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Mary Shomon

The TSH Thyroid Test: What You Need to Know

By August 6, 2010

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If you already been diagnosed with a thyroid problem -- or you suspect you have a thyroid condition are are trying to get diagnosed -- there is almost no way to escape the everpresent TSH test.

TSH is short for Thyroid Stimulating Hormone, and this test is considered by conventional doctors to be the "gold standard" for diagnosing thyroid conditions and overseeing thyroid treatment.

Do you understand the TSH test, what it measures, what the numbers mean, and how it all 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, here we are in 2010, and 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.

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Comments
August 6, 2010 at 10:40 am
(1) Tabatha Basco says:

This one little test has tripped me up for a long time. The first time it was run was in December 1987. Since then my doctors have been repeating the mantra, “there is nothing wrong with your thyroid” until I coerced my VA primary care into ordering a full thyroid panel in August 2008. As a technician, here is my analysis.

What is most revealing is the assumptions this test is based on. First and foremost is the inverse log/linear relationship of TSH to Free T4 “Laboratory Medicine Guidelines: Laboratory Support For The Diagnosis Of Thyroid Disease”.

When a doctor uses only TSH for diagnosing possible thyroid conditions he/she is ASSUMING this relationship holds true in every case. During my training as an electronics technician for the U.S. Navy I was taught never to assume anything; prove it.

In my case I had to prove to my doctor that for me, TSH was approximately proportional to FT4; both were declining after a momentary spike in TSH. Something in my vocation we would call a transient event. The average slopes of the graphs of TSH and FT4 where both negative and approximately proportional.

But this is a big problem. Most doctors do not perform trend analysis. They only perform static analysis. Even fewer perform comparative trend analysis. This is very easy to do with the advent of computerized medical records. My psychiatrist does it every time I see him.

Before relying on this one test to diagnose, doctors must establish it’s relativity to the individual patient. After all the saying goes, “when you ASSuME you make an ASS out of U and ME”. Don’t assume; prove it.

August 6, 2010 at 5:24 pm
(2) Paula says:

I have no thyroid and stopped taking iodized salt because of elevated blood pressure. I was tired, cranky, achy all day and don’t sleep good at night. I started using sea salt and it seemed to help . I took some iodine and put it on my wrist and it just sat there and didn’t absorb. I started putting a drop in a glass of water and it seems to help. Should I still get a urine test to see if I need iodine?

August 6, 2010 at 9:47 pm
(3) Johann Mitchell says:

Paula, you shouldn’t stop eating salt because your blood pressure is high. Doctors who tell you to do that are getting their information from TV, not from reputable sources.

What they are trying to express to you is that right before someone DIES from salt deprivation, their blood pressure drops slightly. Salt is an essential nutrient, and as of the end of the last century, doctors in hospitals had KILLED at least eight people that I’m aware of by depriving them of salt!

If you want to lower your blood pressure, you should cut out (or cut down on) sugar. A little sugar will raise it a little bit. More will raise it more, etc. You see where this is going. This finding was in the same clinical trials where the media mixed up their results and claimed that salt raises your blood pressure.

The difference was that the sugar people threatened to sue if they reported this even though it was true. Because it IS true, the media would have won that battle, but it would have cost both sides such incredible amounts of money that the media decided not to bother to report it.

August 13, 2010 at 3:00 pm
(4) Tom says:

In 2008 had thread removed due to cancer…my dr has me on .2 mg synthroid. My thyroid level in blood is .02. I feel awful. 47 year old male 6 foot 170 lbs. Used to be 195…fatigued constantly no appetite and weight loss. He wants to surpress cancer growth but a can’t take the pain…any suggestions?

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