Professor wont start thyroid medication until TSH reaches 10!

[Powerdome]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

 

[Vince]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

He sure doesn't know anything about how to treat hypothyroidism, does he.

 

[Vince]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

He sure doesn't know anything about how to treat hypothyroidism, does he.

 

[Vince Carter]

That's insane...by most labs that's double the max lab values

 

[CoastWatcher]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

I think you should say, "Goodbye..."

 

[MarkM]

Maybe this professor should be working at the morgue instead of the hospital?

 

[ratbag]

Yes run for your life and find another MD hopefully not an endocrinologist. Get a private hormone specialist like Defymedical.com they can get you sorted out. If you have Hashimoto's leaving it to go to 10 means your thyroid gets further damaged. No one should go there even with an idiot for a Doctor.

 

[Systemlord]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

A professor at a university you say? It seems this professor is going by the old range values, the ranges have been reduced from 10.0 to 4.5 some time ago.

This professor is a bit outdated, much like a Windows XP OS, if you don't update it you get left behind.

No Reverse T3 tested.

 

[Vettester Chris]

Rarely ever does TSH reach 10!! That's insane!!

First rule with a physician that is diagnosing your thyroid: If their primary method of assessment is based on the TSH assay, then it's time to seek a new physician. TSH is a good marker to compare against the other more important lab results, i.e Free T3, Free T4, RT3, and antibodies.

In post menopausal women experiencing severe cases of estrogen dominance, it is not unheard of for TSH values to be < 0.5, along with FT3 and FT4 levels below reference range. Even in extreme hypothyroidism cases where patients FT4 and FT3 levels are at 10% of reference range (and normal RT3), it's rare to see TSH go above 5.5.

 

[Will Brink]

My TSH is around 4.5 low normal T3, T4.....Im not worried about it just yet, but just asked my doctor who is a professor of endo at a university hospital.

He said no problems, we dont medicate until it gets to 10 (TSH)...

Not sure that anything needs to be said!!!

Without all your other numbers hard to say, but at 4.5 I'd be concerned, and any one who will not treat until TSH hits 10, has no business treating other human beings at all. The Endocrine Society for example revised its TSH recs and above 2.5 as possible sub clinical hypothyroidism and none of the labs I have seen go above 5 as their upper range. You have "professor" you're dealing with who has apparently not looked at the lit in decades. Run as fast as you can away...

Just wow.

 

[Neil]

Sadly, this doctor has zero business treating human beings. As Will said above, "Just wow."

The TSH test was not developed until the 1970's, it measures something called "thyroid stimulating hormone". It does not measure actual thyroid hormone at all. In a perfect world, if your thyroid gland is stimulated, it should produce thyroid hormone. But along the way, things can go wrong, so even is the TSH test is completly normal, the patient can still be very low in actual thyroid hormone. So, a good doctor might look at the TSH, but if the patient has complaints of coldness, lack of energy, unexplained weight gain, sluggish reflexes, sleeping issues, libido issues, the doctor SHOULD pull a complete thyroid panel....and this would include the all important FT3 test....this last measures the actual unbound honest-to-goodness thyroid hormone that's available to circulate throughout your body. It's the gasoline that helps your cells and body function.

One of our dogs has a chronic illness, and once a year our vet pulls a full thyroid panel. It costs me plenty, but even our vet knows to pull a full panel. That's for our dog....you deserve as much.

There is an excellent book you can get at Amazon. You can buy a used copy, it's an easy read. It's called "Hypothyroism, The Unsuspected Illness" by Dr. Broda Barnes. It will open your eyes about all the thyroid gland is responsible for in the human body. https://www.amazon.com/Hypothyroidi...swatch_0?_encoding=UTF8&qid=1531930190&sr=8-1

I would go to Dr. Saya, he understands how to treat an actual human being.

 

[Neil]

Powerdome, another thing about your "low normal" test. The reference ranges for these lab tests are overly broad. If you go to a craptastic HMO doctor, you know, the type of doctor that has to see 60 patients a day just to make a living in today's insurance climate, they will look at these broad reference ranges and say "well, you are within range".

But "low normal" is not optimal. Having a total testosterone of 250 might be "in range", but it's hardly optimal. Having a sensitive E2 of 40 might be in range, but it's not optimal either. You get my drift.

In wellness medicine, and here at site's like Excel Male, guy's are trying to fine tune and get to optimal, it's far finer than the broad reference ranges of most lab results.

 

[Bernie]

I have high TPO antibodies and a TSH. of 5 and without symptoms and was seeing a prominent hormone specialist on the West coast. He said there is actually no medical evidence that thyroid replacement is necessary in the asymptomatic patient. He suggested that thyroid replacement is advocated by the pharmaceutical companies.

 

[Vince]

I have high TPO antibodies and a TSH. of 5 and without symptoms and was seeing a prominent hormone specialist on the West coast. He said there is actually no medical evidence that thyroid replacement is necessary in the asymptomatic patient. He suggested that thyroid replacement is advocated by the pharmaceutical companies.

I would say that statement is completely false, what prominent hormone specialist are you talking about. If he's so much of an expert in a field I'm sure we'll know him if you post his name.

 

[CoastWatcher]

I have high TPO antibodies and a TSH. of 5 and without symptoms and was seeing a prominent hormone specialist on the West coast. He said there is actually no medical evidence that thyroid replacement is necessary in the asymptomatic patient. He suggested that thyroid replacement is advocated by the pharmaceutical companies.

Good luck with that.

 

[Bernie]

It’s Rand McClain. I believe he is associated with Defy Medical

 

[CoastWatcher]

It's Rand McClain. I believe he is associated with Defy Medical

I have great respect for Dr. McClain, he's a member here and answers questions regularly on the Forum. I respectfully disagree with him based on my own clinical experience.

I do wish you well.

 

[Dr Justin Saya MD]

The key to Bernie’s post above is that he specifies “without symptoms” and “asymptomatic”. In Dr McClain’s defense, most on this site would routinely state “only treat high E2 levels if there ARE SYMPTOMS”, yet are disagreeing with Dr McClain’s decision here to NOT treat Bernie’s thyroid when there are NOT SYMPTOMS. It goes deeper than this, but to some that would seem like a double-standard or hypocritical.

Fact is it’s complex and we don’t have all of the details Dr McClain had when he made those comments on this specific case. With that said I will also state that I haven’t seen many patients with elevated TPO Ab and elevated TSH that *were* completely asymptomatic, though they do exist.

 

[Vince Carter]

Some one running an elevated TSH absent symptoms or presenting as asymptomatic is something completely different from Hashi's.

 

[Will Brink]

I have high TPO antibodies and a TSH. of 5 and without symptoms and was seeing a prominent hormone specialist on the West coast. He said there is actually no medical evidence that thyroid replacement is necessary in the asymptomatic patient. He suggested that thyroid replacement is advocated by the pharmaceutical companies.

That's the operative term. Most seek out a doc due to symptoms, so minus symptoms or other related derangements that might benefit from high TSH (and lower t4/t3?), there's no automatic reason to add thyroid per se. I have also seen people with low T, but not symptomatic, so it's a choice vs a need to treat and between doctor and patient to discuss and decide.