Do all labs give the same comment on TSH?

[Mollyfan]

Just wondering if the message on my recent result was common? It seems very sensible to me.....

Detectable, preferably lower half of range and definitely not above reference range.

[SeasideSusie Remembering]

Mollyfan

Fairly common on many NHS reports. Unfortunately TSH doesn't tell us our thyroid status, it's the FT4 and FT3 (the actual thyroid hormones, TSH is not a thyroid hormone) that do that. And for those taking T3 or NDT it tends to have the effect of lowering, even suppressing, TSH when optimally medicated which many doctors fail to realise.

[Mollyfan in reply to SeasideSusie]

I was thinking it was quite sensible.....It is the comment on TSH only and the result would be interpreted with T4 ( although not T3 which is a major omission). It seems to accept that the a TSH can be below range as long as it is detectable and also suggests that it should be in the lower half of the range at most. I think my point is that it does not support a GP saying that a TSH of 4 is OK on treatment.

[helvella Administrator Thyroid UK]

It is better than some!

I'd argue even using the phrase "normal reference range" is unacceptable. See lower down for more explanation.

It needs to state "adult" - as it is presented, that could apply from birth upwards.

If they are going to say "lower half of normal reference range", let them be helpful and include numbers! Between 0.35 and 2.565. All too many doctors are not brilliant at arithmetic, let alone brain fogged patients.

If they are going to say "older", they need to tell us what that means! Over 40? Over 60? Over 65? Over 80?

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...

[Mollyfan in reply to helvella]

Very true..... reference range would be a better term. I have recently changed practice ( and therefore lab) and this comment seems better to me than the previous one. At least they try to say lower half!

[pennyannie]

Can anybody tell me what " uncomplicated " primary hypothyroidism means please ?

[tattybogle in reply to pennyannie]

It's a disease that well behaved, trusting patients, who respect GP's authority, get. (those ones who just happen to also get fibromyalgia and ME and need antidepressants and painkillers added on after their 'uncomplicated 'thyroid has been treated )

I once saw my notes before a General Anaesthetic "Mild Systemic Disease, Adequately Compensated " .... NOT

[pennyannie in reply to tattybogle]

Well yes, I find this description confusing and interesting :

So we have this medical term of " uncomplicated " primary hypothyroidism and presume therefore that there also exists in medical terminology a " complicated " primary hypothyroidism .

I would like to know the difference, and not sure I can cheat this one, as I frequently do on the crossword puzzle, otherwise I'd never finish any of them.

Maybe that's an idea :- a quick reference thyroid disease word puzzle solver for the medical terminology used to categorize and describe us !!

[tattybogle in reply to pennyannie]

GP's Book of Disease Definitions:

"Complicated Primary Hypothyroidism " ~what happens after your previously 'uncomplicated' patient meets some other 'uncomplicated' patients and they start talking to each other and asking you awkward questions like "what exactly is my fT4 blood result please ? "

[pennyannie in reply to tattybogle]

Touche

[DippyDame in reply to tattybogle]

...and any awkward questions about the vitally important FT3 send them running for the hills!!

[greygoose in reply to tattybogle]

🤣🤣🤣