Is this result borderline?

[Roz123]

Hi I had a thyroid test done 6 weeks ago and it came back TSH 6.1 which according to the doc was high (she said this should be under 4) and said to come back in 6 weeks for another blood test. The result has just come back at 5.5 so they have said to come back in another 6 weeks. Why so many blood tests? Is this result borderline or what?

[PinkNinja]

You are clearly hypothyroid but they may just be covering themselves to make sure that your high TSH is not the result of a viral infection, hence the repeated tests. If it is still above range after your next test, they should really treat you.

Make sure that you have your test early in the morning (8am or close to) as this is when your TSH is naturally highest. This may help them to decide that you do actually need treatment.

Carolyn x

[Roz123 in reply to PinkNinja]

Thanks CarolynB. Both tests were early in the morning and in 6 weeks I will also put on another 9.10 appointment. Hopefully they will decide one way after the next test in (third time lucky).

[ladytelita]

I suspect the waiting game that is now going on will be because your second test was lower than the first and they'll be hoping it rights itself without medication. What time of the day did you have the blood taken? This can make a difference to the results.

[Roz123 in reply to ladytelita]

Thanks ladytelita. Yes both tests were done at the same time, 6 weeks apart. You are probably right they think it will come down again in another 6 weeks. We will see.

[Muffy]

Did you have your tests at the same time of day? If you didn't, it can make an enormous different in the results, especially if one was say, taken at 8.30am and the other at midday.

As Carolyn has said, have your test as early as possible in the morning. Also, is your GP only doing a TSH test? If she is, then you need FT4 as well and in a perfect world, you really need FT3 as well.

[Roz123 in reply to Muffy]

Thanks Muffy. Both tests were done at 9.10 in the morning. When I asked for the result they just said one of the results looked a little high so maybe they did test FT4 and FT3 as well. Not sure.

[Muffy]

Could you try to have them taken at 8am next time?

It would also be a good idea to ask your doctor if they checked the thyroid hormones. FT4 should always be checked as well, but in a perfect world as I said before, FT3 should also be tested along with antibodies.

[Roz123 in reply to Muffy]

Thanks Muffy but 9.10am is the first appointment so will have to take it again next time. Hopefully in 6 weeks I will get it sorted one way or another.

[Chiquitita]

Hi Sunshinekid!

The TSH test on its own is sadly a completely defective tool to diagnose a thyroid condition even though GPs tend to treat it as “the Oracle”.

If you have already had a result of TSH = 6.1, that is already indisputable evidence that you are hypothyroid and you should already be getting treatment. There is no need for further TSH testing to confirm a hypothyroid diagnose.

The most common cause of hypothyroidism is by far autoimmune thyroiditis (Hashimoto), which happens when one’s immune system goes berserk and starts attacking useful parts of one’s body, like the thyroid gland.

As the attack on the thyroid gland progresses, the TSH fluctuates widely up and down for years, until eventually the thyroid gland loses the battle, ceases to function completely, packs up, and THEN the TSH starts shooting up and up (never to go down again) until you either get treatment or end up in E.R… This seems to be the climax GPs are waiting for before they confirm a diagnose… it seems they have to wait until the battle is completely lost before they are prepared to help you.

During the time when the battle between the thyroid gland and the confused antibodies is taking place, generally the patient starts gradually developing hypothyroid symptoms, as the thyroid starts debilitating and producing less hormones. But it is important to know that every now and then the following happens: during the battle, parts of the thyroid start to “rupture” and as a result, there are sudden acute “discharges” of thyroid hormone into the bloodstream (like a volcano suddenly erupting) and this means the patient can suddenly feel quite the opposite for a few days or even just hours: completely “hyper”, with palpitations, sweat, inexplicable anxiety attacks. When this happens, the TSH dramatically descends and if tested at this time, the patient might get an incorrect diagnose as hyperthyroid if the GP doesn’t know enough about how this works… it has been known to happen.

So it is completely misguided to just test TSH while this “battle” is taking place as the readings will go up and down and up and down as the immune attack on the gland flares up and calms down… Anytime the test comes back “low”, the GP will say “come back in 6 months”. It is crazy stuff.

Let me tell you my own TSH readings from the past (all samples taken first thing in the morning), prior to starting medication:

14 Jan 2010 7.63

2 Nov 2010 1.89

11 May 2011 3.2

25 Jun 2012 4.1

31 Oct 2012 1.99

27 Dec 2013 5.6

5 Feb 2013 7.74

13 April 2013 2.73

My advice would be to insist that thyroid antibodies are tested (both anti TPO antibodies and anti-thyroglobulin antibodies), this confirms whether you have auto-immune thyroiditis (as I said, it is by far the most common cause of thyroid disorders). But unfortunately doctors don’t tend to want to request antibody testing until they see a blood test result showing TSH above 10, which is mad. You can get the tests done privately, though…

Waiting for the TSH to be above 10 to confirm a diagnose of hypothyroidism is like waiting 9 months to confirm a pregnancy. If you have already had a TSH test result of 6.1, that’s like you are well into your pregnancy… you want to start looking after yourself now… you are not borderline pregnant.

I wish I’d known all of this years ago, I wish I had taken action…

I’ve posted this video before, but I’ll repeat it here, I think the doctor explains it well:

youtube.com/watch?v=25fU6We...(Not working as expected?)

Take care, look after yourself and don't allow them to have you playing the waiting game.

[Roz123 in reply to Chiquitita]

Thanks Chiquitita. Hopefully I can get sorted in another 6 weeks (here hoping).

[Heloise]

TSH can change throughout ONE DAY. Waiting weeks on end to take more tests that are as close in numbers as yours doesn't really accomplish anything more, Since they have to test again after starting on thyroid, it just adds to the testing. Unless they have you DO something between tests, it makes no sense.

[Roz123 in reply to Heloise]

Thinks Holoise. It probably changes daily because my moods change drastically from day to day. Hope I can get sorted in 6 weeks time. Will keep you posed.