Have you been told that your TSH is normal when you know that it’s really not normal? I’m guessing that the picture looks something like this: You went to your doctor’s office with legitimate complaints. You may have been struggling with weight gain, fatigue, cognitive changes, mood changes, depression. Perhaps you presented with constipation, or any number of different gastrointestinal problems. You may have noted skin changes, hair thinning, eyebrow thinning, and changes in your menstrual cycles, libido, and overall fertility. Basically, my patients tell me that everything feels off.
Is this you? And still in spite of all of the data to suggest otherwise, the conventional medical doctor just checks a TSH to measure thyroid hormone function and assess thyroid health. I can’t think of less insightful advice. So stick with me through this blog and you’ll see why.
A TSH “normal” range may not be your normal range
I’m making these blogs and videos because I want to give you the tools that you need to really understand your health, and to create really a toolkit of all the factors needed to live long, live well, and enjoy what life has to offer.
As you know, TSH stands for thyroid stimulating hormone. It is a hormone released by the brain that basically tells the thyroid gland to make more or less thyroid hormone. The important thing is it doesn’t reflect the amount of free thyroid hormone that’s in the bloodstream, and too frequently doctors only check the TSH. The result commonly comes back in the mid normal range, and in spite of all those symptoms that you’ve been complaining of, they tell you that everything’s normal, and to come back next year.
And the cycle continues.
Start with a TSH. But don’t end with a TSH
The best way to assess your overall thyroid function is to first assess a TSH, which is just a starting point. Its range is between 0.5 and 5.0 mIU/liter, and ideally I want to see people in the lower parts of this range. Optimal is probably between about 0.5 and 1.5. You will also need to measure your free hormones, which are known as free T3, and free T4. People seem to feel the best, as symptoms go away, when these numbers are in the upper half of the lab’s range.
In rare cases, I will measure something called a reverse T3, but I will need to make another post about that, and explain why it might be important. It is the doppelganger of T3, T3’s evil twin. But this marker rises only in certain infrequent clinical scenarios.
For a TSH>4, you need to check for Hashimoto’s antibodies. Just do it.
The one thing that I want to stress here is that if you have a TSH that’s in the higher part of your range, like maybe a TSH greater than 3.5 to 4, I’ll strongly recommend that you also look to see if there’s some component of autoimmunity that is damaging your thyroid gland.
The autoimmune process is known as Hashimoto’s thyroiditis, and it’s characterized by elevated autoantibodies. These are known as TG, or thyroglobulin, and TPO, which stands for thyroid peroxidase.
Thyroid testing in a nutshell
So there you have it. In a nutshell, this is what you need to really understand what’s going on with your thyroid health. You need to measure a TSH, free T3, and a free T4. And you will need to be sure to measure the autoantibodies, anti-TG and anti-TPO if your TSH is in the high normal range, or above the normal range.
Ideally, your TSH is in the 0.5 to1.5 range. The best place for your free hormones is in the upper half of their normal ranges. And finally, if you do have a really high TSH, you absolutely need to ensure that you don’t have an autoimmune process going on. I can’t tell you how many times I have diagnosed thyroid autoimmunity in patients whose primary care doctor had been managing their high TSH levels for years, without everconsidering Hashimoto’s.
So there you have it, another really important tool for your health toolkit. I am maintaining this blog, and making these videos to give you good information. Of course, I always welcome comments and subscriptions. And if you like this information, be sure to share it across your social networks.
Want to watch the video? Click here https://www.youtube.com/watch?v=iDWfNFdzS_Q&t=2s
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