The TSH Reference Range Wars: What's "Normal?", Who is Wrong, Who is Right...

Buy Lab Tests Online

Nelson Vergel

Founder, ExcelMale.com
thyroid tests.jpg


There is ongoing controversy about whether reliance on the TSH test -- to the exclusion of clinical symptoms and other tests such as Free T4, Free T3, and antibodies tests -- is medically sound. That is a controversy that is unlikely to be decided for years. The situation today, however, is that the majority of physicians do rely almost exclusively on the TSH test to detect thyroid disease, and monitor the effectiveness of treatment.


Surprisingly, however, while the medical community does rely on the TSH test, there is complete disagreement within the community as to what constitutes the "normal range."

What Do High and Low TSH Levels Mean?
 
Last edited:
Defy Medical TRT clinic doctor

OMI100

Member
Good articles..... All one has to do is find a DR that understands that the TSH test is NOT the gospel.... That in itself is a daunting task... Much like finding a needle in a hay stack...
 

Nelson Vergel

Founder, ExcelMale.com
Only reverse T3 was associated with mortality.



J Clin Endocrinol Metab. 2016 Nov;101(11):4385-4394. Epub 2016 Aug 23

Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study.

Pearce SH1, Razvi S1, Yadegarfar ME1, Martin-Ruiz C1, Kingston A1, Collerton J1, Visser TJ1, Kirkwood TB1, Jagger C1.


Abstract

CONTEXT:
Perturbations in thyroid function are common in older individuals but their significance in the very old is not fully understood.

OBJECTIVE:

This study sought to determine whether thyroid hormone status and variation of thyroid hormones within the reference range correlated with mortality and disability in a cohort of 85-year-olds.

DESIGN:
A cohort of 85-year-old individuals were assessed in their own homes (community or institutional care) for health status and thyroid function, and followed for mortality and disability for up to 9 years.

SETTING AND PARTICIPANTS:

Six hundred and forty-three 85-year-olds registered with participating general practices in Newcastle and North Tyneside, United Kingdom.

MAIN OUTCOMES:
All-cause mortality, cardiovascular mortality, and disability according to thyroid disease status and baseline thyroid hormone parameters (serum TSH, FT4, FT3, and rT3). Models were adjusted for age, sex, education, body mass index, smoking, and disease count.

RESULTS:
After adjustment for age and sex, all-cause mortality was associated with baseline serum rT3 and FT3 (both P < .001), but not FT4 or TSH. After additional adjustment for potential confounders, only rT3 remained significantly associated with mortality (P = .001). Baseline serum TSH and rT3 predicted future disability trajectories in men and women, respectively.

CONCLUSIONS:

Our study is reassuring that individuals age 85 y with both subclinical hypothyroidism and subclinical hyperthyroidism do not have a significantly worse survival over 9 years than their euthyroid peers. However, thyroid function tests did predict disability, with higher serum TSH levels predicting better outcomes. These data strengthen the argument for routine use of age-specific thyroid function reference ranges.
 

Nelson Vergel

Founder, ExcelMale.com
Thyroid. 2016 Nov 3. [Epub ahead of print]

The association between changes in thyroid hormones and incident type 2 diabetes: A 7-year longitudinal study.

Jun JE1, Jin SM2, Bae JC3, Jee JH4, Hur KY5, Lee MK6, Kim TH7, Kim SW8,9, Kim JH10.



Abstract
BACKGROUND:
Thyroid hormones are important regulators of glucose homeostasis; however, the association between thyroid hormones within the reference range and type 2 diabetes remains unclear. The aim of this study was to clarify the incidence of type 2 diabetes according to the baseline levels and changes of thyroid stimulating hormone (TSH) and thyroid hormones (free thyroxine [FT4] and triiodothyronine [T3]) in euthyroid subjects.

METHODS:
Among the participants who consecutively underwent thyroid function tests between 2006 and 2012 through a yearly health check-up program, 6,235 euthyroid subjects (3,619 men and 2,616 women) without diabetes were enrolled in the study. The change in each hormone was calculated by subtracting the baseline value from the level at the end of follow-up or 1 year before the diagnosis of diabetes.

RESULTS:
During 25,692 person-years of follow-up, there were 229 new cases of type 2 diabetes. After full adjustment for potential confounders including HbA1c and fasting glucose in Cox proportional hazards models, the individuals in the highest tertile of TSH change (2.5 to 4.2 &#956;IU/mL) had a greater risk of incident type 2 diabetes (hazard ratio
=1.44, 95% confidence interval [CI]: 1.04 - 1.98, p for trend = 0.027) in comparison with individuals in the lowest tertile (-4.1 to -0.5 &#956;IU/mL). Simultaneously, the highest tertile of T3 change (16.3 to 104.7 ng/dL) and FT4 change (0.2 to 1.6 ng/dL) conferred protective effects against diabetes (HR = 0.60, 95% CI: 0.43-0.85, p for trend = 0.002 and HR = 0.34, 95% CI: 0.24 - 0.48, p for trend < 0.001, respectively) compared to those in the lowest tertile (-76.5 to -1.8 ng/dL and -0.6 to 0.0 ng/dL, respectively). These associations remained significant when each of the hormones was analyzed as a continuous variable. However, baseline levels or tertiles of TSH and thyroid hormones were not associated with the risk of diabetes.


CONCLUSIONS:
Individual changes in TSH and thyroid hormones even within the normal reference range were an additional risk factor of incident type 2 diabetes.
 

GreenMachineX

Active Member
Only reverse T3 was associated with mortality.



J Clin Endocrinol Metab. 2016 Nov;101(11):4385-4394. Epub 2016 Aug 23

Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study.

Pearce SH1, Razvi S1, Yadegarfar ME1, Martin-Ruiz C1, Kingston A1, Collerton J1, Visser TJ1, Kirkwood TB1, Jagger C1.


Abstract

CONTEXT:
Perturbations in thyroid function are common in older individuals but their significance in the very old is not fully understood.

OBJECTIVE:

This study sought to determine whether thyroid hormone status and variation of thyroid hormones within the reference range correlated with mortality and disability in a cohort of 85-year-olds.

DESIGN:
A cohort of 85-year-old individuals were assessed in their own homes (community or institutional care) for health status and thyroid function, and followed for mortality and disability for up to 9 years.

SETTING AND PARTICIPANTS:

Six hundred and forty-three 85-year-olds registered with participating general practices in Newcastle and North Tyneside, United Kingdom.

MAIN OUTCOMES:
All-cause mortality, cardiovascular mortality, and disability according to thyroid disease status and baseline thyroid hormone parameters (serum TSH, FT4, FT3, and rT3). Models were adjusted for age, sex, education, body mass index, smoking, and disease count.

RESULTS:
After adjustment for age and sex, all-cause mortality was associated with baseline serum rT3 and FT3 (both P < .001), but not FT4 or TSH. After additional adjustment for potential confounders, only rT3 remained significantly associated with mortality (P = .001). Baseline serum TSH and rT3 predicted future disability trajectories in men and women, respectively.

CONCLUSIONS:

Our study is reassuring that individuals age 85 y with both subclinical hypothyroidism and subclinical hyperthyroidism do not have a significantly worse survival over 9 years than their euthyroid peers. However, thyroid function tests did predict disability, with higher serum TSH levels predicting better outcomes. These data strengthen the argument for routine use of age-specific thyroid function reference ranges.
High rt3 was associated more with mortality???
 

Systemlord

Member
There was another guy on another forum who started TRT, 3 weeks in TSH was measured at 2.7, previously 2.3 and his Free T3 has dropped to the bottom of the ranges, here his TSH was in range.
 
Buy Lab Tests Online

Sponsors

bodybuilder test discounted labs
Defy Medical Telemedicine hormones
Discounted lab tests
TRT in UK Balance my hormones
Testosterone books nelson vergel
Free Testosterone Book
Register on ExcelMale.com
Trimix HCG Offer Excelmale
Thumos USA men's mentoring and coaching
Testosterone TRT HRT Doctor Near Me

Online statistics

Members online
13
Guests online
4
Total visitors
17

Latest posts

Top