TSH Labs / Hypothyroidism

[TDM812]

Can some please take a look at my TSH lab by Quest, and tell me if this is ok? I can see that it looks to be in range, but I’ve read in various places that it’s high. Thank you in advance.

 

[TDM812]

Can some please take a look at my TSH lab by Quest, and tell me if this is ok? I can see that it looks to be in range, but I’ve read in various places that it’s high. Thank you in advance.View attachment 6686

If so, what is thee recommended supplement/dose?

 

[Vince Carter]

TSH In isolation is a very poor gauge of Thyroid function, especially anything over a 2.0 should be cause for more a in-depth look.

If its affordable there are 5 tests that should be run together to get a good picture:

TSH
FT3
FT4
Reverse T3
Antibodies

 

[TDM812]

That sounds like solid advice. I have read an iodine deficiency could be the root. Until I can get labs done, what type/dose supplement would you recommend to start the restoration process?

 

[cnc1]

From everything I have read, iodine deficiency is unlikely if you live in the United States because iodine is in everything we eat and some of things we drink. There is iodine in rainwater, grains, meat, vegetables and fruits.

 

[Sean Mosher]

I've personally used both Lugol's 2% and Nascent Iodine.
I prefer the Nascent and continue to use it.
You could always start very low, maybe 1 drop of Nascent, and see if that helps at all.

 

[Vince Carter]

Is it Iodine supplementation that can drive up TSH so that it appears high?

 

[Sean Mosher]

When you first start it can (especially if you're very deficient) then it should normalize within 2-3 months.
That's why it's important to go very slow and start very low when adding iodine in.
There's a lot of information out there about high dose iodine which I can't personally speak to so you just have to be very careful.

 

[TDM812]

Has anyone heard of estrogen levels, and/or the use of an AI being responsible for thyroid issues?

 

[TDM812]

I just received some of my labs back. Anyone care to hazard a guess? They are in range, but......from what I read, the ranges are fluid.

 

[Vince]

I just received some of my labs back. Anyone care to hazard a guess? They are in range, but......from what I read, the ranges are fluid.

I can only see TSH.

 

[Systemlord]

I just received some of my labs back. Anyone care to hazard a guess? They are in range, but......from what I read, the ranges are fluid.

In range is the problem, the TSH ranges are invalid and yet doctor still cling to the invalid ranges. TSH isn't a thyroid hormone and is a poor diagnostic tool, if you wish to know how the thyroid is performing, you have to test thyroid hormones. Thyroid hormone are Free T4, Free T3, Reverse T3 and antibodies.

Your doctor will not be able to help you diagnose or treat your thyroid.

Optimal VS Normal Thyroid Levels for all Lab Tests & Ages

The evidence for a narrower thyrotropin reference range is compelling.

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter. The remainder with higher values are outliers, most of whom are likely to have underlying Hashimoto thyroiditis or other causes of elevated TSH.

 

[lowTengineer]

In range is the problem, the TSH ranges are invalid and yet doctor still cling to the invalid ranges. TSH isn't a thyroid hormone and is a poor diagnostic tool, if you wish to know how the thyroid is performing, you have to test thyroid hormones.

The reference you quoted also says "95% of normal individuals have TSH levels below 2.5 mU/liter."

I see the upper ranges talked about a lot and the lower threshold of 2.5-3. If you were to test only TSH and get a result of 1.75-2, would this indicate that further thyroid testing is not needed?

I haven't asked Defy but plan to at my next appointment. They have TSH included in the routine follow up labs. At what point does TSH indicate the need for further testing? Or is it a horrible test and nobody should ever use it?

 

[Systemlord]

The reference you quoted also says "95% of normal individuals have TSH levels below 2.5 mU/liter."

I see the upper ranges talked about a lot and the lower threshold of 2.5-3. If you were to test only TSH and get a result of 1.75-2, would this indicate that further thyroid testing is not needed?

I haven't asked Defy but plan to at my next appointment. They have TSH included in the routine follow up labs. At what point does TSH indicate the need for further testing? Or is it a horrible test and nobody should ever use it?

Often times it's difficult to gauge symptoms by just looking at TSH, you don't test only LH to determine T status without checking Total T and Free T. If this is a follow up appointment than that's different. I assume you have further testing at an earlier time unless you declined a thyroid panel do to costs.

 

[Vettester Chris]

TSH can be impacted with both subclinical and overt hypothyroidism (primary & secondary), and it's best served as a secondary marker to compare against other more crucial assays like FT3, FT4, RT3 & antibodies (all noted in other posts). No true conclusive diagnosis can be made on just TSH. If anyone tells you differently they're behind the times!

Additionally, if a physician or anyone starts steering you towards labs that say "Free Index" or "Uptake", run, they're useless and don't provide any real details to the condition of the thyroid. Everything you need to make a general assessment of how your thyroid activity looks is provided above. If there's an imbalance or flagged marker then it might require further investigation into areas like iron, adrenals, electrolytes, etc., but for now just focus on the correct thyroid labs as Step 1.

 

[torrential]

Is it Iodine supplementation that can drive up TSH so that it appears high?

Vince Carter, this is an excellent question.

Buried in my brain is a piece of info that I hardly ever see mentioned. Iodine is carried throughout the body by the Sodium Iodide Symporter, abbreviated NIS (N for Sodium/Na, I for Iodine, S for Symporter). When there is iodine available to transport, the body creates the NIS protein to grab it and take it to where where it's needed. The carrier of NIS? Thyroid Stimulating Hormone. When supplementing iodine TSH will rise, sometimes significantly, unrelated to levels of the thyroid hormones we are concerned with here.

This isn't the best info but I didn't want to show up empty handed

Sodium-iodide symporter - Wikipedia

...Iodine uptake is a result of an active transport mechanism mediated by the NIS protein, which is found in the basolateral membrane of thyroid follicular cells.
blah blah blah
...Note that the regulation of NIS expression in thyroid is done by the thyroid-stimulating hormone (TSH) ...

Personal example: Years ago Dr. John diagnosed me as subclinically hypothroid. Started me on a full Brownstein iodine protocol, titrated doses from trace up to 50mg/day and back to 12.5mg/day over four months. TSH shot through the roof, as high as 7.85 at one point, while T3, T4, etc, inched slowly towards optimization.

It's common to see well intentioned and otherwise well informed folks tell us "Iodine causes hypothrodism because when you take it TSH goes up." As we see in our discussions of thyroid health and mentioned by several on this thread, TSH alone cannot be used for diagnosis of thyroid conditions. Consideration of its role in the NIS is yet another reason why this is true.