Why the obsession with TSH?

[Min789]

Please could someone let me know why doctors and endocrinologists are so obsessed with TSH results ? Why do they insist that all is not well even if you feel well and your T4 and T3 are in a good place? I feel like challenging the doctor but would like to be prepared for what their argument might be. At the moment my TSH is only 0.05 but feel great. There must be a reasoning behind their obsession surely!!!

[SlowDragon Administrator]

Low TSH no heart issues

academic.oup.com/jcem/artic...

In summary, patients on long-term T4 with either an increased serum TSH (>4 mU/liter) or a suppressed TSH (<0.03 mU/liter) have an increased risk of cardiovascular disease, dysrhythmias, and fractures when compared with patients with a TSH within the laboratory reference range. Patients with a low, but not suppressed, TSH (0.04–0.4 mU/liter) had no increased risk of these outcomes in this study.

They are misguided/refuse to reconsider their intransigent views of last 30 years.....etc etc

TSH is a relatively new test .....and cheap

Hopefully views are slowly changing

Remember In the 1900-1960's smoking was said to be good for your health and it took massive amount of work to get opinion changed

[Min789 in reply to SlowDragon]

Thank you SlowDragon. Very helpful. I will print out and highlight relevant parts when I next visit Doctor or Endo.

[Marz]

Poor training - influences of BigPharma - Medics dominated by Guidelines - a truly sad state of affairs ...

Ask your Endo to explain how the thyroid works and WHY the TSH is important ...

[Min789 in reply to Marz]

I expect he will say that it can cause osteoporosis as he is sending me for a bone scan which I'm having on Thursday. I'm hoping that comes back ok.

[Marz in reply to Min789]

Think that has been debunked long ago with research posted here ...

[SlowDragon Administrator in reply to Min789]

Osteoporosis can be linked to low FT3......common issue when dosing according to TSH

Osteoporosis

thyroidpatients.ca/2018/07/...

[Caroline888 in reply to Min789]

Hi Min789

Coincidentally my surgery phoned me about a week ago to tell me they'd arranged an appointment for me at the hospital to have a DXA scan. I had not requested this or even seen my GP recently. It was said to be a routine appointment. TSH was not low when last tested on the NHS so they can't be using that as a reason for the scan. From what I understand being hypo itself makes us more at risk of osteoporosis. The questionnaire I have to fill in asks if I have any of various conditions of which underactive thyroid is one.

My appointment is tomorrow. Fingers crossed we both have satisfactory results!

All the best😊

Caroline

[Min789 in reply to Caroline888]

Yes Caroline888 fingers crossed. If it's all ok we have another string to our bow, plus it will be good to know all is ok......if it is. 😬

[Hidden in reply to Marz]

If the country's doctors work to guidelines, while patients have symptoms. Surely a simple computer problem could match symptoms to guidelines and get better results. Add in alogrithms, that assess lots of variables, and we could get personalised and accurate diagnosis, potentially.

[Marz in reply to Hidden]

As far as I can see - observing symptoms as part of the diagnosis has long gone ! Not sure they would know what to feed into the computer 🤔 The 'art' of diagnosis ...

[Hidden in reply to Marz]

I'm talking about eliminating them altogether.

[humanbean]

What keeps their stupid paradigm alive (in my opinion)...

Misogyny - a group of patients who are mostly female must not be allowed to change an endo's nice easy job of only paying attention to TSH and treating with Levothyroxine to keep it in range.

[Min789 in reply to humanbean]

😂

[Hidden in reply to Min789]

It's so easy a computer could do it.. Oh now wouldn't that be an improvement?

Labs even highlight when its out of range. Yet they're too lazy to tell us or do anything about it.

[greygoose]

Do have a look at this thread that was posted just after yours:

healthunlocked.com/thyroidu....

[Min789 in reply to greygoose]

Thank you greygoose. It all helps. What I really don't understand is why there's not more action being taken to get the NHS to be more aware of this problem and to change the information that they send out to the doctors and endocrinologists regarding TSH. There is so much information out there so why isn't it getting through?

[greygoose in reply to Min789]

Because Big Pharma doesn't want it to get through. BP doesn't want hypos to get better, therefore it under-educates doctors - it's BP that decides what doctors learn in med school, because they control the purse strings. If doctors stopped prescribing drugs for every symptom as if it were a separate disease, and treated patients correctly with thyroid hormone, BP would lose several small fortunes. And, they don't want that! A patient 'cured' is a customer lost. It's all to do with money.

[Min789]

Alll those people that could be well. It's so awful.

[LAHs]

TSH is a very good first approximation of whether you are hypo, hyper or normal. It's a bit like a thermometer, it takes your temperature and let's you know if you have a fever, you are normal or you are stone cold dead. Once you know which, it points you in the right direction for fixing the problem, and that's all!

[Hidden in reply to LAHs]

Isn't it more like a last stage indicator. Many times people gradually develop problems, and TSH shows up once its set in.

[LAHs in reply to Hidden]

No not really, you feel ill, you go to the docs. If s/he (or you) suspect a problem with your thyroid then the first measurement is TSH. If it's normal s/he looks elsewhere for your illness. If it's high s/he will test further for FT3, FT4 and level of antibodies (if you are lucky). It wouldn't make sense to do it the other way round. Again, it's like the thermometer, it's the first thing the nurse does before you even see the doc.

[Lora7again]

I wonder this as well because it doesn't give a good indication of how your thyroid is functioning. For example last year I collapsed with a suspected heart attack I was sweating and shaking and I knew it was my thyroid. The Doctor who was in charge of A & E tested just my TSH it came back at about 0.54 so within range but I think my T4 and T3 might have been too high but they did not test that even though I was so ill. When I felt under active abour 3 years ago my TSH was 0.88 but my T4 and T3 were too low for me. I was losing hundreds of hairs and was virtually bedridden for over two years. My TSH is 0.70 now and feel ok but I will be doing a blood test next week once I am fully recovered from this nasty bug.

[Hidden]

I went to the NHS walk in centre after a fall. I had neck pains. The doctor checked my feet for broken bones, didn't touch my neck. He then put everything is fine.

[Min789 in reply to Hidden]

Unbelievable 😡