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Mary Shomon

Everything You Ever Wanted to Know About the TSH Thyroid Test

By August 10, 2006

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If you have a thyroid problem -- or even suspect you have one -- there is almost no way to escape the everpresent TSH test.

TSH stands for Thyroid Stimulating Hormone, and this is the test that conventional doctors consider the "gold standard" for diagnosing a thyroid condition, and in particular, for diagnosing hypothyroidism.

But do you REALLY understand the TSH test, what it's measuring, what the numbers mean, and how it affects your health?

Here's a question about TSH tests that doctors rarely discuss this with you, but comes up all the time with many patients... And perhaps of greatest importance to thyroid patients is the ongoing controversy over the approved "normal range." Back in late 2002/early 2003, endocrinologists said that the TSH normal range was being narrowed, and the new guidelines meant millions more were considered hypothyroid under the new standard. This was a dramatic dramatic change of position for the endocrinology community.

Unfortunately, almost four years later, many doctors still aren't practicing according to these standards. Some are not even aware.The debate rages on, however, and if you care about your thyroid health, you'll want to make sure you're read about "The TSH Reference Range Wars" to discover what's normal, who is wrong, who is right...and what it all means for your health.

Finally, be sure to bookmark the handy chart on key thyroid function tests for your reference.

August 11, 2006 at 7:14 am
(1) James M. Lowrance says:

The argument is often presented by advocates against TSH testing, that hypothyroid patients will not recieve adequate treatment if a Dr. adjusts their medication, using the treatment TSH standars. I believe however, that TSH is valuable, especially when used together with the free levels of T-3 and T-4, in adjusting a patients thyroid medication.
I especially believe TSH is extremely valuable in diagnosing hypothyroidism because it detects it even in early stages.

August 11, 2006 at 10:18 am
(2) Pat Aseltyne says:

I never see anything referring to TSH being at 0 or close to it. What does that signify? Can an achy body be rellated to thyroid maljustment? Thank you.

August 11, 2006 at 12:54 pm
(3) Marjorie Jones says:

I am not seeing any reference to iodine levels in this discussion. I just had a test that said my iodine level was zero. Any significance?

August 11, 2006 at 3:16 pm
(4) Shelley says:

I learned the hard way that a TSH reading of 0 means that your TSH is so low, it is undetectable. Please see your physician ASAP. I will try to relate my story briefly. Over a period of about 10 months, I lost significant weight (80+ pounds). Then the weight stopped, though I still had about 30 more pounds to lose. I was tired, had a general feeling of malaise, cranky, depressed, losing some hair, my eyes began to take on some of that asymmetrical “buggy” appearance, and oddest of all, my ears would intermittently become clogged. I begged my doctor not to reduce my meds (I take Armour; for me it is a superior product to Synthroid), because I was afraid I wouldn’t lose any more weight. He insisted I see an endocrinologist, but I would have to wait months for that appointment.

Then I read Mary Shomon’s article about being over medicated. I had no idea that some of the symptoms of being hypothyroid would appear when over medicated! I assumed that the extra meds would enable me to lose weight faster, and that I would feel more energetic, etc. So my Dr. started to decrease the Armour. I had been taking 2 1/2 grains. It’s taken months of testing, and I am now down to 1 grain per day. And I am feeling enormously better. My skin is back to having a glow, my hair isn’t falling out, my eyes are brighter, and I’m just much healthier. Best of all, the scale has begun to nudge in the proper direction.

To get to the point, if you have a TSH of 0, it would seem that you are either hypothyroid, or you are receiving too much medication, making you appear hypothyroid. And yes, an achy body would be indicative of many things, including thyroid function. I would urge you to talk to your health practitioner soon.

Obviously, I am not an expert, and anything I have said is only my own personal experience. Perhaps there are others here with knowledge and experience who can further enlighten you. Best of health to you.

August 15, 2006 at 7:09 pm
(5) Norma says:

In the disorder called “central hypothyroidism,” the PITUITARY CAN BE THE CULPRIT IN THE LACK OF CIRCULATING TSH.

August 15, 2006 at 7:17 pm
(6) Norma says:

To continue…………if for some reason, i.e.disease, genetics,etc., TSH is not produced by the pituitary (which is where it is made and secreted), the patient requires supplementation with exogenous thyroid, whether Armour or Synthyroid.The thyroid isn’t getting a message from the pituitary to manufacture its hormone. The cycle is interrupted.

In the same patient, a TSH test is meaningless. I know this only too well because the doctor who took care of me didn’t and I suffered when my meds were withdrawn……….with a TSH of 0, I was thought to be hyperthyroid.

This is an unusual situation, I know, but when it’s your situation, all others fall by the wayside.

In other words, the TSH story is anything but simple.

September 24, 2006 at 12:24 pm
(7) Mercedes says:

Interesting reading. I have hypo and was diagnosed in March with it. I had to have blood test every month. I started with 123 TSH! I July my reading was 6.something. In August rocketed up into 69. something!!!!!! WOW! So my doctor increased my Synthroid from 0.2 to 0.3. Next month I felt like hammerd dog do. Fatige, feeling mean towards others, (luckily I can controll myself), all the symptoms of hypo. The only reason I realized that I was getting too much was that my hearth jumping out of my chest. So when I had my next test it was 0.35 TSH!!! I was over medicated for a month. It looks like the lab made a mistake and my doctor had no idea.

November 26, 2008 at 10:25 am
(8) Angela says:

I am reading these and realizing…I am not alone, which is a relief. I’ve been to 5 Endos this year. After feeling awful for a year and like I was going to have a heart attack, and no relief from a dr and trying Armour which was worse for me than Synthroid, I stopped my meds when the dr told me i could not lower them. two weeks later I had a 10ft fall and head injury. Well Yes my body went through of a lot of trauma but after almost a year of doctors and 4 more endos and trying to raise my synthroid 1/4 of a .25 a day! Took me 6 months to get to .50! After therapy for my head, CTs of my sinuses MRI’s checking for Brain tumors… Vascular drs. cardio drs… As I raised my meds and now went off as instructed by my 5th Endo… 95% of my symptoms all year were not from my accident, but thyroid related!!! I had the problem before accident. After two years of calm, my hair started falling out, tremors, heart palps (sinus problems, not connected to thyroid by my ENT) My TSH was tested and was 6.8 or so. Couldn’t raise meds, they put me an Amitrypilene and raised them to 1…after off Amitrypilene things got so bad, that’s when I went off. TSH with no meds was 16… at 1/2 of a .25 TSH steadied at 12. Started raising synthroid and look back now and realize muscles hurting and turning to mush, hair loss, weight gain (which I lost 15 lbs while on low dose!) sinus problems, major vision problems, pain in bones… problems with head…are from raising the meds! finally told my neurologist who was stumped (a professor) that every time I raise my meds I can’t function for three weeks… at .50 and feeling tremors and barely having hair left, my new endo said the meds are making me HYPERthyroid and for some people a TSH that is higher may be normal for them. I am now back at .12 1/2 of .25 and having sinus problems and stomach problems again, yeast infections… my hair stopped falling out and weight is coming off and and am at rest, in my body…. still have these awful black looking eyes that started when I “raised” my meds, but they seem to be getting worse…but I will wait it out and may have to start all over again raising, HOWEVER! it is nice to have a doctor that believes me. I have waisted two years going to doctors who are blaming it on anxiety and telling me to go to a psychiatrist! It is an awful feeling. I lost my job thought it was from my accident…it is my thyroid. So much FOR TSH! ALSO, I could not wait to try Armour, I heard such good things about it… but my T3 and T4 are in normal range…all along… the Armour was actually worse for me. I thought I was going to have a heart attack after 2-3 days instead of 5-6 on the synthroid. I was blaming it on the synthroid also… but it is actually my body being HYPERthyroid. God Bless and be with all of us with Thyroid Disease. My mother is hypo and has been taking 1 sythroid for 30 years no problem! Everyone is differnt, but a good doctor who can deal with the problems openly is SO HARD TO FIND. I had to heads of Endocronology Depts in hospitals tell me to get help for anxiety, woiuld have put me on MORE drugs! Saying Synthroid Levoxyl ONLY meds that are good… Its crazy!

June 4, 2009 at 12:27 am
(9) Sharon says:

I have been fighting with problem for over 20 years. I tried to ask about over-medication and was told “take it or don’t” (meds). I don’t know what to do as I have medical tests (other than thyroid) that are now really off. I do not know what to do. I tried stopping once but had no direction. Now I feel stuck. And I don’t know how to get back in here (blog) to see what advice you may offer! Guess I got to sound off a little.

August 13, 2012 at 10:44 pm
(10) Kelly says:

My TSH levels have gone from .49 to .78 to 1.45 in one year. I am experiencing major fatigue, infertility, depression, unexplained aches, unexplained weight gain, complete drop in sex drive and just plain don’t feel ‘normal’. I’m being treated or depression and ADDbut I still suffer from memory loss and seem to forget more than I remember.
My doctor tells me I’m fine. She will not order the T4 or T3 tests even with my requests.
My grandma had her thyroid removed and my aunt was diagnosed with hypothyroidism.
I am 35 and my doctors explanation to these issues was ‘ you are just getting older’! I’m 35!!!!
Pleasant do I do next?

September 5, 2012 at 7:36 am
(11) vinit kumar says:

i am a hypo man got dtected 7 months back since then my doc . has put me on eltroxine , but why my weight is goin up and down sometimes i find my jeans are so tight to wear smtimes i find them loose , i loose weight for no reason and gain the same for no reason,,,,,,,,,,,,,any idea abt it need help my age is 23 years and on a dose of 100 mcg .

December 31, 2012 at 2:54 pm
(12) cliff says:

I am a man and at 42 years of age got diagnosed with hypo thyroid which I was told was 26 instead of between 2 and 5 normal. It was like nothing I would want to experience again, but my levels are still high after a year at 137 mgs. I had breathing problems, had sevear heart skipping that beat so hard I could always be hearing and feeling it all day for weeks on end. I truely felt I was going to die. I had hair loss, depression, felt cold and confused daily. The fucking doctors kept telling me to go on anti depressants! I was a carpenter for many years and pretty fucking tough and seldom went to doctors unless it was pertinent, but this hypo thyroid thing kicked the shit out of me(for over a year) and my doctors just do not seem to take it seriously whatsoever. In some ways I would not hope this on anyone, but at the same time I would hope a male doctor gets it bad so this can be taken more seriously!
Cliff Vancouver BC

February 7, 2013 at 5:04 pm
(13) Charlene says:

I just got my t4 free blood test results and the number is 0.06. I have Hashimoto Disease. I am on 112 Synthroid right now. What is going on, I have called my Dr. but have not heard back.

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July 7, 2013 at 12:21 am
(17) Paula says:

I am a 54 year old women and was just diagnosed with Hypothyroidism. My level was 11.8. I had gained 25 pounds in 2 months and was so tired I could do anything. I have also had trouble with my Sciatic nerve for about 13 years now. They started me on meds 2 weeks ago and I still am so tired and sleep a lot. I am also on Depression medication and have been for years. Is this all normal?

July 24, 2013 at 7:50 pm
(18) Richard says:

Just tested a little on the high side (hyper) after being off thyroid medication for 6 months. The only thing i have been taking is Fulvic Acid Minerals. balancedgreen.org

August 31, 2013 at 10:55 am
(19) mepragoo says:

I am really baffled by my thyroid test results! My TSH is 0.0, but my Free T3 and T4 results are normal, and not even on the lower or higher end of normal- but right smack dab in the middle of normal! What could that mean? In researching it before I get back to my GP with the results, I saw where that could mean sub-clinical hyperthyroidism. And I do actually have symptoms of hyper-, and I’ve had them for years now, even when my TSH was 1.3 about 2 yrs ago. The tremors, anxiety for no good reason, bags under my eyes that I can’t explain otherwise (I’m 32yrs old.) irritatingly dry eyes that are sensitive to light, trouble sleeping etc etc. But then I have some symptoms of hypo- too, like really heavy painful periods, thick skin and puffy face, feeling tired and serious fatigue. i’m really confused! i guess the best thing right now would be to take another test in a month or so, and see if it tells a progressive story or something, I don’t know. Anyone else has 0 TSH but normal Free T3 & T4? does this happen with Hashimoto? Is it an autoimmune problem? And oh yeah- I forgot to mention- I have several nodules on my thyroid.

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November 30, 2013 at 3:09 am
(21) Bithika Chakraborty says:

TSH-6.50 .Now I am taking eltroxin75mg.

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