Guest Author - Jim Lowrance
The questions in this series were sent to me from thyroid patients or those asking on behalf of patients. I have briefly summarized the questions that were asked, followed by the answers I supplied them.
QUESTION: My TSH level reached 7.8 on lab results, does this indicate need for treatment?
ANSWER: A TSH of "7.8" is not normal. About the highest TSH normal value you'll find at blood labs is 6.0 but most are in the 4.5 to 5.0 range for upper limit.
As you know, TSH rises as the thyroid begins under-functioning (hypothyroidism) and will continue to elevate as it progresses. The T-3 and T-4 levels will begin to fall as this happens, so better evaluation would be to include tests of these two levels as well. Even if they have not begun to fall a TSH at your level can potentially cause a full array of hypothyroid symptoms.
Quote from National Institutes of Health/U.S. Gov:
"Normal values are from 0.4 to 4.0 mIU/L for those with no symptoms of
abnormal thyroid function. However, those without signs or symptoms of an
underactive thyroid who have a TSH value over 2.0 mIU/L but normal T4 levels
may develop hypothyroidism sometime in the future. This is called
subclinical hypothyroidism (mildly underactive thyroid) or early-stage
hypothyroidism. Anyone with a TSH value above this level should be followed
very closely by a doctor.
If you are being treated for a thyroid disorder, your TSH level should be
between 0.5 and 2.0 mIU/L.
Normal value ranges may vary slightly among different laboratories. Talk to
your doctor about the meaning of your specific test results." (MedLinePlus Medical Encyclopedia: TSH)
Also: If you are taking an anti-thyroid drug (ATD) which slows thyroid production in patients who have hyperthyroidism your Dr. would need to adjust the dose of that medication so that it allows more thyroid hormone to be produced. If you aren't taking an ATD, that TSH level would merit treatment with a thyroid hormone replacement medication in the eyes of many Doctors, especially when you’re experiencing an array of hypothyroid type symptoms.
QUESTION: I’m treated for hypothyroidism but am not seeing relief of some symptoms I believe may be caused by adrenal fatigue but the problem is my most recent doctor is uninformed in regard to adrenal issues. I’m seeing a new Endocrinologist soon and hoping he offers better assessment and treatment, do you have any thoughts on this you might share?
ANSWER: I'm glad to hear you have the appointment with a new Endo Tuesday and hope this one ends up being the one you've been hoping to find. I went through five Doctors before finding the one who properly treats me.
I have always retained a degree of symptoms including those of adrenal fatigue even with optimized treatment and the symptoms range from mild to moderate, depending on how much stress I may be experiencing and if I abuse my diet with too much refined sugar and by indulging in caffeine and chocolate. These last two I list especially, leave me felling ill and very fatigued. I feel the autoimmunity aspect of thyroid disease, will keep its patients experiencing a degree of symptoms not matter how good their treatment which puts us in a position to improve everything we possibly can to help with it, like diet, exercise and proper sleep habits.
(SEE PARTS ONE and TWO, in the "Related Links" found below.)
Also watch for Part Four of this Thyroid Q & A series, coming soon.
