I have been advised, via this site, that optimal TSH should be 1 or below, in ref range of 0.25 - 4.20
Is there any evidence to back this up that could be presented to the GP.
It seems if you are somewhere in the middle, eg 2.65 you are normal!!
Thanks
Pussycatwillow, Most people will feel better with TSH <1.0 and with FT4 in the upper range. TSH 0.25 is also 'normal' as it is within range.
Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.warvill@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP when you request a dose increase.
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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.
I think it is based on when most feel well but others will no doubt add research
When you state:-
It seems if you are somewhere in the middle, eg 2.65 you are normal!!
That's what doctors say when there patient is somewhere in the 'normal' range. They believe that if you are in the range you need no more thyroid hormones increased as we are 'normal'.
That's not the case. We should be given thyroid hormones to eradicate all clinical symptoms and we will probably have a TSH lower than 1 and some might even need a suppressed TSH to feel well.
Shaws, Forgive lengthy reply, but your comment: 'We should be given thyroid hormones to eradicate all clinical symptoms and we will probably have a TSH lower than 1 and some might even need a suppressed TSH to feel well' has inspired me to present to you my January Blue Horizon Thyroid +10 results.
My case:
I have multiple hypo symptoms and have had for years, the fatigue can be severe if I overdo it (i.e. do anything after lunchtime. I quit work in 2007). TSH & T4 always 'normal' until I went to US and was tested for everything by an ENT consultant and prescribed Armour (30mg, but 'take to level where you feel well' - in my case 90mg), on which I was restored and very happy for 3 years - on return to UK Armour withdrawn and told I was 'normal' - all symptoms ignored. Since 2013 have been trying to resolve guilt (yes, they tried to blame me for the prescription and told me I had osteoporosis - my 'own fault' - but a dexa shows I'm normal for age).
My blood numbers at point of Armour prescription were almost same as now (see below) .
Thanks to this forum I've taken tentative steps to understanding bloods vs symptoms, listening to my body and believing the wonderful doctor in the US, and considering supplementing myself - life's too short to live in the reduced way I have to. Very tentative, thanks to high anxiety and low self-belief - taken me this long to post my results for fear all would say, no, you're normal.
The BH T+10 (taken at 2pm - only appt. available) results below:
FT4 15.29 (12-22)
FT3 4.55 (3.1-6.8)
TSH 1.75 (0.27-4.20)
RT3 20 (10-24)
TT4 98.6 (64.5-142)
TPA 16.1 (-34)
TGA -10 (-115)
B12 H814 (140+)
Folate H+45.4 (10.4-42.4)
Am consulting Nutritionist to resolve gut and adrenal issues, just as I had for 2 years prior to seeing the US doctor.
The US doctor prescribed Armour based on the following:
TSH 1.33 (0.4-4.5) and after a year on 90mg TSH 0.01 (0.4-4.5)
T4 8.3 (4.5-12.5) T4 6.4 (4.5-12.5)
T3 90 (76-181) T3 132 (76-181)
TGA -20 (-20) TGA -20 (-20)
TPA 32 (-35) TPA 24 (-35)
He said I had auto-immune hypothyroidism. At the time I hadn't even heard of the thyroid and simply took the medication and felt well - since 2013 it has been a steep learning curve. But clearly, no point in consulting a doctor with my numbers.
It seems to me we all have our own 'settings' to feel well - and I heard on a Radio 4 Inside Science programme this week (bbc.co.uk/programmes/b0713p... all organs in our bodies (kidney, heart, skin etc) may be sexually defined - which one would assume would impact blood ranges and medicating. But who am I to question.
Any comments, Shaws? Thanks in anticipation.
I am in no way an 'expert' and I am not knowledgeable about 'bloods' but like you we can find our way through the maze of 'normal'.
Before the blood tests and levo were invented, all of us were diagnosed by doctors due to our clinical symptoms alone, given NDT until all symptoms were eradicated - even on a trial basis. Dr Skinner, Dr Peatfield, Dr Lowe and others state that we are underdosed nowadays due to the blood tests being 'somewhere' in the range. The doses prescribed pre-tests were between 200 to 400mcg. All of them don't take notice of the TSH and they concentrate on the patient.
When doctors pronounce - you are normal - it only means that our bloods are within the range. The don't realise that we are in the surgery because we don't feel well at all - don't feel normal -and if we take a page of our clinical symptoms, they ignore them (don't know them). They believe that what is on the computer print-out is the most important way to diagnose us, ignore us altogether then they can prescribe 'other' meds for the symptom(s) which they neither know nor understand and don't realise our body is crying out for an optimum dose - not 'normal'..
I like this doctor's method:-
web.archive.org/web/2010103...
web.archive.org/web/2010103...
An excerpt from the following:
The problem is that for individual patients, we don’t know that ratio. These endocrinologists fail to realize that statistical inferences from large groups of patients do not tell us specifically enough what we need to know clinically about individual patients.
Because the pituitary is far more sensitive than other tissues to thyroid hormone—and just how much more sensitive in individual patients, we do not know!—we can’t reliably deduce the effects of a particular dose of thyroid hormone on most body cells from the effect of that dose on the pituitary thyrotroph cells.
The near impossibility of this deduction being valid is made clear by many studies in the field of thyroid hormone resistance. The studies show that in many patients, various tissues differ in how sensitively they respond to a particular dose of thyroid hormone. That is, not all tissues respond to the same dose of thyroid hormone with the same vigor. Hence, from an individual patient’s TSH level, we can reliably validly deduce nothing about the effects of a thyroid hormone dose on tissue cells other than the pituitary thyrotrophs.
web.archive.org/web/2010103...
Another excerpt:
So I have to slightly reformulate your question: "Is there any way to tell whether enough thyroid hormone is getting to my cells and being used effectively within them." We do indeed have indirect tests that with acceptable accuracy tell us how your cells are responding to however much thyroid hormone you’re taking.
Since the end of the 1800 hundreds, for example, the basal metabolic rate has been used. This test is an accurate enough measurement of oxidative metabolism inside people’s cells. Thyroid hormone powerfully controls the rate of oxidative metabolism. If you have a low metabolic rate from hypothyroidism, then you almost certainly have slow oxidative metabolism and a measurably slow metabolic rate.
The downside of this test is that there is variability in the measurements, and I now know, from studies I’ve conducted with the test, that the most accurate assessment of a person’s metabolic rate comes from multiple measurements, preferably taken in the middle of the night. Despite the inconvenience required for accurate testing, this test is the single most useful measurement of the cellular effect of thyroid hormone.
healthunlocked.com/thyroidu...
How the patient feels is the priority.
Re your bloods, TSH is lowered due to late test. FT3 and FT4 could be towards the upper part.
The normal range for TSH is strangely shaped like a lopsided sombrero in that the vast majority of healthy people have values around 1-2 units. There is a long "tail" of values going up to about 4.5, but these only occur in a minority. So the odds are for an individual that you should be in he 1-2 area. It could be that you are one of the few who live well above that range, but the statistical odds are against you. Additionally of course, everyone has their own healthy TSH range which is a lot smaller than the range that includes everyone (50% smaller). Therefore a TSH for one person could be healthy, but in another the same result would indicate something not right.
Most GPs don't understand statistics. The curve for distribution of TSH is skewed - in other words the highest bit (most results) is not over the middle of the range, but far to the left of it. See besitzstandswahrer.de/blog/...
Thyroxine (and T3 and NDT) tends to suppress TSH so that's another spanner in the works.
2.65 is more likely to be normal than 4, but that's about it
Thanks for all replies.
Reason I ask is that my TSH is usually 1 or below.
Husband and son are 2.68 and 2.75 respectively.
I wonder if they would feel better is their TSH was lower and or suppressed.
Suppressed TSH
Suppressed TSH
Suppressed TSH - Reasons
Suppressed TSH Fears
TSH Suppressed
