TSH — Why It’s Useless

Talk to any Endoc­ri­no­lo­gist or most medical-school-trained doc­tors, and you will be told that the TSH lab is a relia­ble phy­sio­lo­gi­cal mar­ker of thy­roid func­tion (i.e. whether you are hypo or hyper), plus it’s an accu­rate guide for your medi­ca­tion sup­ple­men­ta­tion amount.

Addi­tio­nally, you will be told that the lower your TSH while on desic­ca­ted thy­roid, the grea­ter your chance of osteo­po­ro­sis or heart attack.

Or you will be told that there’s an opti­mal place to be on the TSH range when on meds, such as bet­ween 1 and 2, or ‘fill-in-the-blank’.

But, expe­rien­ces of patients have found ALL THE ABOVE to be totally false!

Not only are patients with OBVIOUS hypothy­roid symp­toms being told they have no thy­roid pro­blem because of a “nor­mal” TSH (i.e. a TSH num­ber in range), they are being held hos­tage to the TSH range when on thy­roid medi­ca­tions, EVEN THOUGH the patient con­ti­nues to have typi­cal hypothy­roid symp­toms while in the range.

WHAT IS THE TSH??? In your body, the Thy­roid Sti­mu­la­ting Hor­mone (TSH) is synthe­si­zed and sec­re­ted by your pitui­tary gland…i.e. it’s a PITUITARY hor­mone, NOT a thy­roid hor­mone. You can view the TSH like a mes­sen­ger sent to knock on the door of the thy­roid. And its pur­pose is to regu­late your thy­roid gland – to tell it to pro­duce more, or to tell it to pro­duce less. In a healthy indi­vi­dual, its mes­sage is based on whether your blood levels have too little thy­roid hor­mo­nes to meet the demands of your body, or too much.

When the thy­roid gland beco­mes disea­sed or disa­bled and fails to do its job ade­qua­tely (called hypothy­roid), the TSH knocks and knocks on the door, and theo­re­ti­cally, the TSH lab will show a high num­ber. Or, if the thy­roid gland gets on its exer­cise bicycle and over­pro­du­ces thy­roid hor­mo­nes (called hyperthy­roid), the TSH lab will theo­re­ti­cally go low to show that the TSH in your body isn’t knocking.

Occa­sio­nally, patients will have a very low TSH with raging hypothy­roid symp­toms, and that can point to a pro­blem in the Pitui­tary gland, called Hypo­pi­tui­tary. The lat­ter is usually due to a disea­sed pitui­tary gland, or a pro­blem with the Hypotha­la­mus, which is the organ that sends it’s mes­sen­ger to the Pitui­tary. (The Hypotha­la­mus, Pitui­tary and Thy­roid glands make up with is called a Feed­back Loop.)

WHEN WAS THE TSH LAB DEVELOPED?? The TSH lab test was deve­lo­ped around 1973, and it is our unders­tan­ding that appro­xi­ma­tely 200 volun­teers were used to esta­blish the “nor­mal” range. Over the years, addi­tio­nal popu­la­tion stu­dies have been done to back up the range. The “nor­mal” refe­rence range is inten­ded to repre­sent the range of values for those in a healthy popu­la­tion without any thy­roid pro­blem. The lowest and highest rea­dings to create the range are usually thrown out.

But sad to con­si­der, how do they really KNOW that those in the so-called healthy popu­la­tion weren’t already on a slide into hypothy­roid? How many millions of hypothy­roid patients have been told they were nor­mal, even when symp­toms per­sis­ted that doc­tors dismissed?

Dr. David Derry (in the second link below) of Canada was prac­ti­cing medi­cine when the TSH lab was intro­du­ced, and he made the pro­found observation:

“The con­sen­sus of thy­roi­do­lo­gists deci­ded in 1973 that the TSH (lab) was the blood test they had been loo­king for all through the years. This was about two years after I star­ted prac­tice. Having been taught how to diag­nose hypothy­roid con­di­tions cli­ni­cally, I was in a posi­tion to watch to see what the rela­tion of the TSH was to the onset of hypothy­roi­dism. What I found was many peo­ple would deve­lop clas­sic signs and symp­toms of hypothy­roi­dism but the TSH was ever so slow to become abnor­mal, rise and con­firm the cli­ni­cal diag­no­sis. Some­ti­mes it never did. Finally I began trea­ting patients with hypothy­roid in the nor­mal man­ner I was taught. I could not see why I had to wait for the TSH to rise for me to be able to treat them.”

Dr. Derry dis­co­ve­red exactly what we, as patients, have expe­rien­ced for more than three deca­des! Namely, not only has the TSH lab fai­led to reveal that we were ALREADY hypothy­roid, it fails us when we are dosing our medi­cia­tion. In other words, the TSH is tho­roughly unre­la­ted to how we feel!

This has been ESPECIALLY true when on ina­de­quate T4-only meds, and it con­ti­nues to be true when we start on Armour IF we are for­ced to stay within the TSH range.

WHAT IS PATIENT EXPERIENCE WITH THE TSH LAB? It’s lousy. First, there is a huge body of hypothy­roid patients who have a so-called “nor­mal” TSH lab…along with clas­sic or raging hypothy­roid symp­toms. And because doc­tors have become lab-obsessed rather than giving cre­dence to cli­ni­cal pre­sen­ta­tion, patients remain undiag­no­sed for years before the num­ber rises high enough to reveal the condition.

Then, even when the patient is on a T4-only medi­ca­tion, or on desic­ca­ted thy­roid, some symp­toms remain – from mild to disa­bling – when they are for­ced to stay in the TSH range. Addi­tio­nally, because doc­tors view the TSH man-made lab as infa­lli­ble, they fail to unders­tand that the con­ti­nued symp­tom com­plaints by patients reveal that the lab and its range is unre­lia­ble and a huge failure!

Patients who have switched to natu­ral desic­ca­ted thy­roid have dis­co­ve­red that when they are allo­wed to dose by the COMPLETE eli­mi­na­tion of symp­toms, which also puts the free T3 at the top of the range, they will end up with a TSH lab VERY BELOW range.….…and not one hint of hyperthy­roid. It is not uncom­mon to see a TSH of .009 or .004 when opti­mal, for exam­ple, yet not one iota of hyper. (If you do have a sup­pres­sed TSH with hyper-like symp­toms, it’s time to check your adre­nal sta­tus or your Reverse T3/Free T3 ratio. The STTM book has more infor­ma­tion about the latter.)

Addi­tio­nally, patients see both their heart health and their bone strength com­ple­tely improve, even with a TSH far below the so-called nor­mal range, when on an opti­mal amount of desic­ca­ted thy­roid and strong adre­nals or ade­quate adre­nal support.

WHAT IS THE BOTTOM LINE ABOUT THE TSH LAB ACCORDING TO THE EXPERIENCE OF PATIENTS? Two words: it sucks. It lea­ves hypothy­roid patients undiag­no­sed for years. And even when on meds, its dubious nor­mal range lea­ves patients with con­ti­nuing hypothy­roid symp­toms, inc­lu­ding bone den­sity and heart pro­blems. The best use for the TSH per­tains to what is IS: a PITUITARY HORMONE! And for that, it’s a good guide to reveal if you have a mal­func­tio­ning pitui­tary gland, espe­cially if you have a very low TSH and low free T3, accom­pa­nied by raging hypothy­roid symptoms.

For thy­roid diag­no­sis and dosing.…the man-made TSH lab gets an F on the thy­roid report card, as do doc­tors who use it.

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Want to order your own lab­work?? STTM has crea­ted the right ones just for you to dis­cuss with your doc­tor. Go here: https://sttm.mymedlab.com/

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ARE YOU A SMOKER?? There is evi­dence that smo­king can lower your TSH, and with our current cul­ture of lab-obsessed doc­tors, it may be wise to avoid smo­king the day of your lab­work. See an inte­res­ting research study on smo­king and your TSH here.

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Want to read more? Below are links to artic­les about the TSH and it’s fallacy:

http://www.altsupportthyroid.org/tsh/tshmedrefs5.php
http://www.thyroid-info.com/articles/david-derry.htm
http://www.drlowe.com/frf/t4replacement/addenda.htm#Addendum%204
http://thyroid.about.com/od/thyroiddrugstreatments/l/blderryb.htm

And for further info, here’s the link to the web­page that sta­tes that “esti­ma­tes of ave­rage nor­mal sec­re­tion for euthy­roid humans are 94 – 110 µg T4 and 10 – 22 µg T3 daily (259).” And that is appro­xi­ma­tely equi­va­lent to 3 – 5 grains desic­ca­ted thy­roid. And when you get to that range of desic­ca­ted thy­roid, you WILL have a sup­pres­sed TSH lab, which tells you how inac­cu­rate the esta­blished man-made TSH range is: http://www.thyroidmanager.org/Chapter2/2-frame.htm

A further note from Janie: I have obser­ved that at least 50% of thy­roid patients who come to thy­roid groups or forums have a VERY “nor­mal” TSH, even as low as the one’s…with raging hypothy­roid symp­toms. It can take years for the TSH lab result to rise and reflect their hypothy­roid state. Not only has the man-made TSH lab been a total fai­lure for diag­no­sis of hypothy­roid, it fails the patient even on thy­roid sup­ple­men­ta­tion! We can only hope that doc­tors will start paying atten­tion to “cli­ni­cal presentation”!

Need help inter­pre­ting your lab results? Go here.

***All the above on the TSH plus more can be found in Chap­ter 4 of the Stop the Thy­roid Mad­ness book.