Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 Hi Kate, I've had symptoms of low thyroid function on and off for almost all of my adult life. I had a thyroid function test in my thirties after a period of debilitating fatigue but the doc said " all normal " . This happened again and again for nearly 20 years, until I was so ill 3 years ago that I couldn't even climb the stairs in my house. At that point my TSH was still only 8 and the doc said my symptoms were too severe for such a low TSH. To cut a long story short he eventually prescribed thyroxine and my dose was raised until I was taking 100mcg. My TSH was .9 and I still didn't feel OK. My free T4 was mid range but my free T3 was very low. I had to insist on the T3 test, most doctors don't do it. I saw a private doctor who did a full clinical examination (the first time anyone had taken my temperature, blood pressure and pulse in connection with a thyroid diagnosis!) and he raised my dose of thyroxine to 200mcg. This was still not OK so now I take 125mcg of Thyroxine (T4) and 20 mcg of Liothyronine (T3). My free T4 and T3 are near the top of the range The added T3 has worked a miracle in my life and given my a quality of living I never expected to have again. Interestingly my 24 yr old daughter has complained about feeling fatigued and cold for a year or two. Two years ago I persuaded her to ask for a Thyroid Function test. Her TSH (only test done) was 1.9. She has recently started a new job and had to have a medical. She says she is feeling really good and is interested that her TSH is now .6. I think she is lucky that she has a record of the level at which she feels good. Maybe all women should have the test done each year, because after years and years of untreated hypothyroidism the TSH reading surely can't be trusted. --- Kate wrote: > I didn't want to push for further thyroid tests, > without first > talking to those who understand the thyroid best: > those who genuinely > live with a thyroid condition. > > ~Kate > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 Hi again Kate, Sorry to jump in here as this question was to Meleese but this site should give you some ammunition. http://www.thyroid.org.au/Information/NormalTSH.html --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the " Frees " ? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 Hi again Kate, Sorry to jump in here as this question was to Meleese but this site should give you some ammunition. http://www.thyroid.org.au/Information/NormalTSH.html --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the " Frees " ? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 I've just noticed that some of that article can only be accessed if you join Thyroid Australia. I downloaded it some time ago. I've posted it below although the chart doesn't show up. I can email it to you if you'd like it. The most common questions that Thyroid Australia is asked involve the interpretation of Thyroid Function Tests (TFT’s). Many people have been told that their TFT results are ‘normal’. So what is ‘normal’? In this article we will focus on the test for Thyroid Stimulating Hormone (TSH) which is the most common test ordered. The ‘normal’ Reference Range for the test is intended to represent the range of values which can be expected in the healthy population – ie those without any thyroid ailment. The Reference Range is found by taking a sample population of healthy individuals and determining their TSH levels. The lowest and highest 2.5% of readings are excluded so that the Reference Range covers 95% of the healthy population. There are a number of different tests for TSH with different levels of sensitivity. They each have their own Reference Range. The most common tests generally have lower limits to their Reference Ranges around 0.2 to 0.5 mIU/L and upper limits from 3.5 to 5.0 mIU/L. A recent study in Norway provides a good example of the use of the TSH test in practice.1 The study involved 65,000 people. They were asked questions about their thyroid status and those with a history of thyroid illness were excluded. The blood samples were tested for Thyroid Peroxidase Antibodies (which are an indicator of likely thyroid illness) if they produced a TSH reading greater than 4. Samples with positive antibody results were also excluded. The survey, therefore, attempted to exclude people with any indication of thyroid illness, but still included those with Thyroid Peroxidase antibodies whose TSH reading was 4 or less. The TSH test kit used for the study had a nominated Reference Range of 0.2 to 4.5 mIU/L. The results for women are shown in the chart. The results for men were only slightly different. The features of this result are: • The distribution of TSH readings in the healthy population is skew. It is not the common bell shaped curve centred in the middle of the reference range. • The most common value, or Mode, is at 1.25. • The Median value is at 1.50. This means that half the population (50%) have a TSH reading below 1.50. • The average, or Mean, value is at 1.68. Over 60% of the population have a TSH reading below this value. • The centre of the Reference Range for the test kit used in the study is 2.35. Almost 85% of the healthy population have a TSH reading below this value. • The 2.5 percentile point (ie the point which excludes the bottom 2.5% of the population) is at 0.48. The 97.5 percentile point (ie the point which excludes the top 2.5% of the population) is at 3.6. The range between the 2.5 and 97.5 percentile points (0.48 to 3.6) is much narrower than the test kit’s Reference Range (0.2 TO 4.5). • This narrowing of the range would suggest that the reference group used to calibrate the test kit possibly included people with some level of thyroid illness. • This narrowing of the range between the 2.5 and 97.5 percentile points would potentially have been even more pronounced if all samples had been tested for Thyroid Peroxidase Antibodies. The conclusions which can be drawn from this survey are: • TSH results in the upper half of the Reference Range have a low probability of being ‘normal’. This does not mean that they are not ‘normal’. It means that they are unlikely to be ‘normal’. • The Reference Ranges for TSH tests are potentially too wide, especially at the upper end. This suggests that ‘high normal’ TSH readings should possibly be treated with more suspicion than they currently appear to be. • The centre of the Reference Range is clearly not a good target point because very few of the healthy population have TSH readings around this point. • A much better target point would be around 1.0 to 1.5. But some people will feel better at higher levels or lower levels. This supports Prof Jim Stockigt’s view that the target should be a TSH reading around 1.0.2 Another important point which needs to be borne in mind when interpreting statistics like these is that it is the population which has a range of values with probabilities for each reading. Each healthy individual is only at one of the points. They are ‘normal’ when they are at that point. For those on thyroxine replacement, being in the Reference Range is not good enough in itself. You need to be at your own set point. This will probably be near the lower end of the Reference Range. This analysis of the distribution of TSH readings in the healthy population supports our recommendations to thyroid patients: • Obtain a photocopy of all your Thyroid Function Tests. Also get copies of the ones you have had done in the past. These copies will show both the readings and the Reference Ranges. • When you are going for a new test, make a note of how you feel (especially make a note of any of the major symptoms of thyroid overactivity or underactivity), your weight and your dose. When you obtain your copy of the test result, write this information on the copy. Over time, this process will allow you to make an informed judgement in consultation with your doctor of what the correct set point is for you. • Do not accept that a Thyroid Function Test is 'normal' just because the result is within the Reference Range if you are still feeling unwell. References 1. T Bjøro et al, 'Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trøndelag (HUNT).' European Journal of Endocrinology 2000 143 639-647. Download here. 2. J Stockigt, 'Subclinical Hypothyroidism or Mild Thyroid Failure: How important is early diagnosis and what treatment is optimal?' Interview With Sigma Pharmaceutical 2001 http://www.thyroid.org.au/Information/Stockigt.html. Accessed 30 December 2001. Alun s is an actuary with his own consultancy. He is also Secretary of Thyroid Australia This article is published in our newsletter Thyroid Flyer Volume 3 Number 1 January 2002. This article can be reproduced provided it is reproduced in full, acknowledges the source and is not sold for profit. © Copyright 2001, Thyroid Australia Limited ABN 71 094 832 023 333 Waverley Road, Mount Waverley, 3149, Australia Thyroid Australia Home-www.thyroid.org.au --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the " Frees " ? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 I've just noticed that some of that article can only be accessed if you join Thyroid Australia. I downloaded it some time ago. I've posted it below although the chart doesn't show up. I can email it to you if you'd like it. The most common questions that Thyroid Australia is asked involve the interpretation of Thyroid Function Tests (TFT’s). Many people have been told that their TFT results are ‘normal’. So what is ‘normal’? In this article we will focus on the test for Thyroid Stimulating Hormone (TSH) which is the most common test ordered. The ‘normal’ Reference Range for the test is intended to represent the range of values which can be expected in the healthy population – ie those without any thyroid ailment. The Reference Range is found by taking a sample population of healthy individuals and determining their TSH levels. The lowest and highest 2.5% of readings are excluded so that the Reference Range covers 95% of the healthy population. There are a number of different tests for TSH with different levels of sensitivity. They each have their own Reference Range. The most common tests generally have lower limits to their Reference Ranges around 0.2 to 0.5 mIU/L and upper limits from 3.5 to 5.0 mIU/L. A recent study in Norway provides a good example of the use of the TSH test in practice.1 The study involved 65,000 people. They were asked questions about their thyroid status and those with a history of thyroid illness were excluded. The blood samples were tested for Thyroid Peroxidase Antibodies (which are an indicator of likely thyroid illness) if they produced a TSH reading greater than 4. Samples with positive antibody results were also excluded. The survey, therefore, attempted to exclude people with any indication of thyroid illness, but still included those with Thyroid Peroxidase antibodies whose TSH reading was 4 or less. The TSH test kit used for the study had a nominated Reference Range of 0.2 to 4.5 mIU/L. The results for women are shown in the chart. The results for men were only slightly different. The features of this result are: • The distribution of TSH readings in the healthy population is skew. It is not the common bell shaped curve centred in the middle of the reference range. • The most common value, or Mode, is at 1.25. • The Median value is at 1.50. This means that half the population (50%) have a TSH reading below 1.50. • The average, or Mean, value is at 1.68. Over 60% of the population have a TSH reading below this value. • The centre of the Reference Range for the test kit used in the study is 2.35. Almost 85% of the healthy population have a TSH reading below this value. • The 2.5 percentile point (ie the point which excludes the bottom 2.5% of the population) is at 0.48. The 97.5 percentile point (ie the point which excludes the top 2.5% of the population) is at 3.6. The range between the 2.5 and 97.5 percentile points (0.48 to 3.6) is much narrower than the test kit’s Reference Range (0.2 TO 4.5). • This narrowing of the range would suggest that the reference group used to calibrate the test kit possibly included people with some level of thyroid illness. • This narrowing of the range between the 2.5 and 97.5 percentile points would potentially have been even more pronounced if all samples had been tested for Thyroid Peroxidase Antibodies. The conclusions which can be drawn from this survey are: • TSH results in the upper half of the Reference Range have a low probability of being ‘normal’. This does not mean that they are not ‘normal’. It means that they are unlikely to be ‘normal’. • The Reference Ranges for TSH tests are potentially too wide, especially at the upper end. This suggests that ‘high normal’ TSH readings should possibly be treated with more suspicion than they currently appear to be. • The centre of the Reference Range is clearly not a good target point because very few of the healthy population have TSH readings around this point. • A much better target point would be around 1.0 to 1.5. But some people will feel better at higher levels or lower levels. This supports Prof Jim Stockigt’s view that the target should be a TSH reading around 1.0.2 Another important point which needs to be borne in mind when interpreting statistics like these is that it is the population which has a range of values with probabilities for each reading. Each healthy individual is only at one of the points. They are ‘normal’ when they are at that point. For those on thyroxine replacement, being in the Reference Range is not good enough in itself. You need to be at your own set point. This will probably be near the lower end of the Reference Range. This analysis of the distribution of TSH readings in the healthy population supports our recommendations to thyroid patients: • Obtain a photocopy of all your Thyroid Function Tests. Also get copies of the ones you have had done in the past. These copies will show both the readings and the Reference Ranges. • When you are going for a new test, make a note of how you feel (especially make a note of any of the major symptoms of thyroid overactivity or underactivity), your weight and your dose. When you obtain your copy of the test result, write this information on the copy. Over time, this process will allow you to make an informed judgement in consultation with your doctor of what the correct set point is for you. • Do not accept that a Thyroid Function Test is 'normal' just because the result is within the Reference Range if you are still feeling unwell. References 1. T Bjøro et al, 'Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trøndelag (HUNT).' European Journal of Endocrinology 2000 143 639-647. Download here. 2. J Stockigt, 'Subclinical Hypothyroidism or Mild Thyroid Failure: How important is early diagnosis and what treatment is optimal?' Interview With Sigma Pharmaceutical 2001 http://www.thyroid.org.au/Information/Stockigt.html. Accessed 30 December 2001. Alun s is an actuary with his own consultancy. He is also Secretary of Thyroid Australia This article is published in our newsletter Thyroid Flyer Volume 3 Number 1 January 2002. This article can be reproduced provided it is reproduced in full, acknowledges the source and is not sold for profit. © Copyright 2001, Thyroid Australia Limited ABN 71 094 832 023 333 Waverley Road, Mount Waverley, 3149, Australia Thyroid Australia Home-www.thyroid.org.au --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the " Frees " ? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 That's fine ..........I'm sure there are plenty of references like that, just need to find them............Meleese in Oz xxx -------Original Message------- From: Hi again Kate, Sorry to jump in here as this question was to Meleese but this site should give you some ammunition. http://www.thyroid.org.au/Information/NormalTSH.html --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the "Frees"? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2006 Report Share Posted October 23, 2006 That's fine ..........I'm sure there are plenty of references like that, just need to find them............Meleese in Oz xxx -------Original Message------- From: Hi again Kate, Sorry to jump in here as this question was to Meleese but this site should give you some ammunition. http://www.thyroid.org.au/Information/NormalTSH.html --- Kate wrote: > In haste I failed to ask this: I take it then I > should be requesting > the "Frees"? > To help out my doctor, do you know of a reliable > site that mentions > that a TSH of 2.1 (or whichever value)w/symptoms > should be further > evaluted? > I think my new doctor is receptive. > > > > > > > Kate while a TSH of 2.1 accompanied by symptoms > almost always > indicates a > > thyroid problem. A better indicator would be your > Free's. Were the > free T3 > > and free T4 done as > well??.........................Meleese in Oz > xxx > > > > > > -------Original Message------- > > > > From: Kate > > > > Hello, > > > > I have had many thyroid like symptoms (both hyper > and hypo), yet my > > TSH values are normal. > > August of last year, my TSH was 1.54 (when I began > feeling crummy). > > In January it was 1.19 (beginning to feel terrible > and anxious) and > a > > few months ago, it was 2.1 All within normal. > > > > Interestingly, I read that hypothryoid can cause > an increase in > > cholesterol. Last year (April) I had high > cholesterol and March of > > this year, my cholesterol was within normal > values. > > > > No other thyroid tests were done other than the > TSH. > > > > My question is, could something be going on > despite normal TSH? If > > so, is this common? > > There seems to be conflicting answers in regards > to this when > > searching online. > > > > Could this simply be a hormonal imbalance > occurring outside the > > thyroid gland? In taking questionarres, one might > gather that I > > either have a thyroid problem or going through > perimenopause. > > I am 34 years of age. > > > > > > Many years ago, my mother was treated > temperorarily, with Iodine, > > for her thyroid. > > > > Thanks much for taking the time to read this. > > > > Confused in Alaska, > > ~Kate > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2006 Report Share Posted October 24, 2006 > I believe that my hypothyroidism began after my > tonsillectomy when I was 8 years old. >Sometimes, the thyroid loses oxygen during the > surgery and never fully recovers. this is very interesting - i was 18 when i had my tonsils out and i was 28 when my tsh was low and doc gave me synthroid. it was after my third full term pregnancy as well. sue __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2006 Report Share Posted October 24, 2006 > I believe that my hypothyroidism began after my > tonsillectomy when I was 8 years old. >Sometimes, the thyroid loses oxygen during the > surgery and never fully recovers. this is very interesting - i was 18 when i had my tonsils out and i was 28 when my tsh was low and doc gave me synthroid. it was after my third full term pregnancy as well. sue __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.