Should I challenge my TSH result?

[ElBurge]

Hi – I have just had my first TSH test, with a result of 4.53, I am a 38 year old male, BMI of 29 and always struggled to lose weight regardless of having an excellent diet and 5 day a week gym routine. Have a strong family history of Hypothyroidism. I was told that normal range is up to 5.5 regardless of everything I have read online suggesting it is 4.5, with lower figures being quotes as more appropriate. Should I just accept I am on the edge or “normal” or should I push for a T4 test?

Many thanks

[Clutter]

Elburgh,

There are no universal TSH ranges. Your lab will have calibrated the range in accordance with the manufacturer's instructions for the machinery they use and local population average results.

TSH 4.53 indicates your thyroid is failing but NHS will not diagnose hypothyroidism and commence treatment until TSH is >5.5. You could supplement 200mcg selenium which is good thyroid support but I think it is clear that you will have a diagnosis of hypothyroidism within the next year or two.

If you want to order private thyroid tests order TSH, FT4, FT3, thyroid peroxidase antibodies and thyroglobulin antibodies via thyroiduk.org.uk/tuk/testin... but be advised your GP practice will use the lab ref ranges for the lab which they use to analyse your results.

[ElBurge in reply to Clutter]

Thanks for quick reply. Would a GP operating privately treat then? I have had on-going issues with my GP and weight complaints regardless of what i do - I have pre-hypertension and had been treated for depression, so i find it crazy that studies show a clear correlation between BMI and TSH levels, where if an improved thyroid function could improve my metabolism, help further shift weight and therefore improve by blood pressure and mental well being.

(I also work in my own NHS CCG and we have no policies on levels for treatment, so the GP is entirely at their own free will on this one.)

[Clutter in reply to ElBurge]

ElBurge,

I think you'll find that most NHS GPs follow BTA guidance and won't treat until TSH is over range or FT4 is below range but if a GP thought it clinically necessary s/he could prescribe a trial of Levothyroxine.

Some private GPs or endos will treat when TSH is over 3.0.

Email [e-mail] if you would like a list of member recommended endos and private GPs.

[SlowDragon Administrator]

If you get private tests and this reveals high antibodies (Hashimoto's) then treatment should be started

Similarly if you have low vitamin D, folate, B12 or ferritin and improve these with supplements this may increase your uptake of thyroid hormones, increasing your TSH and revealing you do need thyroxine

All thyroid tests should be done as early as possible in morning and fasting. This will give highest TSH, which as you have discovered is all they incorrectly consider.

[humanbean]

What conditions applied when your blood was taken for the TSH test?

One of the things that people here learn is that time of day affects TSH level and so does fasting (or not).

So to maximise your TSH please make sure you are tested no later than 9am, and preferably earlier. Also, get blood taken having fasted overnight and delayed breakfast until after the blood draw. Water can (and should) be drunk freely while fasting.

See the graphs on page 2 of this paper :

reboundhealth.com/cms/image...

Also, if you look at the graphs on page 3 you can see that some people will benefit a lot from getting tested before 9am and some people will hardly benefit at all. But until you try it you'll never know.