Tsh slightly elevated, doc put me on meds for it?

[hamplition]

So im on test for years now. Went in for my 3 month checkup and my tsh came up as 5.7

The doctor prescribed me 50 mcg unithroid

It would explain alot, such as my fatigue, sleep issues. Brain fog and being cold for a while now.

Should i start on the meds, or should i test my t3, t4, rt3 and antibodies first to see if i really need this medication?

 

[CoastWatcher]

Assuming you confirmed that undeniably high TSH value with a repeat test to rule out lab error, I think it’s safe to say you’re dealing it’s a thyroid issue. I’d certainly want to know a lot more about my thyroid’s performance before I started any drug regimen. Dig deeper.

 

[Systemlord]

Please note the TSH reference ranges are invalid, it was later determine the population group that made up the reference ranges were later discovered to include those with thyroid dysfunction. The data shows that 95% of patients who were normal had a TSH <2.5. So your TSH is a little more than slightly elevated.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were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.

Note T4 only treatment isn't always recommended or optimal, depending on your Free T3 and Reverse T3 levels, these tests would indicate what type of treatment is needed. Often patients still have symptoms on T4 only treatment.

If Reverse T3 was elevated, T3 only treatment would be needed. If your doctors prescribe thyroid medication without testing for Free T3 and reverse T3, that's not a good sign.

 

[Powerdome]

My TSH was around 8 yesterday...if symptoms are not present, is there a need to take meds? I would hope not...my Free T4 and T3 were in normal range (although on the low side to be fair)

 

[Vince Carter]

In isolation, TSH is a very poor indicator of Thyroid function. If they're affordable we like to recommend these 5:

TSH
Free T3
Free T4
Antibodies
Reverse T3

 

[Gman86]

Ya if that TSH is correct, you’re full blown hypothyroid. You want TSH to be well below 2.5. Ideally 0.5-2.0. 5.7 is very high.

I agree with everyone. Need to get repeat labs to rule out lab errors. Need to get a full thyroid panel. And if your TSH is correct, you absolutely need medication. But the one you’re prescribed isn’t the best. Very little success with synthetic T4 only medications. Depending on your T4 to T3 conversion, and RT3, you might need straight T3 without any T4. If conversion is good, and RT3 is within range, a natural desiccated thyroid supplement would be the ideal plan of action.

 

[Vince Carter]

Great point that if given T4 only you more likely have a chance to fail with that treatment if there's a disfunction in the conversion to T3. More success to be had to with a T4 and T3 blend if not all T3.

 

[Gman86]

Great point that if given T4 only you more likely have a chance to fail with that treatment if there's a disfunction in the conversion to T3. More success to be had to with a T4 and T3 blend if not all T3.

Exactly. If reverse T3 is 15 or over, straight T3 would be recommended. If free T4 is normal/ high, but free T3 isn’t optimal, then there’s a conversion issue, and again, straight T3 would be recommended. Otherwise, a natural desiccated thyroid medication that has a mix of T4 and T3 would be recommended.

 

[Systemlord]

My TSH was around 8 yesterday...if symptoms are not present, is there a need to take meds? I would hope not...my Free T4 and T3 were in normal range (although on the low side to be fair)

If one is on iodine supplementation, it can increase TSH and render it useless for diagnostic purposes.

 

[Vince Carter]

I saw my TSH do that on Iodine, I was under <2.0 as I recall but went up over 3 something on Iodine and came back down w/o Iodine.

 

[Powerdome]

Not taking iodine...

 

[Bob Lee]

My TSH has been a little over 3.7 the last three checks. T3 at 3.0

Is this enough to medicate? Is it going to help me? Yes, libido is meh, little sluggishness, but I read about people having these huge TSH numbers and feel little silly taking meds for these numbers.

On the other hand, also read many who said they felt like crap over 3.0

 

[Systemlord]

My TSH has been a little over 3.7 the last three checks. T3 at 3.0

Is this enough to medicate? Is it going to help me? Yes, libido is meh, little sluggishness, but I read about people having these huge TSH numbers and feel little silly taking meds for these numbers.

On the other hand, also read many who said they felt like crap over 3.0

Never met anyone that felt amazing or had a super high libido with their TSH over 3.0. The studies show normal healthy people have a TSH <2.5.

 

[Gman86]

My TSH has been a little over 3.7 the last three checks. T3 at 3.0

Is this enough to medicate? Is it going to help me? Yes, libido is meh, little sluggishness, but I read about people having these huge TSH numbers and feel little silly taking meds for these numbers.

On the other hand, also read many who said they felt like crap over 3.0

3.7 might not seem that high to most, but it is WELL over the limit. Anyone that knows what they are talking about will want to medicate you 100% of the time. It’s not even a question. You’re not even close to normal. Not trying to scare you or anything. It just seems like you are unsure whether a TSH of 3.7 is an issue or not. Just want to let you know that you 100% have hypothyroidism with a TSH of 3.7. Unless you had a free T3 of 3.7+, free T4 midrange, RT3 below 15 and total T3 midrange. If you had all those values within those ranges I described, then I would say not to worry about the high TSH. But I’m pretty sure it’s impossible for those numbers to be good with a TSH so high.

 

[Gman86]

Never met anyone that felt amazing with their TSH over 3.0. The studies show normal healthy people have a TSH <2.5.

Exactly! 0.5-1.5 is ideal. Anything above 2.0 is cause for concern. 3.7 is an extremely obvious sign of hypothyroidism, and I don’t see how you wouldn’t feel a lot better once you optimized your thyroid.

 

[Bob Lee]

Never met anyone that felt amazing or had a super high libido with their TSH over 3.0. The studies show normal healthy people have a TSH <2.5.

Thank you. That’s the information I was looking for.

 

[Bob Lee]

Exactly! 0.5-1.5 is ideal. Anything above 2.0 is cause for concern. 3.7 is an extremely obvious sign of hypothyroidism, and I don’t see how you wouldn’t feel a lot better once you optimized your thyroid.

Thank you! I’m going to talk to my doctor.

 

[OMI100]

A LOT of DRs have NO clue based on their medical training that they receive.
You need to know if your DR treats to ranges or symptoms.
A WORLD of difference.
FT3, FT4 - BEST MID LEVEL (50%) TO UPPER 75% (OR HIGHER) - SOME REFERENCES SAY UPPER 1/3)
RT3 - AROUND MID RANGE
Minimum labs should be TSH, FT3, FT4 and RT3.
If your DR treats to ranges one could be at either end of the reference range and you feel like crap, but the DR will tell you that you are within range and all is good.
Varying combinations of lab values point to different underlying conditions and treatment protocols.
Finding a DR that has an understanding of optimal ranges is a hard find.
BTW there are a few sites out there that do an excellent job of explain this subject clearly.

 

[albatross]

In the UK most doctors are next to useless with Thyroid issues. My TSH was 9.8 and the doctor told me it was in range and they only tend to treat people over 10.

I did find a doctor willing to put me on trial of 25mcg Synthroid which did very little except push my TSH down to 4.8. According to the doctor I was now 'fixed'

The only real way out of the mess was to do my own research and source NDT.

 

[Systemlord]

In the UK most doctors are next to useless with Thyroid issues. My TSH was 9.8 and the doctor told me it was in range and they only tend to treat people over 10.

I did find a doctor willing to put me on trial of 25mcg Synthroid which did very little except push my TSH down to 4.8. According to the doctor I was now 'fixed'

The only real way out of the mess was to do my own research and source NDT.

What a waste of a medical degree, getting TSH <5.0 in range an call it a day, just wow! I'll bet your doctor never checked actual thyroid hormones ~ Free T3 or Reverse T3.