got my results back yesturday and my tsh level is 5.7 and some places recommend 4.0 to be the highest but my doctors recommend 5.5, my doctor is saying 5.7 is not too bad yet he knows ive been suffering with bad depression for a few yrs and maybe thats whats been coursing it. does anyone have an opinion regarding this?
cheers
ash
Hi reefy
heres some useful info they may be beneficial to you..
During diagnosis, most doctors use the TSH test to evaluate your thyroid function and determine the optimal course of treatment. [NOTE: however, that some practitioners feel that relying solely on TSH -- a pituitary hormone -- without also evaluating the circulating levels of actual thyroid hormones T4 and T3 -- may not be able to detect more subtle thyroid problems, or conditions that are resulting from improper conversion of thyroid hormones. TSH is also not necessarily sufficient to monitor hypothyroidism during pregnancy. For these reasons, some practitioners also include other valuable blood tests, including T4, T3, Free T4, Free T3, Reverse T3, and antibodies tests.]
A major hitch in this connection of TSH to hypothyroidism and hyperthyroidism is an ongoing disagreement in the medical world.
As of 2008, at most labs in the U.S., the normal reference range is approximately 0.5 to 5.0. So levels below 0.5 are considered possible evidence of hyperthyroidism, and levels above 5.0 would be considered possible evidence of hypothyroidism. There is, however, an ongoing, five-year dispute among thyroid experts, because as of late 2002, some endocrinologists believed that the range should be narrowed significantly, to 0.3 to 3.0.
Endocrinologists have not yet reached agreement about a standardized normal reference range for the TSH thyroid test, despite the fact that they consider this test the gold standard test to use in diagnosing and treating many thyroid problems.
When you are being treated for hypothyroidism with thyroid hormone replacement drugs, doctors will typically attempt to medicate you into this so-called "normal" reference range -- of a TSH from .3/.5 on the low end, to 3.0/5.0 on the high end. (Patients who have had thyroid cancer, however, are often given suppressive doses that maintain TSH near to 0 in order to prevent cancer recurrence).
So, when you've gone for a checkup, and your TSH comes in below normal (and your doctor does not have you on a suppressive dose of thyroid hormone), they may want to REDUCE your dosage of thyroid hormone, because levels below normal are considered potentialy "hyperthyroid" (overactive.)
jay x
thanks jay, well regardless what the doctor says if my tsh is 5.7 i would rather get it down to around 3, do you know if 5.7 maybe the reason why im so depressed and low in energy, i fluctuate from feeling ok to feeling really bad and ive been on 3 different medications and still dont feel any better
Hi, I suggest you ask the GP for a printout of your blood test results (the receptionists can do this at my GPs), then you will be able to see for yourself what your result is (the range for the test that was done will be in brackets to the right hand side if it looks like my printout). That way you can see for yourself if you are in range. If you are not, look up the symptoms of hypothyroidism, note how many you have and go see a different GP. Jay summarised the ongoing debate brilliantly and GPs vary in how they interpret results. To answer your question: yes, depression is a symptom of an underactive thyroid, as is fatigue (aka lack of energy).
The next bit of this post is not relevant to you right now, but may be once you are on thyroxine, if after 3-6 months on the corect dose you contine to have hypothyroid symptoms but your blood test results are classed as being in the 'normal' range. I am one of the people whose body doesn't convert T4 to T3 properly. This was found out by accident when I stopped the thyroxine (aka T4) tablets for 8 days then had a blood test - T4 was in range but T3 was below the lower limit of the range. I am now on a medication that replaces T3 as well - a natural desiccated thyroid called ThyroGold.
It is very difficult to balance all three quantities, TSH, T4 and T3. You can get miserably sick while trying to pull TSH into an "acceptable" range. I went by symptoms first. I cranked up my T4 dose until I was making sufficient T3 to make me feel OK. When my doctor retired and I reverted to the Endo in this practice she reduced my T4 dose in order to raise my TSH (which was close to zero). The result of this master stroke was that I was ill with all of the hypo symptoms for 2.5 years! I fired that endo and now I am on a good dose of Armour thyroxine because it has T3 in it. Result is that I now feel fine.
I would not medicate to TSH, that presupposes a perfect pituatory and the ability to convert T4 to T3 (It's T3 you need to feel OK). Regarding the latter that is another long story - you have to make sure that you have all of the catalysts present in your system plus a good working liver, plus (my own pet theory) that the current synthetic T4 medication is "convertable". i.e. bad conversion may not be the patient's fault - it might lie in the manufacture of the drug, or in one brand of drug (the one you are on).
Read, read and read some more, make sure you are in the driver's seat otherwise you are looking at another few years of depression, dont' be afraid of changing doctors if the one you have will not listen to your symptoms.
Hi LAHs, I understand where you're coming from with increasing T4 until feel ok - I did the same and now wish I hadn't. I now have a number of other autoimmune diseases and personally think it was the over-dosing on T4 that was to blame. I don't convert T4 to T3 correctly. My theory is that because T4 wasn't being converted to T3 it stayed in my bloodstream doing damage, whilst not relieving my hypoactive thyroid symptoms. I found out, by accident, I wasn't converting T4 to T3 correctly: I stopped T4 for 8 days then had a blood test. The blood test showed T4 in range and T3 below range. As there was enough T4 available, T3 should have been in range. I also have developed a number of allergies and food intolerances. So the lesson I have learnt is: that when T4 wasn't fixing my underactive thyroid symptoms, I should have had T3 added in, instead of just increasing T4. As I said before I now on a natural desiccated thyroid and feeling much better.
Hi Barbara,
That is very interesting. We (my GP and I) had practically no input from the endo (who was supposed to be the specialist). My GP and I shared logical minds and had only a little knowledge on this subject. I have to admit that I didn't feel 100% confident that cranking up the T4 was the right solution, but we had no other input to my situation. I don't think I have experienced any harm, maybe I was just lucky.
My next problem to solve is, "Why is all this making me fat?!"
Any suggestions from any quarter would be appreciated.
Hi LAHs, to reply to your question 'why is all this making me fat'? My theory is that it's all the 'extra' stuff they put in processed food to keep it fresh and to make it taste good after they have used poor quality ingredients. Frozen is better than ready meals as being frozen automatically keeps food fresh. Try avoiding high glycaemic foods such as white sugar, white flour, white rice. Go for wholemeal instead.