TSH reference ranges

[siskin]

I am trying to find info. on the lower TSH reference ranges of 0.3 to 3. to show my doc.

I have found info. on May Shalom web site but when I link to AACE where it is supposed to be it is "page not found".

I know my gp is so closed minded she would only consider something properly referenced by what would be a legit authority, whoever that may be..

[shaws Administrator]

Maybe this is the link you want

aace.com/files/hypo-hyper.pdf

[siskin]

Hi Shaws, thank you for link, but can't use that for doc. as it clearly says "TSH most sensitive test" and in an angry throw away statement I told doc. that TSH was now considered by many to be useless. She replied show me the references, so am searching for that as well.

[shaws Administrator in reply to siskin]

It is an unfortunate phrase I agree but I think nearly all the Endos believe that, except us.

If I come across something, I will post you.

[siskin in reply to shaws]

Thanks shaws. It really is a right mess. Even the "experts" seem to contradict themselves in their own articles.

They are also so badly written, frequently without paragraphs which nowadays I often feel too tired to take in.

What few articles refer to, is the role of the hypothalamus, and the role of TRH and what is stimulating the hypothalamus to produce the TRH .

I am cream crackered and going to bed now.

Night night

[NBob]

I put this paragraph in a letter to my GP, printed out the research and attched it to the letter. I am seeing the GP next week when i will informher that she has a duty to read the research as best evidence and a duty to reflect on it under Good Medical Practice. if she doesnt act on this evidence and alotmore i have given her i wil lthen consider making a formal complaint. heres the evidence

I am aware of numerous pieces of research that conclude that exogenous thyroxine can be taken safely without causing atrial fibrillation and osteoporosis. The chief of these are:

1. "It is safe for patients who take thyroxine to have a low (0.04 – 0.4 mU/l) but not suppressed (=0.03 mU/l) serum TSH concentration. There is no risk of atrial fibrillation or osteoporosis at the low TSH level".

Is it safe for patients taking thyroxine to have a low but not suppressed serum TSH concentration? Graham Leese & Robert Flynn University of Dundee Endocrine Abstracts (2010) 21 OC5.6

2. “The aim of thyroid replacement therapy is to achieve a euthyroid state. This should be determined by the signs and symptoms of the patient rather than solely on the position of the pituitary hormone TSH in the disputed reference range.

In a large study of patients with new-onset AF, less than 1% of AF incidence was caused by overt hyperthyroidism. Therefore, although serum thyroid-stimulating hormone (TSH) is measured in all patients with new onset AF to rule out thyroid disease, this association is uncommon in the absence of additional symptoms and signs of hyperthyroidism”.

"How useful is thyroid function testing in patients with recent-onset atrial fibrillation? Krahn AD, Klein GJ, Kerr CR, Boone J, Sheldon R, Green M, Talajic M, Wang X, Connolly S. Source University of Western Ontario, London. Arch Intern Med 1996, 156:2221-2224".

3. Abnormalities of heart morphology associated with impaired exercise performance occur as a consequence of long term therapy with fixed TSH-suppressive doses of L-T4, but these abnormalities improve or disappear after careful tailoring of TSH-suppressive therapy.

"Cardiac Function, Physical Exercise Capacity, and Quality of Life during Long-Term Thyrotropin- Suppressive Therapy with Levothyroxine: Effect of Individual Dose Tailoring Giuseppe Mercuro, Maria Grazia Panzuto, Alessandro Bina, Maria Leo, Rosanna Cabula, Laura Petrini, Francesca Pigliaru, And Stefano Mariotti Institute of Cardiology (G.M., M.G.P., A.B., M.L.) and Endocrinology, Department of Medical Sciences (R.C., L.P., F.P., S.M.), University of Cagliari, 09124 Cagliari, Italy 2000

4. The benefits of treatment of mild thyroid failure with appropriate doses of L-thyroxine outweigh the risk.

"Hypothyroidism as a Risk Factor for Cardiovascular Disease Bernadette Biondi and Irwin Klein Endocrine, vol. 24, no. 1, 1–13, June 2004"

5. "There are disjoints between FT4-TSH feedback and T3 production that persist even when sufficient T4 apparently restores euthyroidism. T4 treatment displays a compensatory adaptation, but does not completely re-enact normal euthyroid physiology.

(In other words, using TSH tests is not a relaible tool to assess people on Levothyroxine)

"Is Pituitary Thyrotropin an Adequate Measure Of Thyroid Hormone-Controlled Homeostasis During Thyroxine Treatment? Hoermann R, Midgley JE, Larisch R, Dietrich JW. Eur J Endocrinol. 2012 Nov 26. [Epub ahead of print] Source R Hoermann, Department of Nuclear Medicine, Klinikum Luedenscheid, Lüdenscheid, Germany".

[DeniseR in reply to NBob]

Thanks, I was also looking for something like this to take to my endo. Don't know if it's going to be enough but it's something