How Much Tsh Fluctuation Is Normal?

[munchkinette]

(Follow up to my earlier thread, "Hair Loss")

I got my test results back. My TSH is 2.81. I know that's borderline using the new "normal" ranges. My TSH a year ago was 1.46, so it has doubled since the last test. Is this a normal amount of fluctuation? What tests should I get next? So many of my symptoms fit with a thyroid issue, and multiple family members have thyroid disorders, but I don't know what to say to my GP. The normal range on my tests say that TSH should be .4 to 4.0. (Actually not my GP, but filling in while my regular GP is on maternity leave, so he doesn't know me.)

Is this enough for a referral to an endocrinologist? So far my other tests (ferritin, CBC, metabolic panel) look normal. I haven't gotten the Vit D test back yet, although I do take 5000 IU and I'm absorbing iron, so I don't expect it to be off.

[MaryJones2]

My Endo is very good and I think his personal range is .5 - 2 - he doesn't rely on the lab range because the one he uses still thinks 5 is normal...

I would find a good Endo - especially if you have hypo symptoms. GPs so often don't know enough to effectively treat it. You'll need a full thyroid panel test at some point too and an Endo will order that for you whereas a GP might think it totally unnecessary especially if your range is within lab limits. Also, if your cholesterol is higher than last year that is a good indicator that you have something going on with your thyroid.

[munchkinette]

  On 12/6/2011 at 11:14 PM, janetw said:

My Endo is very good and I think his personal range is .5 - 2 - he doesn't rely on the lab range because the one he uses still thinks 5 is normal...

I would find a good Endo - especially if you have hypo symptoms. GPs so often don't know enough to effectively treat it. You'll need a full thyroid panel test at some point too and an Endo will order that for you whereas a GP might think it totally unnecessary especially if your range is within lab limits. Also, if your cholesterol is higher than last year that is a good indicator that you have something going on with your thyroid.

My cholesterol is higher, but only because of my HDL. My regular doctor (not the sub) said it was excellent, even though it was higher. Last time I saw her was this summer though, which is about a month before my symptoms started. My main concern is to fix the hair loss ASAP. I can't afford to lose much more! I've also been getting panic attacks. I had no idea those could be related to thyroid disorders until I started googling thyroid issues... but those have been happening a lot lately as well.

[ElseB]

I had my levels tested recently and it was 5.2. The doctor said that was only slightly elevated. But how is that slightly elevated if the top end of normal is 3 or 4????

[mushroom]

The old range topped out at a higher level - that has been out of date since about 2003. It takes some places a while to catch up. Try googling it.

[ElseB]

  On 12/7/2011 at 12:09 AM, mushroom said:

The old range topped out at a higher level - that has been out of date since about 2003. It takes some places a while to catch up. Try googling it.

So would 5.2 be considered hypothyroidism??

[mushroom]

  On 12/7/2011 at 12:27 AM, ElseB said:

So would 5.2 be considered hypothyroidism??

Yes, today everything over 3.

[MaryJones2]

munchkinette - check out www.stopthethyroidmaddness.com It's a pretty good resource. My HDL was the only thing that was high too. Everything else was low but it was so high it put me over the 200 threshhold.

[ElseB]

I've been reading about how goitrogenic foods are bad for people with hypothyroidism. I give up. I don't know what to eat anymore. Cutting out gluten was hard, but not as hard as cutting out goitrogens will be. There's two things I can't get through a day without eating: a huge green vegetable smoothie, and peanut butter. And here I thought I was doing my body good by eating lots of green leafy vegetables.

[Roda]

You really need to have a full thyroid panel done. Going by just the TSH can miss early or subclinical hypothyroidism. My endocrinologist goes more by my symptoms and my free T4 and free T3. I don't convert the T4 meds well. I had a normal free T4 and TSH but has a low T3 when I presented in 2007 to my endocrinologist. I was symptomatic and I was given T3 meds in addition to the T4 meds for the hypothyroid. Some people do well on T4 only while others need a T4/T3 combination. For me I feel the best with my TSH supressed and my free T3 slightly elevated. Of course this is tailored for each individual.

The tests I would request are: TSH, free T3, free T4 and thyroid antibody tests.

[burdee]

  On 12/7/2011 at 3:47 AM, ElseB said:

I've been reading about how goitrogenic foods are bad for people with hypothyroidism. I give up. I don't know what to eat anymore. Cutting out gluten was hard, but not as hard as cutting out goitrogens will be. There's two things I can't get through a day without eating: a huge green vegetable smoothie, and peanut butter. And here I thought I was doing my body good by eating lots of green leafy vegetables.

As long as you cook your green vegies (brocolli, kale, etc.), you won't get much goitrogenic effect. However, a few foods like soy and walnuts (in moderate amounts) will block absorption of your thyroid supplements. Also waiting an hour after taking your supplements before eating will allow you to absorb them without interference from food. Nevertheless, most of those 'goitrogenic' rules were for people whose thyroid is still functional. Once you need thryoid supplements, you aren't depending as much on your thyroid to produce thyroid hormones. So 'goitrogenic' vegies won't affect your overall thyroid hormone levels, which depend on your supplements.

I eat loads of green leafy vegies (all cooked except for lettuce) and peanut butter almost every day. I'm doing well with my thyroid supplements.

[Roda]

I don't worry much about goitrogenic effects from foods. I've been on thyroid replacement since 2000. My dose is getting up there. I'm currently taking 112 mcg levothyroxine(T4) and 25 mcg of liothyronine(T3) a day. I am careful about taking my vitamin/supplements several hours after/before my thyroid meds and taking my thyroid meds on an empty stomach and waiting about an hour before eating.

[Gemini]

  On 12/7/2011 at 4:10 AM, burdee said:

As long as you cook your green vegies (brocolli, kale, etc.), you won't get much goitrogenic effect. However, a few foods like soy and walnuts (in moderate amounts) will block absorption of your thyroid supplements. Also waiting an hour after taking your supplements before eating will allow you to absorb them without interference from food. Nevertheless, most of those 'goitrogenic' rules were for people whose thyroid is still functional. Once you need thryoid supplements, you aren't depending as much on your thyroid to produce thyroid hormones. So 'goitrogenic' vegies won't affect your overall thyroid hormone levels, which depend on your supplements.

I eat loads of green leafy vegies (all cooked except for lettuce) and peanut butter almost every day. I'm doing well with my thyroid supplements.

This is one of the most intelligent posts I've read on here lately! Too many people mistakenly think you cannot eat cruciferous veggies because they're bad for your thyroid. Not true, as Burdee stated so well.

My thyroid antibodies were 1200 6 years ago, right before my Celiac diagnosis. I have been hypothyroid for 20 years. I eat all the goitrogenic veggies, steamed, and even eat some soy but make sure I have no soy within 4 hours of taking my thyroid hormone. Today, my thyroid antibodies are within the normal range, which is under 40 for the lab I use. Never a good thing to limit your veggie intake, unless you have an out and out allergy to one.

I also eat loads of peanut butter and my thyroid usually behaves itself well.

[pricklypear1971]

To the OP, my doc thought variances within 1 point were "normal" on a tsh. As long as you didn't get out of range....