TSH 1 or below

[activelazy]

Almost everyone here says that TSH should be 1 or below. Is it a word of mouth or is it really based on people's own personal experience?

Please tell how you discovered for yourself that 1 or below was the level you needed.

Thank you

[Clutter]

ActiveLazy,

It's because euthyroid (normal) TSH in healthy patients without thyroid dysfunction ranges between 0.5 - 1.75. Read Treatment Options written by Dr. A. Toft a consultant endocrinologist in thyroiduk.org.uk/tuk/about_...

TSH doesn't really have anything do with how well you feel. TSH is a response to FT4 and FT3 levels. If FT4 and FT3 are low TSH will be high and if FT4 and FT3 are high TSH will be low. The goal is really to have adequate FT4 and FT3.

[jimh111]

The better studies find healthy people have a TSH in a range of e.g. 0.4 - 3.5. However, most patients diagnosed with primary hypothyroidism (a failing thyroid gland) usually need a TSH below 2.0. Perhaps this is because they are treated with levothyroxine and they need doses that lower their TSH a little in order to get normal levels of the active hormone T3.

Many of the patients on these forums are more difficult cases and some of them need a TSH below 1.0. Some need a supressed TSH down below 0.3 or 0.1. So it is wrong to say TSH needs to below 1.0. Many patients do well with a TSH above 1.0 and many need a much lower TSH.

[faultythyroid]

I was stuck on a tsh of 2.5 for quite a while and felt shattered. It wasn't until I managed to get my dose increased and it hit 1 or below that I got some zip back in me

[activelazy in reply to faultythyroid]

I was looking for this. Thank you. My TSH is 2.7 but I'm not on any medication. Had inflammation to the thyroid gland which is now gone. Just wonder if I am hypo.

My TSH was 1.08 before illness. Just have this one reading somehow. Does it mean anything?

[faultythyroid in reply to activelazy]

It's worth following up on given your history, especially if your FT4 is low too. Also worth getting antibodies checked if you haven't already. I had subacute thyroiditis and my thyroid gradually packed up after. I had antibodies tested a while back and they came back positive...

[activelazy in reply to faultythyroid]

Oh. That's what I had. Subacute Thyroiditis. A year ago my TSH was 6.3. This was in March 2016. Post Thyroiditis. Since then TSH has been falling without medication. 4.5 then 3.9 then 2.9 then 2.5 and now 2.7. Antibodies were negative a year ago and now also recently came back negative. TPO at 7 in January 2017.

My FT4 is not low, I think. It's 18

[SlowDragon Administrator in reply to activelazy]

There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin)

Both need checking, if either, or both antibodies are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

TPO is rarely checked and TG almost never checked. More common to have high TPO or high TPO AND high TG, but negative TPO and raised TG is possible, though rarer.

[activelazy in reply to SlowDragon]

Both were checked a year ago and both were quite low. Recently, TPO checked and it's 7.

[Hidden]

I have noticed that a low TSH (definitely below 1) results in lower levels of antibodies and anti-thyroglobuline (I have Hashimoto's) , compared to a "TSH anywhere in range" which some doctors seem to settle for...

[jimh111 in reply to Hidden]

Good point, I was only looking at hypothyroidism.

Activelazy - Do you have symptoms?

[activelazy in reply to jimh111]

Yes, tiredness, pain, some sort of nervousness. Can't go upstairs at normal speed. I used to be fast at everything. Please also see my response to faultythyroid.

Arms get tired very quickly. Legs weak too.

[SlowDragon Administrator]

Graph showing distribution of typical TSH - median is 1.25

web.archive.org/web/2004060...

[activelazy in reply to SlowDragon]

Yes thank you. Saw this once before which suggests I might be hypo. But my FT4 of 18 is good to docs. FT3 is 5.😖

[Treepie in reply to SlowDragon]

Slow Dragon,I am being pedantic but you quoted the mode.The median for women was 1.5 and a little higher for men.

[diogenes Remembering]

A recent paper by Ito et al which TUK has on file shows that in patients with no thyroid, body markers such as Sex Hormone Binding Globulin which are a nonthyroid indication of sufficent thyroid hormone, are only normalised when TSH is in the range 0.03-0.3 therefore even below 1. Of course there is a continuous spectrum of changes in the TSH range, ranging from slight downward alteration from the healthy range if a lot of thyroid is still working, right down to near suppression when there is none. In actual fact there isn't a usable TSH range at all if the extent of thyroid loss isn't known. And usually this is the case.

[Hidden]

A 6months supply GP, gutted he left, 10+ years ago told me he wanted my TSH down to 1. I didn't understand but always remembered it. I understand now. I was languishing on 75mcg and he told me I would need 175mcg or more. I ended up on 200mcg. Can we clone him!

[activelazy in reply to Hidden]

Aw Please find him.

[puncturedbicycle]

I like to say you should be allowed to try enough meds to get your tsh below 1 and see if your symptoms improve. No one should be compelled to have a tsh below 1 or above 1 if they don't feel well on that level, but they should be allowed to see where in the range they feel well.

[Glynisrose]

TSH can become irrelevent when at low levels. I don't have a thyroid and it annoys me when 'doctors' judge everything by it.

[activelazy]

Thank you everyone for your replies. I don't know if I am hypo or not but my TSH was 1 before illness, is all that I know. So, despite my current not so bad FT3 and FT4 I will once again try to convince the unconvinceables to help me bring it down to 1. Only by having the meds can I know if things improve.

[Angel_of_the_North]

If you look at a chart of TSH levels in allegedly healthy people, you'll see that it is skewed to the left with a huge peak around 1.2-ish and most of the results falling between 0.5 and 1.5. The graph falls off really fast and hardly any results are over 3.0. So statistically, you are more likely to be healthy with a TSH around 1 and studies show that people on levo need lower TSH (and higher FT4) to get the same FT3 levels as healthy people - so under 1 seems sensible to aim for - but it's FT3 that really matters.

[activelazy in reply to Angel_of_the_North]

Hello Angel of the north. My FT3 is 5.1. Upper limit is 6.8. I am contemplating, after reading so much about TSH of 1 or below, that may be when I was well and when TSH was 1.08, may be then my FT3 was above 6.

I go past you everyday by the way. I mean the Angel of the North 😎