I was trying to locate a page I have referred to previously that advises that a TSH over 3 indicates underactive. And that the NHS reference range up to 5 is too broad.
thyroiduk.org.uk/tuk/testin...
This page no longer seems to be active and the similar page its been replaced with is now showing the NHS reference range.
Any help would be much appreciated.
fozzie07, The link you have is very old. Content of the Thyroid UK website has been changed significantly since then.
Thank you for coming back to me. Is there similar information on the site? Or another site that you know of along those lines? Or are we thinking that thyroid uk has changed their mindset/reviewed the science. Because they had quite a firm view that the NHS reference range was too broad. I want to know if I am now using out of date information.
I'm not familiar with everything on the current site, but I don't recall seeing similar information there now.
Member diogenes is our 'go to' source for up to date info and papers here on the forum. He is Dr John Midgley, an advisor to Thyroid UK thyroiduk.org/about-thyroid...
Have a browse through his posts here (there are a lot!). healthunlocked.com/user/dio...
Any help?
bmcendocrdisord.biomedcentr...
Time for a reassessment of the treatment of hypothyroidism
John E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann
I've managed to locate the webpage I'm referring to through an online archive service.
It offers the normal range of TSH between 0.1 and 2 as a better guide than the standard textbook interpretation.
Now, the website refers to the NHS reference range which is the textbook reference.
So, there has been a shift in opinion at Thyroid UK and I'm simply asking why?
Please see link below to read for yourself
web.archive.org/web/2016081...
fozzie07, 'there has been a shift in opinion at Thyroid UK and I'm simply asking why?'
As we don't run Thyroid UK, or have any control over the website, we can't really answer your question. You would need to ask Lyn mynott, CEO of Thyroid UK. You can email your question to her at enquiries@thyroiduk.org
How much levothyroxine are you currently taking
It’s important to get full thyroid and vitamin testing done once a year as detailed in previous post you made 3 years ago
healthunlocked.com/thyroidu...
what are your most recent thyroid and vitamin results
Always test thyroid levels early morning and last dose levothyroxine 24 hours before test
References for keeping TSH low
healthunlocked.com/thyroidu...
Thank you.
I would just like to know why thyroid uk have changed their advice. Because I have been offering other people advice based on the previous webpage, which has been inline with my own experience.
Unfortunately Pages get updated all over the internet
This is useful one
NHS England Liothyronine guidelines July 2019
sps.nhs.uk/wp-content/uploa...
Page 9
Test for Deficiency of any of the following: Vitamin B12, Folate, Vitamin D, Iron
See page 13
1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)
from PULSE magazine for GP's... The article is available from ThyroidUK
If you want a copy of the article then email tukadmin@thyroidUK.org
and ask for a copy of the Dr Toft article in Pulse magazine. The quote is in answer to question 6.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
Perhaps the following may help allay your concerns about "numbers"....
pmj.bmj.com/content/94/1117...
"The normal range: it is not normal and it is not a range"
Main messages (from above)
Health is a relative and not an absolute state.
The reference interval acts as a comparator for the patient’s blood result. It is not the arbiter of whether disease is present or not.
Natural fluctuations in a blood result can occur.
Comparison of a result against the reference interval should be informed by the clinical suspicion made beforehand.
I do understand what you’re talking about, although I don’t know what’s on Thyroid uk website. I’ve always read on this forum that TSH over 3 for longer than a few months with no other illness present should signify hypothyroidism. Much of Europe will diagnose at 3, I’ve read here. The NHS don’t diagnose unless it’s over 5, and sometimes only when it’s over 10.
Like you I would be interested to know if there is a change to the view that TSH should be below 3.
No information 
Am I missing something!!
Vitamins information 
Information required 
(NHS Choices page)
