72. satori says:

    Hi Dana,

    Thank you so much for your article, and it is extremely useful!

    I am 32 years old. It is 12 weeks of my pregnancy ,and this is my first baby. When I was 8 weeks, my doctor tested my blood hormone level.

    The value of T3 TOTAL is 91 ng/dL, T3 UPTAKE is 25 %, T4 FREE is 1.2 ng/dL, T4 (THYROXINE) TOTAL is 8.0 mcg/dL, FREE T4 INDEX is 2.0, TSH is 9.90 mIU/L.

    The TSH is too high, but the doctor didn’t remind me that the value was abnormal till I went to the clinic to do my 12 weeks examination.She didn’t take any medication on me. I am afraid the thyroid can influent my baby’s intelligence. What should I do?

    Look forward to your response.

    Satori
    May 5th

  73. Rebecca Myers says:

    I have been suffering with Hypothyroid symptoms for a while now. Every 6 months or so I have a doctor tell me- “You HAVE to have thyroid problems. You have ALL the symptoms!” Then like many, the TSH levels always come back normal. Last week I had another thyroid test ran. Like always, they said “Well, your thyroid is FINE.” For the first time I insisted they give me a copy of the report. The results were as follows:
    T3T- 1.26 (Normal 0.8-2.0)
    T3 Uptake- 35.10 (Normal 23.0-40.0)
    T4- 7.6 (Normal 4.0-12.0)
    TSH- 1.710 (Normal 0.485-4.86)
    Free T4- 0.8 (Normal 0.8-2.2)

    Even though all results are in “normal” range, what is striking to me is that my Free T4 is the exact bottom of normal! Could this mean that I actually have Hypothyroid? Again, let me remind you that I am having severe symptoms like extreme weight gain (from 115lbs to 270lbs in 4 years), I freeze to death all of the time, I require 10-12 hours of sleep a night and I’m still tired, and hair loss among others! I am only 27 years old! I should NOT feel this bad!!!! HELP!!!

  74. I have hypothyroidism I have had it for the past 2 years. My doctor has put me on levothyroxine 0.025 mg medication. My doctor only goes by the TSH numbers. All the times I would go to get a blood test my TSH numbers stayed the same and she kept me on the same medication. Just recently I took a blood test and my TSH number was 5.53 mlU/L my doctor told me that was not normal and wanted to increase my medication to 0.050 mg. She told me since I still had some of the other 0.025mg medication left, to just double those pills (take two of those a day). I have been taking two of the 0.025mg pills a day for about a week, and for the past few days I have been feeling worse. I have been getting light headed and it feels like I’m going to faint at times, and I’m more tired than usual and my eyes seem more watery or tired. I also have been getting slight shakiness and it feels like my heart is beating more rapidly. I’m going to lower my medication and just continue to take one pill a day. I have been reading how doctors should do more test than just check the TSH levels for thyroid. Should I be changing doctors? my doctor just goes by TSH levels and It seems like she just like to put people on medication.

  75. ihave got TSH levels 96.23 & i had all the symptoms what should i do?

  76. ihave got TSH levels 96.23 & i had all the symptoms what should i do? and im 7 weeks of pregnency also.plz suggest me.

  77. Hi Dana, Thanks for this website. Great info.
    I had a TSH and Free T4 test done.
    What do these results mean:
    TSH 1.410
    Free T4. 1.21
    I do have some symptoms
    Sensitive to heat and cold, fatigue,

    Thanks for your time.
    Alex

  78. poonam patil says:

    my Serum TSH (ultrasensitive) : Result 0.33 ulU/ml
    remarks is Suppressed TSH in Hyperrange.
    Say me what is meaning of this sentence and range?
    i had all the symptoms what should i do?
    What can i do?

  79. hi !
    I don’t speak English very well .. so sorry if there will be any wrong words.

    I found your blog while i’m looking for TSH .. i’m 24 y/o girl .. not married so I don’t have kids or any planning to have kids . my TSH is 7.38 .. what should I do ? is it very high ? my doctor said I should take Injection .. but I didn’t until now coz I wanna know first is there any another Treatment .

    please replay ! I don’t have anyone to ask ! : (

  80. All my labs on minerals/adrenal are fine.

    However my tsh : 3.08

    Free t4 : 1.36
    Free t3: 3.9

    I told my doctor i have had alot of weight gain fatigue i sleep for like 15 hrs and still feel terrible.
    All she did was start me on armour( since i wanted something more natural) but anyhow she put me on 15 mg with no plans on increasing until my next appointment in 3 months! In the meantime i feel terrible.

    She didnt even want to put me on meds to start with how do i convince her to increase until i reach optimal levels? ? Please help me with your advice.

  81. Hi Dana, I am glad to see that you have stood up for hypothyroidism community. My younger sister was a victim of this as doctors over-looked to do a full test avoiding the obvious symptoms she had demonstrated as an infant to an adult. Currently I am writing a biochemistry academic article/short essay in the topic of highlighting the “false and so called normal range” of hypothyroidism testing. I am facing a difficulty accessing statics for people who are suffering from this disease across countries, by ethnic group. I am also looking for statics that shows the inaccurate diagnosis of current TSH ranges used in many labs, hospitals, clinics across the globe. Appreciate your input. Cheers, j.

  82. I had tongue cancer and under went surgery and 5 weeks of radiation therapy. Last year my TSH was 1.24 but it now has increased to 5.16. It has been two months since my last treatment. Can radiation damage the thyroid gland? If so, will it ever return to a normal level or will it be necessary to have medical intervention?

  83. I have had Hashimotos for 10 years and I am 43 years old. When I was diagnosed, my TSH was just over 5. With my old dose of Synthroid (50 mcg.) it got as low as .5, then over the years, crept up to just over 4.0 a year ago. It was stable for 9 years, then hypothroid again. My dose was increased to 75 mcg. last year, and now, one year later, my TSH is up to 3.8. However, my doctor, a top thyroid specialist, has not increased my dose yet. She takes a lot into consideration, including free T4, which she says has been close to the hyperthyroid level sometimes, even when TSH was on the high side. So, there is a conflict between on the two numbers and my doctor has to find the right balance, which keeps me from being symptomatic. I do think that as I am getting older, I am creeping up to hypothyroid level TSH numbers faster. However, I was becoming lax in taking my medication as directed, so it may be my fault the TSH went up. It is hard to remember how important the medication is, after having Hashimotos for so long and I wake up starving, so very hard to wait an hour to eat. Now, I am taking it as directed again, and waiting for another blood draw to see how I am doing. I agree that TSH can’t be the only factor, and my doctor has made this clear to me. Very interesting post!

  84. These were my results as well. TSH @ 8.7 and the others were on the low end of normal. My Dr. said I didn’t have to take the medication as long as I felt ok. What would make TSH high and the free T4 & 3 normal?

  85. Hi … i have a problem of irregular menses. My doctor advise me for thyroid tests …. results are as under ….
    T3 = 2.5 nmol/L
    FT4 = 15.26 pmol/L
    TSH = 4.46 mIU/L
    please tell me if i have a thyroid disease… please help me .. i m very worried

  86. Hi,
    On the 25th Sept TSH 0.68 & Free T4 19.0, 20th Oct TSH 4.8 & Free T4 11.8 and 14th Nov TSH 3.6 and Free T4 13.1.
    I had a goiter and the left side of my thyroid removed before the blood tests on the 20th Oct and feel like crap. I struggle with a stiff neck, dry and itchy skin, my bowel movement before the operation was perfect now I am absolutely constipated. I also feel my eyesight has changed, blurry. My doctor has used the old range and I am in the range. Appreciate your feedback its driving me crazy, just want to get back to normal. regards Susan..

Trackbacks

  1. […] Most conventional doctors rely on TSH as the gold standard to measure thyroid functioning. Unfortunately TSH alone does not provide a complete picture. Most doctors typically don’t run a full thyroid blood panel nor do they investigate fully the patient’s medical history, symptoms, family history and thorough physical exam. If doctors are going to rely on TSH alone, however, they should at least use the updated lab standards. Right? Unfortunately many traditional doctors are still using the old outdated standards, leaving millions of people undiagnosed and suffering from debilitating symptoms. It is up to us to take control of our thyroid health and insist our doctors use the updated standards, even if they look at us like we are CRAZY for questioning them! [Read more…] […]

  2. […] report it is 5.1 mclU/ML…( I am taking euthrox 100 mg everyday) Please chk the below link.. Is your thyroid doctor using the old TSH lab standards? So should i take this as normal range or its more? Just want to do something abt my weight loss.. […]

  3. […] TSH levels are meant to be between 0.5 and 2.5 (or thereabouts; there’s a lot of discussion on this topic). Mine was at […]

  4. […] diagnosis and treatment (anyone with levels over 5.0 was diagnosed with hypothyroidism).  But in November of 2002, they narrowed that range to .3 to 3.0.  Some people say it should be narrowed further – […]

  5. […] read articles about how TSH alone is an unreliable thyroid lab test, and they […]

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