DR. IZABELLA WENTZ, PHARM D

Thyroid Pharmacist

My TSH Is -Normal-...Can I Still Have Hashimoto's

What To Do If Your TSH Is Normal and You Are Anything But!

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Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications.

However, this test can often time be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows.

Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range.

This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.

In recent years, The National Academy of Clinical Biochemists indicated that 95% of individuals without thyroid disease have TSH concentrations below 2.5 μIU/mL, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3-3.0 μIU/mL (1).

However, most labs have not adjusted that range in the reports they provide to physicians and have kept ranges as lax as 0.2-8.0 μIU/mL. Most physicians only look for values outside of the “normal” reference range provided by the labs and may not be familiar with the new guidelines. Thus, many physicians may miss the patients who are showing an elevated TSH. This is one reason why patients should always ask their physicians for a copy of any lab results.

Optimal Thyroid Lab Ranges

Functional medicine practitioners have further defined that normal reference ranges should be between 1 and 2 μIU/mL, for a healthy person not taking thyroid medications. Anecdotally, most patients feel best with a TSH between 0.5-2.0 μIU/mL.

It’s important to remember that reference ranges may not be applicable to everyone. What is normal for one person may be abnormal for the next. Reference ranges take into account the average values of 95% of the population. Thus, not everyone falls within the “normal” reference range. If you are in the 5%, you may experience symptoms of hypothyroidism or hyperthyroidism with TSH values that are considered normal. All doctors are taught the old adage “treat the patient and not the lab tests,” but unfortunately not many conventional doctors seem to follow this advice.

Some thyroid advocates may dismiss the use of the TSH altogether, but I disagree.

When considered in the right context and the right reference range, the TSH is one of the many tests that may be useful to optimize thyroid function. Other tests that I recommend include Free T3 and Free T4 levels. These reveal the amount of hormone available to the body.

Take Charge of Your Own Health!

Normal Washing Machine

Personally, I still have a copy of a TSH test that showed a value of 4.5 μIU/mL with a note from the physician that said “Your thyroid function is normal. No need to do anything.”

Meanwhile, I was sleeping 12+ hours per night, under two blankets in Southern California and wearing sweaters in the middle of July! I made the mistake of trusting another human being with my health, and I lost a year of my life because of it. Instead of pursuing my passions, I came home from work each day and collapsed.

I don’t want you to make the same mistake I did.

I encourage you to take charge of your health. Learn as much as you can about your condition. Always request a copy of your labs. Don’t be afraid to tell your doctor that you are not feeling well on current therapy and insist on getting better care.

There are plenty of Hashimoto’s doctors out there that will provide the care you need, so don’t be afraid to seek out a second opinion.

I wish you the best of luck in your healing journey!

Here is a sample letter for your doctor…(scroll to read)

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Liked this post? You may be interested in my other posts…

PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.

For future updates, make sure to follow us on Facebook!

Reference – (Print for your doctor)

1.      2012 Clinical Practice Guidelines for Hypothyroidism in Adults: Available

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Comments

    • This could indicate subclinical hypothyroidism, or an early stage of thyroid dysfunction… People in this stage often benefit from thyroid medications. Hope that helps 🙂

      Reply

      • What would you say about someone who has complained of ongoing symptoms for ten years? I was fine ten years ago then all of a sudden I started gaining weight and couldn’t lose it no matter how hard I tried. I went from a size 0 to a size 10. I started wanting to sleep all the time and was miserable if I couldn’t. Started losing my hair- developed Raynauds- getting headaches. I am cold all the time and have to sit in the bottom of the hottest shower imaginable just to “semi warm” so I can crawl into bed. I can’t lose weight. My nails are brittle and I have next to NO eyebrows left. My TSH was 2.17/ but a few weeks ago was 2.91 even though 10 years ago before symptoms started I was 0.36ish and since I started gaining weight / I’ve never been below 2. My free T4 is 16, but again it used to be higher.

        Reply

  3. What is really the normal level for kids? My daughter is 7 and he level of tsh is 3.1. I’m wondering if that’s ok. She gained lots of weight lately and wondering if it has anything to do with that or if she is just developing into a little lady and she gained weight.
    Reply

    • Colette- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.

      FUNCTIONAL MEDICINE APPROACH TO THE THYROID
      https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid

      CLINICIAN DATABASE
      http://www.thyroidpharmacistconsulting.com/clinician-database.html

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://www.functionalmedicine.org/practitioner_search.aspx?id=117

      Reply

      • My TSH is “normal”…

        TSH=4
        T3Free=3
        T4Free=1.3

        I know you can’t comment specifically on my situation but could such a profile still indicate early thyroid dysfunction? I have numerous typical hypothyroid symptoms and have been feeling progressively worse over the last year. I have started reading your book and am implementing dietary changes and use of supplements,and this has provided some relief , but am still having symptoms that interfere significantly with my quality of life. Additionally, my mother was diagnosed hypothryroid since her 20’s and my sister, maternal grandmother and two aunts have been diagnosed with other autoimmune disorders (Raynaud’s; Lupus; Scleroderma and Fibromyalgia).

        I have expressed my health concerns to my primary care physician and she insists all of my levels are normal and all of my symptoms are simply menopause…even though I have been in menopause for the past 4 years and have only had these symptoms in the last year…

        I will continue to implement your suggested protocols, but would you also still pursue trying to explore a pharmacological intervention, whether it be Synthroid, NDT or Armour or just continue with the suggested protocol? I am at my wit’s end and feel like my doctor thinks I’m just a hypochondriac!

        Reply

        • Lisa – thank you for following this page. I understand how frustrating this all is. 🙂 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.

          These are the recommended labs from my book, page 32.
          RECOMMENDED THYROID FUNCTION TESTS
          * TSH
          * TPO Antibodies
          * Thyroglobulin Antibodies
          * Free T4
          * Free T3
          * Reverse T3 (Optional)
          Did you know that progesterone deficiency can surge into Th-1 dominance. This explains why the peak onset of Hashimoto’s occurs during menopause, when the body’s progesterone drops, or after pregnancy, when a rapid drop in progesterone occurs after the delivery. I do talk a lot about it and go into more depth in my book!! 🙂 You may be interested in my 12 week online program called Hashimoto’s Self-Management Program that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. In addition, any person that goes through the program will get access to a Quick search Q&A Database of 1000+ questions asked by past program participants, Root Cause Assessment based on 100’s of my clients’ root causes and triggers, 2-week Meal Plans, recipes, and shopping lists to get you started on the following diets: Paleo, Autoimmune Paleo, SIBO, Candida. Also, Discounts on lab tests, high-quality supplements, and consultations and much more to support you in your journey! There are a few requirements that you should pay attention to, such as my book which is a required read.
          Hashimoto’s Self-Management Program
          http://hackinghashimotos.com/

          Reply

  4. for years I had my tsh, t4, and t3 normal. I was anything but normal. Hairloss, sleeping all the time, iron issues, heavy periods, problems with my heart. The doctor told me that it was from my high anxiety. After 12 years of suffering I was diagnosed with thyroid cancer, but when they did the pathology on my thyroid the pathologist found a severely diseased thyroid from hashimoto’s. My understanding is that the tsh,t4, and t3 may never show any abnormal results, and that the only way to know if you have hashimoto’s is through anti-thyroglobulin.? and what role does the anti-thyroperoxidase have in hashimotos?
    Reply

    • Denise- Some people with Hashimoto’s test negative for thyroid antibodies because their overall immune health is so weak they do not produce enough antibodies. I’ve tested negative for antibodies several times. Now I’ve insisted on a thyroid ultrasound. Given that Hashimoto’s is one of the leading causes of hypothyroidism worldwide, I wouldn’t stop until I know one way or another.

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well. Have you done all these tests?

      TOP 6 THYROID TESTS FOR DIAGNOSIS
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

      Reply

  5. “I made the mistake of trusting another human being with my health…”
    This is brilliant. I’ve certainly felt the same lately! I spent two years insisting that though my TSH (on Synthryoid) “looked great on paper” I didn’t feel great in person. Finally, I decided to see an acupuncturist and I’m feeling much better! It’s refreshing to have someone believe what you say instead of trying to convince them. What is wrong with that picture? You shouldn’t have to convince your doctor you don’t feel well! “Doctor knows best” is NOT good advice to follow. No one knows your body like you do. If you believe something is wrong, something is wrong.
    Great article.
    Reply

  6. Thank you Michaela,
    I am so glad that you are getting the type of care that everyone of us needs and deserves! Wishing you all the best in your journey!
    Reply

  8. Tanya-if you are hypothyroid and need meds but stop taking them, you can become extremely hypothyroid. You would feel pretty lousy at best, and at worse can fall into a coma and die. Not recommended unless your thyroid can compensate and make enough hormone
    Reply

  9. This is such important info to get out there to the healthcare community! My MD considers my recent TSH of 3.9 as “good news” because it is in the “normal lab range” when I am suffering with classic hypo symptoms and consistently feel better at around 1.0. I am hopeful that when we meet to discuss the labs, he will agree to increase the meds. I will be showing him your letter, Izabella. Thank you for being a voice of reason in this crazy thyroid arena. 🙂
    Reply

  11. I had an extremely stressful childhood. For years I suffered with mood swings, depression, fatigue and no matter how hard I worked out, still felt slow and sluggish. My standard thyroid tests were always normal. I was treated with anti-depressants and birth control. I quit these when I had my daughter and after pregnancy the symptoms came back with a vengeance. Not wanting to return to synthetic treatments, I saw a Dr. who prescribed Thyroid Armor. I started to take this because I was at a loss for what else to do, having modified my diet, sought chiropractic care, do regular exercise and made efforts to reduce toxins several months, I was feeling worse. After starting the meds I felt better. What are your opinions on Thyroid Armor? I can’t find any known side effects or dangers of prolonged use. Thanks!
    Reply

  13. you hit the nail on the head with “I trusted another human being with my health”. I trusted MDs for decades and serious symptoms were overlooked, allowing the condition to worsen to the point that autoimmune conditions developed, including Hashimoto’s – which is how my thyroid function was diminished. I had every classic symptom of hypothyroidism and got the classic “all normal tests” response. Finally it got so bad that I developed a visible lump on my thyroid – THEN I was referred to an ultrasound to confirm it and THEN I was referred to an endo who diagnosed it. I’ve learned so much ON MY OWN since then. I go to doctors to get help with the right prescriptions to manage it, but still have not found one that I believe really understands it and has the expertise to manage it as an autoimmune condition, not just regulating thyroid numbers. Feel so let down by the medical community, as their med school training didn’t cover it… and they seemed to learn a lot of arrogance that they are the only ones with the correct answers… also the struggle with insurance, as they only recognize MDs and DOs but not any of the medical help that is working on autoimmune. I stopped going to the endo when she refused to discuss any options to Synthroid or test me for adrenal stress etc. Now I go to a DO who is helpful but I still feel I am leading the treatment based on my research. Ex: I asked for a cortisol test, I have requested several tests on my labs such as Reverse T3 etc. that the dr didn’t bring up. p.s. I tried Armour last year for several months and developed a distinct swelling in my throat and hoarseness. Switched back to Synthroid in October and added Cytomel T3. Better since then. Armour is too hyped as the ultimate fix. For people with autoimmune conditions – such as Hashimoto’s Thyroiditis – the natural animal thyroid in Armour can give the autoimmune response something more to attack. Maybe it’s the fillers, whatever – Armour is not the conclusive answer for all thyroid patients. My research continues!
    Reply

  14. Lisa- I have been there! Great job on taking charge of your own health! The good news, is that you have a doctor that’s willing to work with you… the bad news is- you have to become a Hashimoto’s expert as no one is more motivated to get you better than you! Have you checked out my book? I think it will help you in your journey. It’s based on 3 years of my personal research to put my Hashimoto’s into remission -www.thyroidpharmacist.com/book -Hope it helps!
    Reply

  15. I’ve spent 3 years listening to my docs spout on & on about my TSH being too low while I kept dosing based on my “frees”. Now I’m on LDN and my “frees” dipped a little bit but my TSH shot up to 22.21.
    The doc said more hormone, but again my “frees” are not that low.
    Should I just ignore the TSH altogether?
    Reply

  16. Hmm- Usually the LDN has the opposite effect, of lowering the TSH. I can’t give you advice over the internet because I’m not familiar with your case, but generally a high TSH with low/normal T4/T3 is considered subclinical, and for me would be an indication to increase thyroid meds, esp. if you are having symptoms. I would recommend consulting with a compounding pharmacist who is familiar with your case and LDN.
    Reply

  17. Thank for educating us on Thyroid matter….. Wishing to find a doctor that has as much knowledge on this matter as you……I am 49 years old. I have been feeling extremely tired for the past 2 years….. Diagnosed with ovarian cysts, recurring kidney stones(x3 in a 5 year period) treated for H pylory and Gerd , loosing my hair as crazy….. 9 nodules on my thyroid gland ! Family history of goiter, graves disease and thyroid cancer. Had a biopsy done and result came back unconclusive suggesting multinodular goiter and repeat ultra sound in 6 months. Nuclear medicine scan’s opinon= Multinodular gland with nodules of various function, the left loer pole is hot/hyperfunctioning and right and left mid pole nodules are cold/hypofunctioning. Tsh 0.5,
    Free T4-10.5
    Free T3-4.9
    Total T3-1.6
    Anti-Thyroglobulin antibody- 13.0
    I was told by ENT specialist that everything is normal, but my symptoms have agravated….. Losing hair ++++, anxiety, nervousness, depression, insomnia, extreme fatigue, palpitations.I have been Off work for 7 months and not getting better. I have No family doctor and do not know what to do but can t live this way any longer…. Willing to travel to USA to get treated…… Can someone help me ….. Want to have my life back!!!! Ty
    Reply

  18. Hi. Why do these websites and blogs basically ignore HYPER thyroidism (such as that caused by Graves Disease)? Not everyone with thyroid disease is Hypothyroid, you know. I’d like to see some more information about Hyperthyroidism, please.
    Reply

    • Jen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  19. Jen
    Chris here. I agree it seems that many ,many sites seem to forget the whole of the Thyroid problem. I was Hyperthyroid for a very long time. And lost alot of weight,had the shakes,muscle wasting and nerve pain and was sweating all the time and hands shaked. YOu’re not alone. I never had a nodule on my Thyroid. But was extremely Hyperthyroid. I also developed Diabetes. Once I had radiation (Capsule treatment) they killed off my Thyroid. I then went Hypo and it is no fun as well. But I agree there seems to be alack of concern or topics on Hyper. Also one of the things less talked about is the fact that many Hyper and Hypo have Neuropathy nerve pain. Ether way feel free to join my Facebook support site. And you will not be left alone. https://www.facebook.com/groups/601250606660090/ I truly wish you well.
    Reply

    • Chris- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  20. I’m in the uk. Have consulted my gp about this but even if he takes the bloods the hospital labs will only do standard thyroid test. If we want anything else we have to pay privately and then pay for our medication privately HELP please
    Reply

  21. Hello,
    I have a pituitary adenoma and was put on levothyroxine by an endocrinologist in TX. I moved and my new doctor said that I didn’t need it anymore. Since that time I have put on over 50 pounds and have had all of the symptoms of hypothyroidism. the only test my doctor ever does is TSH. I am tired of being sick all of the time. Is there anything I can do to help my symptoms?
    Reply

    • Katrina- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  22. Thank you for such a great, informative website! I was diagnosed with hypothyroidism a couple years ago, but because of a lack of insurance, never followed up with a Dr. Earlier this year, I went to a Dr to establish care, and based on lab tests that were 6 months old, he said I was completely normal. I saw the labs, which said my TSE was 3.3. I never went back. Obviously, I need to be treated, but until my insurance covers a different Dr, I’m stuck treating my hypothyroidism with diet, etc. Do you have any recommendations on how to beat improve my condition in the interim?
    Reply

    • Summer- Did you know that if you live in the United States, the UK, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?

      Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.

      But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish”, and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.

      ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
      https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/

      DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
      https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.

      TOP 6 THYROID TESTS FOR DIAGNOSIS
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

      Reply

      • My dr did the following test: TSH: 2.7 and Free T4: 1.0, because of my symptoms. She said those are optimal results and not to worry. However, my symptoms are still present. Should I ask for further thyroid testing or just wait and see?

        Reply

        • Wendy – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress.Every six weeks is usually a good schedule for testing your thyroid hormones.
          These are the recommended thyroid function tests from page 32 of my book:
          – TSH
          ¨ TPO Antibodies
          ¨ Thyroglobulin Antibodies
          ¨ Free T4
          ¨ Free T3
          ¨ Reverse T3 (optional)
          ¨ Thyroid Ultrasound (optional)

          Here is a research article which might help further:
          TOP 10 THYROID TESTS FOR DIAGNOSIS
          https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

          Reply

  23. I’m very glad I have found this site. I’ve been diagnosed with Hashimoto’s and told my thyroid is fine. I’m not on any medication for my thyroid at this time, but have been in chronic pain daily for over a year, in addition to several other symptoms that range from annoying to excruciating to deal with. I don’t, however, have the common Hashimoto symptoms – hair loss, weight gain, swollen throat – BUT, I am extremely pale and constantly cold. I keep going from doctor to doctor thinking there is more to my current condition than just Hashimoto’s, but its contributing to my absolute exhaustion to keep searching for an answer. Can Hashimoto’s – with a TSH of 1.270 – be the root of all of my symptoms? (My symptoms mirror all of those of MS, and that is something I’ve been checked for twice over this year)
    Reply

    • Shay- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. The thyroid gland has been called a thermostat for our body, as it helps to regulate heat. People with hypothyroidism are prone to having low body temperatures and cold intolerance. It’s one of those symptoms that we often brush off, don’t notice and don’t take seriously, but can be very distressful when we do not take the proper precautions. Here’s an article that I hope helps you.

      THYROID AND COLD INTOLERANCE
      https://thyroidpharmacist.com/articles/thyroid-and-cold-intolerance

      Reply

  25. Thank you for your book! I have a copy, and it has helped shed some light on how to manage my Hasimotos. When I go see my general physician next month, I’m going to ask for a full panel blood test, not just the TSH. Would you recommend me not taking my
    Synthroid the day of blood work? I’m going to begin going gluten free but am worried about trying the elimination diet. Did you feel hungry during that time?
    Reply

  26. I haven’t felt like myself in weeks! Some weeks are better than others. My labs are all in “normal” range but on the low end. My last tsh was .47 and free T4 of 0.83. What does this mean??
    Reply

    • Bk- Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications.

      However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows.

      Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range.

      This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.

      WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
      https://thyroidphramacist.com/blog/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.

      TOP 6 THYROID TESTS FOR DIAGNOSIS
      https://thyroidphramacist.com/blog/top-6-thyroid-tests

      Reply

  28. just diagnosed with hypothyroidism tsh 7.71 was 3.80 six months ago 3.80 six months before and 3.52 in 2013
    currently t4-is 8.4
    free t-4 1.05
    t3 132
    anti thyroid abtibody 19
    anti thyroid peroxidasw 32
    newly married a lot of stress snoring of spouse
    any recomondations?? have felt horrible for years always cold tired weight gain,
    any suggestions MD ordered synthroid 25mcg to start and no other advise!!!!
    Reply

    • Sharon- I’m afraid I can’t comment on your lab results due to liability. I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. Did you know that if you live in the United States, the UK, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?

      Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.

      But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish”, and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.

      ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
      https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/

      DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
      https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.

      TOP 6 THYROID TESTS FOR DIAGNOSIS
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

      Reply

  29. Your doc is not ordering the right tests, and likely not prescribing the right medication. Call your pharmacy and ask which docs in your area prescribe Armour. Then start calling the docs and ask who orders the thyroid panel lab? Once you find one that does both make an appointment. Rest is essential, get your hubby some help or move him to the couch. 🙂 Read Izabella’s book because even on the right medication you need to find what caused this at treat that too not just your thyroid.
    Reply

  30. I’m literally in tears right now. After going through a year of hell with such a huge rage of crazy symptoms a tsh of 4 and t4 of .77 my doc prescribed me Cymbalta and Klonopin. I’m feeling so hopeless. I went to the doctor because I am having physical symptoms.
    Reply

  31. I had my thyroid gland completely removed a few years ago due to calcified nodules… Hashimoto’s diagnosis. Since then I have struggled greatly, first with Synthroid (which didn’t work at ALL for me, even with the addition of Cytomel), then finally finding a doctor that would prescribe Armour (which I was on for 10 yrs prior to surgery). Now I still struggle with my levels, and with my doctor. My TSH is VERY suppressed in labs (<0.03), but my T4 is normal. Each time I get results the doc lowers my dosage, and I crash... extreme fatigue, facial swelling, significant hair loss and headaches, etc. I have to convince him each time to allow me barely enough dosage to stay functional, but am still tired, depressed, losing hair, etc.
    I have become gluten intolerant, lactose intolerant, iodine intolerant, etc., and am very careful about eating a healthy, organic diet. Could food sensitivities be preventing absorption of my Armour yet still allow it to influence my TSH levels? I am out of arguments with my doctor, but tired of feeling like this.
    Reply

    • Leeann- Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten?

      Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply

  32. Hi. I have Graves disease and am taking carbimazole. I’m tolerating it quite well and it’s bringing my TFT’s into the normal range. Does anybody else taking carbimazole get abdominal bloating? For the last few months, my weight hasn’t changed much, but I have a distended abdomen. I look pregnant!
    Reply

    • Jen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  33. I think I advised my dr. Wrong and went down on my armour. My tsh is.68. Ft4 .98 low on the range, ft3 4.0 optimum and rt3 also optimum. I now thi k I was hypo instead of hyper but symptoms were making me nutty. I need imput please. I have graves and had rai 12 years ago and ted and double vision . Iwas doi g pretty good for 7or so years. Don’t k ow what happened. I suppose this is another I’m getting older thing . Haha!
    Reply

    • Gwen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  34. My TSH a year ago was 2.130 but my free T4 was .75 I have only gotten sicker. My hair is falling out I’m so fatigued, I’ve been in the hospital for heart palpitations. Just to name a few. I can’t get a Dr do a full panel! I’m so frustrated and don’t know what to do? I’ve left my PC because he wouldn’t even do anything but give me Vitamins I found out later I have celiac! Now I’m looking for a new PC but have no faith in Drs now. What should I ask? Am I not saying the right things?
    Reply

  35. I have Hashimoto’s, My Dr only ran the TSH and it was <0.1 so she lowered me to .50 of synthroid. Retest tsh in 2 mths was .0309 now she wants to lower it again to .25. I have refused and going to a new specialist.
    I am at a loss because I apparently do not understand how this works. If my thyroid was swollen and they prescribed medicine to help it out, why would they take and lower the meds to almost nothing when I am way below normal on the test. I asked for the T3 and T4 which they did not run.
    Reply

  36. Hi After being diagnosed with a over active thyroid for 3 year’s took carbimozole had steroids for graves disease had beta blockers for palpitations..Then I had radiation iodine..Which has know left me with a under active thyroid. I am know left feeling fatigue muscle and bones ache, Feeling cold all the time lack of concentration hair loss…Depression Have A healthy diet try and run my own business when all I want to do is sleep…I take 100mg of lrvothyroxine.. Doesn’t make me feel any different but apparently my bloods are “OK”….Where I know go from here is anyone’s guess…
    Reply

    • Jayne- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  37. I was having hypo symptoms for around 3 years, Dr stated at first app that my thyroid would go “eventually” and i had to wait until lab test stated it had. I was finally diagnosed last year with hypothyroidism and put on 25mcg of Levothyroxin as i was awaiting for cadriac surgery. Since my thyroid has gone, my health has too; heart op, gallstones (just had gallbladder removed 5 weeks ago) kidney calcification ( possible malignancy? ) psoriatic arthritis. My free T4 is 15.8, TSH is 11.2, ESR is 37, CRP is 10.
    Because of heart problem, they had to increase the Levothyroxin slowly. I’m now on 100mcg of Levothyroxin and still feel terrible. I’m wondering if my failing thyroid played a major part in my other health issues?
    Reply

  38. Glad to see there may be some information on hyperthyroidism to read about. That’s what I have and my Dr wants me to do the iodine therapy but unsure at this time.
    Reply

    • Terri- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  39. Find another doctor Katrina. I didn’t, ended up almost 100lbs over weight and sick. A good Natropathic doctor and endo can make all the difference. Hang in there!
    Reply

    • Hara- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  40. I work at a local hospital at the time in housekeeping. Back in 2012 I was emptying the trash in one of the ER rooms and got stuck by a dirty needle that wasn’t placed in sharps container like should have been. Now all the proper test were done to make sure everything was ok. And it was. My question is could something like that cause my thyroid disease or is it a coincidence?
    Reply

  41. I’m in the struggle searching for a way to feel normal. Still crashing in the afternoon, still lacking energy, still not able to lose weight even with regular sweat sessions at the gym 3x a week. I’m art wits end…
    Reply

    • Jennifer- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  42. I recently had several thyroid tests run. TSH, FT4, TPO antibodies, RT3 all within normal limits. I ordered the FT3 from a chain lab. My FT3 was on the low end, but the lab considered it within normal limits at 2.7 pg/mL. I’ve read from other thyroid experts that this value is too low, however. Where do I go from here?

    Reply

  43. From above, isn’t this a typo? What are the numbers that are missing? –“Anecdotally, most patients feel best with a TSH between mIU/mL.”

    Reply

    • David – thank you for following this page. The sentence reads ” Anecdotally, most patients feel best with a TSH between 0.5-2.0 mIU/mL.”

      Reply

  44. My TSH has been running about 0.03, while taking “thyroid pro” and 2 droppers of thyroxidine. When I get off the iodine it goes to about 2.3 and ifeel very tired and unmotivated. How do I know which to back off of? And i’s it necessary with aTSH of 0.03? I have no hyperthyroid symptoms at this range and feel great

    Reply

  45. My most recent labs are TSH of 1.9; T7 1.4; T3 uptake 25.2 and T4 5.6. I am sleeping excessively; with exercise and diet I am not able to lose weight; I am forgetting stuff like crazy; have always experienced hair loss and night sweats but most recently I like to be curled up under my blankets. I was diagnosed with PCOS in the early 90’s and have been monitored but no one can seem to figure out why I am having all these problems. My endocrinologist says my labs are normal. I had been on metformin for years but he determined that since I was not diabetic or trying to get pregnant it was no longer necessary for me to take the medication. I need some answers. Can someone here direct me further?

    Reply

  46. I have been experiencing extreme fatigue, muscular and joint pains for the past 6-7 years. (When I moved to Canada from a warmer country).
    In the past couple of years my symptoms have been getting worse. Chronic pains, (Being outside in the cold makes it worse) fatigue, sleepy, mind fog, memory problems, feeling sad and overwhelmed. I have had low TSH in the past and have a strong family history of thyroid issues. I begged the doctors here in Canada to examine my thyroid properly but all they do is a TSH and then brush it off saying if TSH is normal, they won’t do any further tests.
    I had a miscarriage in october 2016 as well. Have PCOS as well. All the doctors here keep telling me I have fibromyalgia which has no cure just eat healthy and exercise which I have been doing recently with my symptoms getting worse day by day. I strongly feel that I have some underlying thyroid issue as well but I am so frustrated that the doctors don’t listen.
    Can you please guide me how to convince the doctors to do further tests for a thorough diagnosis.

    Reply

  47. I was diagnosed with Hashimotos 4 months back after years of unexplained symptoms. I have been on levothyroxine but changed to armour due to it being natural. (My suggestion not the doctors). I still have inflammation, some days worse than others. I have been on a paleo diet, but now seeing I should cut out more stuff to be more AIP. Opinion on that? My doctor will not do anything else with me due to my levels being normal right now. Also I have a root canal tooth. Is there any way to detox out what it could be doing besides pulling the tooth?

    Reply

  48. My 4 year old son’s labs came back with his TSH at 3.7. Is that too high? His doctor wasn’t concerned.
    We have been gluten free for 3 months and minimal dairy for 2 months. He is gluten sensitive, possibly celiac.

    Reply

  49. Dr. Wentz,
    My wife has normal T3, T4, and Low TSH… but very high thyroglobulin (1.60), high homocysteine (8.40) and high lymphocytes (53). We have gotten the run around for weeks from doctors. Her symptoms get worse daily and the last doctor said that “lots of people have your symptoms.” We are a vegan family and exercise daily (well, used to).

    Where should we look next?

    Reply

  50. I have all the symptoms of Hypo. My recent TSH is 4.36 Free T4 .70
    I finally got in to see the endo Dr and she blew it off and said my symptoms have nothing to do with my thyroid. So frustrating. Weak aching thigh muscles, carpal tunnel, gained 20 lbs in 6 months, SOB, What would you recommend? Could a person have Hypothyroidism with lab values just outside the norm / Dr said they would be WAY out of range ?
    Thanks

    Reply

  51. I feel like I am spinning my wheels and getting nowhere. I got my doctor to prescribe armour, grain free, b12 and working on healing my gut. Every time I go back there is a new issue. SHB 150, ANA TITER 1:40, FT3 4.8, FT4 1.2 and TSH .01. They said my thyroid is dead, low testosterone among other things. A 6 year battle with no end in site it feels like. Help!

    Reply

    • Megan – thank you for following this page. I’m sorry to hear that you are struggling. 🙁

      When I was first diagnosed with Hashimoto’s, I felt so alone. My doctor didn’t think it was a big deal, and none of my friends or co-workers had it. It wasn’t until I started to research online that I found others who were going through the same thing.

      A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.

      https://www.facebook.com/groups/hashimotos411/

      Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.

      Reply

  52. After 10+ years of being fatigued and sleeping 10-12 hours a night, and watching my TSH slowly rise on yearly blood tests, my TSH finally tested out of the range at 4.6 and just like you said, my doctor wants to simply put me on a thyroid prescription. Before I start the medication I am trying the protocols in your new book. Right off the bat, the B1 supplement made a noticable difference in my fatigue. My doctor did the two antibody tests and they were well within normal range. I also had a thyroid ultrasound and was told my thyroid was normal. Will the protocols help someone like me? Or should I just take the prescription and call it a day….

    Reply

  53. Hi. Thanks for taking the time to review this question. I have benefited greatly from your recent series of videos and feel far more empowered to fight for my own health. I have hashimotos and are reducing my TSH and antibodies through a paleo diet among other things! My question relates to my 8 yr old daughter. 15 months ago she was tested for ongoing fatigue and everything was ‘normal’ – TSH 2.08. (t3, t4 ok). There have since been a few other flags but I don’t want to over-react even though she does have the predisposition. My general question I guess it; would you expect a child to have a lower TSH than that or is that still considered absolutely fine, or would you see if as warranting further investigation?

    Reply

  54. Dr. Wentz,
    I have struggled with fatigue for YEARS but was never diagnosed with a Thyroid issue. I do have psoriasis on my scalp, and methylation glitches in my genes (MTHFR & COMPT). I’ve been on the Paleo diet for several years (I was VERY strict for the first two years – & did AIP as well, but have added grains and some dairy this past year & a half). I have many food sensitivities – in addition to gluten, sugar etc. corn is one of the worst for me. My hair was falling out & I had a natural practitioner (does computerized biofeedback) give me Glandular Balance Thyroid (contains raw thyroid from New Zealand Bovine). I took this for about a year, and it helped, but I still struggled a bit with my energy. The past year my once strong nails have turned very flimsy and thin (ripping off with ease), and my skin has thinned, but my hair stopped falling out. About two months ago, I went off of the New Zealand raw thyroid (wasn’t sure it was helping) and began taking a Red Seaweed formulation. I felt better at first, but am really struggling with fatigue and not exactly sure what to contribute it to – my diet additions? going off the New Zealand raw thyroid? not enough sleep?. Just had my annual physical with GYN and received blood results today: TSH 4.68 (it was 2.04 in 2015), T3 2.4, free T4 0.9, ATPO-0.4 (I wonder if the nurse meant to say 4 – results were read to me over the phone). Dr. wants to put me on Thyroid meds, and while I know I need help, I’m concerned about doing so. Do you think going back on a strict AIP Paleo would be sufficient, or do you think I need to be on a Thyroid med d/t my labs? Thank you so much for your guidance!!

    Reply

  55. Thyroid removed 3 yrs ago. Had Hashsimoto and Graves. Been on 88 Synthroid and felt fine until month ago. Am 76. Blood work seems normal except TSHR is 3.72.
    Eyes being affected. Put me on prednisone. Helps a little bit. Scared because f eyesight.

    Reply

    • MB – thank you for following this page.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead,’ or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      IS HASHIMOTO’S A SURGICAL DISEASE
      https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease

      Reply

  56. i want help about my Hyperthyroidism 2 year ago me was hyperthyroidism patient then after 6 month my reports will b normal and my doctor stopped my tablets carbimazole and inderal then after my same condition again my all tests report tsh negative nd then my doctor will take same tablet’s but now 2 Month ago my all lab reports normal but my doctor says to continue tablets then I will stopped same hyperthyroidism but now I’m feeling better nd happy then I take tablets or stopped for month? any negative affect about carbimazole tablet? please tell me
    I was only 21 year hyperthyroidism in my reports some Month ago my weight 38 now 47 nd I will be feel better but I’m confused then stopped tablets and same condition now my last reports of March ft4 0.91 free t3 2.80 anti thyroid peroxidase 27.9 nd serum anti thyroglobulin 20.0 . and was take carbimazole 2 tablets in morning and 2 evening and also inderal. I was patient of hyperthyroidism 2015 and now my all reports was normal then tell what I should?…

    Reply

    • Flavia – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.

      Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.

      We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  57. Out of the blue my doctor called me to come in. I have been on levothyroxine for 25 years and suddenly my TSH is 13.55. She adjusted my dose from 1 to 1.5. How could my number jump so high i.e. 13.55?

    Reply

  58. If my T3 and T4 and reverse T3 are sin the normal range my TSH is always low. Usually less than 0.1. If my TSH is even close to 0.3 my T3 and T4 are below the normal range. In case of the T3 quite a bit below normal. I took synthroid for about 18 years and everything was okay. A couple of years ago my T3’s dropped like a rock. i am now taking NP thyroid. T3’s have improved but TSH still very low and doctors always going crazy. Any advice

    Reply

    • George – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.

      These are the recommended labs from my book, page 32.

      RECOMMENDED THYROID FUNCTION TESTS

      * TSH
      * TPO Antibodies
      * Thyroglobulin Antibodies
      * Free T4
      * Free T3
      * Reverse T3 (Optional)

      Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested:
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol:
      thyroidpharmacist.com/protocol

      Reply

  59. Do you have a link to these updated normal ranges, preferably pdf’s from their respective web pages, I could show a physician? Particularly a pediatrician for a 10 year old girl presenting other symptoms of Hashimoto’s? “The National Academy of Clinical Biochemists indicated that 95% of individuals without thyroid disease have TSH concentrations below 2.5 mIU/mL, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3-3.0 mIU/mL (1)”
    Thanks,
    Michael
    P.S. Enjoyed your books.

    Reply

    • Michael – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.

      These are the recommended labs from my book, page 32.

      RECOMMENDED THYROID FUNCTION TESTS

      * TSH

      * TPO Antibodies
      * Thyroglobulin Antibodies

      * Free T4

      * Free T3

      * Reverse T3 (Optional)

      Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested:
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol:
      thyroidpharmacist.com/protocol

      Reply

  60. I had thyroid cancer in 2009 took both thyroids out plus the parithyroids. I had blood work this week and my TSH is 26.55 what could be causing it to be this high I’m on two kinds of thyroid meds. my energy is down to nothing having headaches short of breath.

    Reply

    • Janice – thank you for reaching out! Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead,’ or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  61. Hi! Good day!
    I am 22 yrl old guy and experiencing the symptoms of hyperthyroidism and thinking of having a test back then. Until having a chek up on a clinic because of chest pain and panic attack, the doctor found out that im high blood and issued a request for some blood test including TSH, T3 and T4. Also my ecg result comes out with a 156 heartbeats/minute. After a day the blood test has revealed then the thyroid function test is normal. TSH 1.66 , T3 160.2 , T4 12.9. Is it possible to have hyperthyroidism with a normal thyroid test. (btw i did fasting on that test)

    Reply

    • Francis – thank you for reaching out. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows.

      Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.

      WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
      https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.

      TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

      Reply

  62. Dr. Izabella, i love your website and thank you for helping people with thyroid issues!
    I habe been diagnosed with colloid cyst ( very small ones, the biggest one is 3mm, but there are more than 10) and the ultrasound also showed a little bit of tyroiditis, the tyroid a little bit inflammed, (that’s what my doctor said) 6 months ago my TSH was 1.8 and now my TSH is 4.5, ( i am taking Bcomplex wich has biotin, i dont know if it could be related with the change in my TSH levels) muy T3 – T4 are normal..my T3 is 101.9 ng/dL and my FT4 is 1.28
    And antiTPO is negative, my doctor prescribed me levothyroxine, i wasn’t sure if it was the right thing to do so i went to another doctor for a second opinion and he said that hormones are not necesary, so now i don’t know what is the right thing to do, i am 24 yo, my nails are trrible, i have acid reflux, whater retention, i am a little bit tired (not too much), mood swings, i think that i also have leaky gut, i started following Dr Axe program a few moths ago for leaky gut , i dont eat gluten, diary, grains, in general i eat very clean.. i will really apreciate if you could help me with this desition..
    Thank you very much

    Reply

  63. What do you recommend for lab results that show normal TSH (1.4), T4, and Free T4, but low-end T3 and Free T3? All I hear is that these are normal results but I am very underweight and am losing hair like crazy!

    Reply

    • Rebekah – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here are the tests you need for diagnosis. Make sure to request a copy of your labs as well.

      Top 10 Thyroid Tests and how to Interpret them.
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests

      Here is another article you might find helpful as well.

      SUBCLINICAL HYPOTHYROIDISM DESERVES CARE AND TREATMENT
      https://thyroidpharmacist.com/articles/patients-subclinical-hypothyroidism-deserve-care-treatment/#

      Reply

  64. Hello Dr. Wentz,
    Just this week I was diagnosed with Hashimoto’s (TPO = 134), and also Hypothyroidism. My TSH was 39.6, then a week later came back at 100. My doctor said he’d never seen levels that high. Starting Synthroid, been treating a separate autoimmune disorder for 3 years so diet (paleo+) and supplements pretty good. Any other advice? How does a TSH come back at 100!?!
    Thanks so much! Your information is all very helpful 🙂
    Emmy

    Reply

    • Emmy – thank you for following this page. Please understand that I can’t give you a diagnosis over the internet. However, I can give you resources for you to understand Hashimoto’s and hypothyroidism/hyperthyroidism. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows.

      Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.

      WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
      https://thyroidpharmacist.com/…/what-to-do-if-your-tsh…/

      Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.

      TOP 6 THYROID TESTS FOR DIAGNOSIS
      https://thyroidpharmacist.com/articles/top-6-thyroid-tests/

      Reply

  65. Good morning Doc,
    Having symptoms of thyroid issues.
    1100 a.m.
    First TSH test: 2.62
    Retested a week later.
    3 p.m
    TSH was 3.23
    FT4 was 1.19
    T3 Free was 3.24.
    Could I be Hypo.. or Subclinical.? Should my TSH levels increase during the day?
    I’m just looking for the possibility or do I need to look elsewhere to get relief from my symptoms. I’m sure my Doc will tell me everything is normal based on the (0.27-4.20) lab limits for TSH.

    Reply

  66. I am struggling with finding a doctor that will listen to my thyroid concerns. For years I have been saying my thyroid is not working optimally, then my thyroid swelled up with four nodules. But my doctor said it was benign and my Tsh is 2.65 so they don’t want to see me for a year. I really struggle with fatigue, brittle nails weight gain, all the symptoms. T4 free is 2.15 t3 uptake is 31.5. I started taking iodine supplements and my goiter shrank but I don’t feel it’s fixing the problem.

    Reply

  67. Hi Izabella,
    I love your story and it inspires me to make sure I will find the reason of my condition and proper diagnosis. I find very hard to get proper diagnosis from the doctors, it seems like it’s a vicious circle. I have done myself all tests that are required to see how my thyroid functions as doctors don’t want to even send me for those tests therefore I had to go to private lab and paid fortune to have them done. I have completed tests because I’m medicine freak and I was feeling tired lately and after reading some articles I came up with an idea that it’s good to check thyroid just in case and this is what I did in Poland.
    My TSH is 5,220; FT3=3,06 pg/ml (Lab norm 2-4,40pg/ml); FT4=1,17 ng/dl (Lab norm 0,93-1,70 ng/dl); anty-TG=13,70 IU/ml (Lab norm 0-115 IU/ml), anty TPO <9 IU/ml (Lab norm 0-34_; Trab <0.8IU/l ( Lab norm 0,00-1,22). I ran also cortisol level ACHC test between 8-10 am and my result is 14,1 ug/dl (Lab norm 4,82-19,5 ug/dl). Sodium level: 140 mmol/l (Lab norm 136-145); Potassium: 4,49 mmol/l ( Lab norm 3.50-5.10); Calcium : 2,36 mmol/l (Lab norm 2,09-2,54); Iron: 71,0 ug/dl ( Lab norm 37-145); Glucose tolerance test with 75g of glucose drink (3 points); glucose on empty stomach in the morning :94,5 mg/dl (Lab norm 70-99); after 1 hour :110,1 mg/dl; after 2 hrs: 101,0 mg/dl. Insulin tolerance test 2 points with 75 g of glucose drink; insulin on empty stomach in the morning: 13,5 IU/ml (Lab norm 2,6-24,9); after 1 hr (43,7); after 2 hrs (32,0). Other than that my MCHC came up slightly low 32,1 g/dl ( Lab norm 32,2- 35,5). Cholesterol CHOL :139 mg/dl ( Lab norm 115-190); HDL: 67 mg/dl; non HDL : 72 mg/dl; LDL: 62 mg/dl; triglycerides: 48 mg/dl. From my results I can clearly see hashimoto and insulin resistance. My question here would be which of those came up first and which one is causing which. I’m not taking any medications yet and I’m in search for good endocrinologist as I live in Ireland, however I would like to get your opinion on it. I’m on AIP since last 3 weeks and I’m doing well. I think that Gluten, Lactose and Soya are upsetting my stomach and they were always doing it but I didn’t see the link between the fatigue I was feeling. Moreover I used to eat a lots of sweets and always felt that I need to have something sweet after meal since I was teenager. I’m 35 now and I have been always active person no alcohol no smoking always on the air. 2 years ago I had a cellulitis from nowhere and since that time it was always in my head why I had that, they ran blood test at that time and no concerns were observed except the fact that my vitamin D was low at that time. Since I’m on AIP diet I take supplements selenium, zinc, b12, d3 and drink cod liver oil. Also I drink no teas, coffees. What would be the best synthetic for my thyroid that would be gluten and lactose free. I just want to be sure that I will not end up with prescription from another doctor for levo which as I heard upsets adrenals and has gluten. Thank you for sharing your story with us

    Reply

  68. Thank you so much for this piece, you mentioned Southern California, I was wondering if you knew of any doctors or facilities (in SoCal) who treat subclinical hypothyroidism. I’m having a hard time finding someone to help. My TSH levels when last checked were 3.18 but I’ve gained 20 pounds in the last six months, I’m tired all the time at my skin is dry I’m freezing cold have horrible brain fog, three classes of hashimotos in my family and so on and so forth. Hope you can help, thank you!

    Reply

  69. Hello! My TSH is 2.47, Free T3 is 2.9, and Free T4 1.30. My doctor prescribed on 30 mg of Armour. My main complaints are fatigue and brain fog. Ideally I would like to tone up but I am at a healthy weight. Does it seem reasonable to take Armour being that my numbers are in a normal range? Thank you!

    Reply

    • Denise – thank you for sharing your journey. Brain fog is a very common symptom of Hashimoto’s. Often we are told that being confused and forgetful is part of normal aging or that we need less stress. Really, much of our symptoms including brain fog can be attributed to low thyroid hormones and food sensitivities. Going gluten and dairy free seem to be some of the most helpful interventions to help decrease or often get rid of brain fog. Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It actually started 8 years before I was finally diagnosed in 2009, after I got Mono (Epstein-Barr Virus) in college. I needed to sleep for 12 hours each night to be able to function, and by “function” I mean after hitting the snooze button on my alarm clock for two hours (ask my poor husband), I would drag myself out of bed and then had to drink 46 cups of caffeine everyday to keep myself awake. I often had Red Bull and Pepsi for breakfast, and was the epitome of “wired but tired”. I hope my articles help you get started 🙂

      OVERCOMING THYROID FATIGUE
      https://thyroidpharmacist.com/articles/top-10-tips-for-overcoming-hashimotos-fatigue

      THIAMINE AND THYROID FATIGUE
      https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      Reply

  70. I stopped taking levothyroxine 25 mcg 6 months ago because of a skipped heart beat which is now normal. In sept. 2017 I was 4.59, March 2018 7.03, June 2018 13.08, all other blood test normal. I am a 78 year old male in good health except for subclinical thyroid. Would going back on levothyroxine at a lower mcg be ok to lower my TSH or something else? I have no clue what will work for me.
    Thank you,

    Reply

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