TSH level query

[Sparkle44]

Hi I have been told that I have a benign nodule on the right of my thyroid. This was discovered during a neck ultrasound. I was told it was benign due to the small size. I am just trying to get to the bottom of my extreme fatigue and noticed some replies to TSH levels suggesting that they should be 1 or lower despite the normal ranges in blood results being higher?

Please can anyone offer some advice as my results for TSH and T4 came back as normal, but if TSH should be lower than 1 then do I need to challenge this with my GP?

Thanks!

[SeasideSusie Remembering]

Sparkle44

TSH levels suggesting that they should be 1 or lower

That is for people who are on Levo. Most treated hypo patients generally feel best if TSH is 1 or lower with FT4 and FT3 in the upper part of their ranges, but it does vary with the individual.

[Sparkle44 in reply to SeasideSusie]

Thank you!

[RockyPath]

Are you being treated for hypothyroidism? Those are certainly some spiky TSH levels.

[Sparkle44 in reply to RockyPath]

Thanks for your reply. No I am not being treated for anything yet. Do you think that is what I might have?

[helvella]

TSH levels vary through the day - highest in the very early hours, dropping through the morning and at their lowest in the afternoon. Towards or just after midnight, up it goes again.

Were all your tests at the same time of day? Unfortunately the difference between, say, 08:00 and 14:00 can be enough to make the difference between diagnosis and being told all is well.

[Sparkle44 in reply to helvella]

Hi yes, all my tests were at the same time of day which was around 11am. My GP has asked to see me but my Prolactin levels are elevated due to a pituitary adenoma. My inorganic phosphate is extremely low. My folate is extremely low and my cholesterol is really bad, so I am not sure if the GP will be concerned about my thyroid results given that they appear to be in the normal range?

[helvella in reply to Sparkle44]

Do you know your Free T4 results?

I'd be totally against basing anything on TSH alone.

[Sparkle44 in reply to helvella]

Hi yes, my TS4 results are:

14.1pmol/L (normal range (12-22)

Thanks.

[helvella in reply to Sparkle44]

Most people would be happier with that significantly higher - at least 17.

Your cholesterol level could very well be high because your thyroid hormone levels are too low.

Have a look at this very recent post by diogenes:

healthunlocked.com/thyroidu...

[Sparkle44 in reply to helvella]

Thanks! So if you had to hypothesize about what is going on for me do you think I have hypothyroidism?

[helvella in reply to Sparkle44]

That is easy to answer. Yes.

Just that your blood test results are not out of range. Yet. But that does not mean you are not suffering from the effects of inadequate thyroid hormone.

Of course, with your other issues, things are more complicated but my view is that hypothyroidism is a genuine problem for you.

[Sparkle44 in reply to helvella]

Thanks for your views and support. I will revisit this with my GP as I have just looked up the symptoms and I have the majority!

List of the most common symptoms associated with hypothyroidism:

Fatigue✔️

Weakness✔️

Weight gain or difficulty losing weight (despite reduced food intake)✔️

Coarse, dry hair and dry skin✔️

Hair loss✔️

Sensitivity to cold✔️

Muscle cramps and aches✔️

Constipation✔️

Depression✔️

Irritability✔️

Memory loss✔️ (Just been referred to the memory clinic!!)

Abnormal menstrual cycles

Decreased libido✔️

Slowed speech (in severe cases)

Jaundice (in severe cases)

Increase in tongue size (in severe cases)

[RockyPath]

That's it, Sparkle44, and all of the other problems you've posted about in the past year. I study done many years ago in Russia found that, among a cohort of nearly 1,200 people with lymphedema (635 primary and 536 secondary disease cases), "hypothyroidism-like thyroid dysfunction was found in 80% of patients with primary lymphedema. Measurements of thyroid hormones confirmed the above findings. It is hold that lymphedema patients should undergo the thyreoidin test and combined treatment including thyroid hormone therapy."

The test numbers are not as important as all of the symptoms that you've suffered, since all of them can be attributed to hypo metabolism due to hypothyroidism. In future, be sure to take your blood test as soon as the lab opens and you'll have the most persuasive TSH result.

[Sparkle44 in reply to RockyPath]

Bless you thanks!! Don’t suppose you can provide me with a quote so I can take it to my GP concerning the link between Lymphedema & Hypothyroidism?? I am at the stage where I am so fatigued that I spend weekends in bed... this isn’t right!!!

Thanks x

[RockyPath]

Sorry, I forgot to include the link to the article on lymphedema: ncbi.nlm.nih.gov/pubmed/801...

Sadly, much research on hypothyroidism and its effects have been lost over time, causing doctors to focus on individual symptoms and find names for individual diseases (lymphedema) and ignore the underlying cause (hypothyroidism).

[Sparkle44 in reply to RockyPath]

Excellent! You pre-empted my question!

Huge thanks x