Thyroid Confusion: Why The TSH Test Range is Still Up for Debate
Six years ago, the American Association of Clinical Endocrinologists recommended using a new thyroid TSH reference range of .3 to 3.0. Six years later, however, laboratories across the U.S. still use the older range of .5 to a top level of 4.5 to 6.0. Endocrinologists' inability to agree is causing confusion and inadequate diagnosis and treatment for thyroid patients. Because while some doctors consider a TSH level above 3.0 as evidence of hypothyroidism, others refuse to acknowledge the new guidelines, and instead cling stubbornly to the older range. And some general practice or family doctors, unaware of the controversy at all, simply review the lab reports, and base their decisions on whether the lab is flagging results as "high" or "low." And given that labs are still using the old range, that means many patients falling in the 3.0 to 5.0 range in treatment limbo.
Endocrine Today has two important new articles that address the TSH controversy, and they are must reading for all thyroid patients. I urge all thyroid patients to read these articles, so you can understand what is going on with your doctors about this issue.
- "Studies, data and dialogue needed to determine TSH range: The gold standard for thyroid dysfunction screening remains debatable", Endocrine Today
- "How should the TSH reference range be determined?" Endocrine Today
- Understanding the TSH Test
- Endocrinologists Say TSH Normal Range is Now 0.3 to 3: Millions More at Risk
- AACE Changes Position re: TSH Normal Range
- Does Your Doctor Know About the New TSH Lab Standards?
- The TSH Reference Range Wars: What's "Normal?", Who is Wrong, Who is Right...And What Does It All Mean For You and Your Health?
Photo: Clipart.com
Comments
I have been fighting with my doctor on this issue for 2 yrs now. I cant get him to help me with this. He tells me every time I have a blood test that everything is just fine. But its now, I know my body and how I feel. I am running around 5.6 to 9.2 on my blood work. SOMETHING is wrong and I cant get him to see that. What do I do?
9.2!!!!!!!!!!!!!!!!
If I had a reading of 9.2 ,my doctor would hardly let me leave his ofice.
We use the .25 to 3.0 range here and I do not feel normal below .27, a fact my doctor recofnises.
I’d say, change GPs and get your mnedical records, they’re yours and you’re entitled to them
Does anyone else have the problem of feeling “normal”, but having Thyroid levels off the charts? Twice in the past 2 years, I’ve had labwork that showed I was hyper, when I obviously wasn’t. . .the doctor responds to the #s, not my symptoms, they bring me “down” until I crash 3 months later. . .only to find that I was “normal” all along. I am constantly having incorrect labs. Is there something I’m eating wrong? I take my Synthroid the same way daily, never double up, never miss. . .6 months of the year I’m Endocrinologist-induced hypothyroid and I’m sick of it. What can cause incorrect lab work??
I have a question about the
“DPC Immulite Third Generation TSH.” How can I – having always used the chart like you post Mary – know how good the reading of my test result being, sTSH (0.188) is? The range posted as 0.400-4.000. can you shed any light on how the two readings compare?Thankyou
Just wanted to give you some hope! Some Drs and labs are finally getting it!! My level has been around 2-3 for the last few years and i felt TERRIBLE> my last test was 3.2 and my Dr. agreed to go ahead and put me on Armour! Yeah victory #1. Then I did lab work after being on Armour for 3 months, and my level was 1.9 and there was a note from the lab underneath my results that said :”Adult TSH concentrations below 5.5 do not rule out the presence of subclinical hypothyroidism” DUH!! but that is Victory #2!! woo hoo. Someone is finally getting it….
One respondent mentioned still having problems after months of faithfully taking Synthroid. I have NOTHING good to say about it! After years of feeling great on Armour, my doctors was told that it had been pulled off the market. (Care to guess where he got that information?
He changed my prescription and the problems began with difficulty regulating the dosage. After years of increased expense for lab work and medication, I find this website and learn that Armour has NEVER been discontinued!
During my years of taking Synthroid, all sorts of health problems have developed. Of course, there is no proof that my illnesses and symptoms were caused by Synthroid. However, now that I’m taking Armour again, I’m feeing much better.
My hypothroidism was congenital and at age 21, it was necessary for me to have a total thyroidectomy to remove a pre-cancerous goiter.
How do I get my Drs. to put me on armor? I have tried diffrent versions of synthroid and have had bad reactions and both y internal medicinedr. and indo. dr. say armor isnt good and when I absolutly need synthroid I will take it, I CANT i have reactions to it what do I do? why cant they perscribe something else? I have Hashimotos
Yes I am with everybody on this too. My lab and Dr.’s use the old range. But I am covered under Kaiser, so it does not matter which Dr. I use because they go from the old range. I have been around a 3.10 and feel horrible with all of the tell tale signs and symptoms that it is not working for my body. I looked back 8 years and when I felt my best I was always under a 2. What can you do in this type of situation? What can you do to get these Dr.’s to listen to their patients who obviously know their bodies. Some days I have a hard time getting out of bed, but I have to so I don’t loose my job.
Help!!
I remember when the TSH range was first changed. At the time I suspected a thyroid problem due to decreased energy levels and a tough time maintaining my weight. My doctor tested my TSH and it was 3.5. I asked that she refer me to an endo so I could get treatment. She did, although she saw no problem with the numbers. I took a print out of the new range to the endo. The endo completely dismissed everything I said and everything I showed her! She tested me again and my TSH was 3.2. She tried to put me on antidepressants and tell me I needed to just exercise and get out of my lazy habits.
I lost my insurance due to a job loss shortly afterwards so I couldn’t get a second opinion. Now here I am several years later and I feel even worse. My dad was just diagnosed with hypothyroidism and the meds have made him a new man. I so badly want my life back, but can’t seem to get a doctor to listen to me or accept the new (now 6 year old) range.
I read on the forum that in the U.S. one can switch to a D.O. (doctor of Osteopathy) instead of a M.D. because they are more likely to go by symptoms and the whole picture than by numbers alone.
I am in Europe and the therapeutic range (meaning treatment goal while on thyroxine) is 0,5-1,5 . One does not use the general population reference range while on treatment. And, on the forums we read that a largish minority just get low TSH and have to be dosed by their free t4 and free t3 instead and tthat those are too low when theyr TSH is normal. Instead they need the ft4 and ft3 in the upper half of the reference range but then the TSH is 0 but they are not over-dosed. Dr. Toft mentions that several times in comments in the bmj.com. He even keeps ome patients on a dose where the ft4 is above range if they need it. Look it up.
This is for ANNETTE: I have Hashimotos and have had a doctor (a locum) tell me that my TSH indicates that I’m hyper. I was not, however, as I have adrenal fatigue – if you have adrenal problems your pituitary gland will tell your thyroid to stop working so that it slows your adrenal glands down. Some of the symptoms of your adrenal glands making you go ‘faster’ are similar to being hyper.
Kate, you commented on adrenal problems, I wsa diagnosed as hyper few years ago,am on Methemizole, and seem ok, except tired..according to my Dr, nothing abnormal about my thyroid ( not enlarged, no nodules) so now I wonder about adrenal gland trouble..