TSH & Hypothyroidism

Nearly everywhere I read people state that TSH is useless in helping one determine the health of their thyroid. But doesn't a high TSH tell you something?

My TSH is over 4 and yet both my free T4 and free T3 is in the upper half of the range. I suffer many of the symptoms of hypothyroidism. I understand that blood tests for free T4 and free T3 tell you what is in the blood, but not what is in the brain.

Dr Mariano says this:


"Generally, it is useful to improve thyroid hormone signaling before adding testosterone. It sets the foundation for testosterone replacement in order to minimize adverse effects.

The brain is a separate compartment from the body when it comes to thyroid hormone. The brain can have different levels from the body. Outside of doing a lumbar puncture to help determine brain levels, the TSH actually is a measure of what is in the brain. Free T3, Free T4, Total T3, Total T4, and Reverse T3 indicate what is in the body.

When body levels are high, yet TSH is also high, there may be a problem with either thyroid transport into the brain or thyroid activation by Astrocytes in the brain. The problem then becomes how to improve brain levels so that mental function can improve. When body levels are already high, increasing thyroid hormone further may result in hyperthyroid symptoms in the body such as heart palpitations or arrhythmias. Assessing for and addressing metabolic-nutritional problems which can cause transport or activation problems in the brain for thyroid hormone would be a focus of treatment. If thyroid resistance as a possibility, particularly if a person shows signs of hypothyroidism despite high body levels, then it may be possible to add thyroid hormone to improve function."

Because of my levels, my doc put me on 30mg of Armour but I'm wondering if it will be enough.

Has anyone dealt with this issue of high TSH but decent blood numbers while still feeling hypothyroid? If so how have you handled it?

If your TSH, FT4, FT3 are all high it is worth testing reverse T-3 to see where you are at. A high TSH would suggest hypothyroidism with low free hormones but since yours are all high it is possible your reverse T-3 could be high as well, giving you a false free T-3 reading.

I personally have pretty good thyroid numbers, although I believe I may have some symptoms of less-than-optimal thyroid.

To be sure, just like testosterone, some people do better at different numbers. There is no one size fits all. If you and your doctor deem a clinical trial of thyroid meds appropriate, I would go with it. For some people, fixing thyroid makes more impact than fixing testosterone. You cite Dr Mariano, and he actually lists thyroid as being more important that testosterone in the hierarchy of things.

Quote:

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Originally Posted by endo518

If your TSH, FT4, FT3 are all high it is worth testing reverse T-3 to see where you are at. A high TSH would suggest hypothyroidism with low free hormones but since yours are all high it is possible your reverse T-3 could be high as well, giving you a false free T-3 reading.

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First, I love Dr. Mariano's statement above; here's a Physician who "get's it"!

endo has it right, you need to look at RT3 and Thyroid antibodies as well.

RT3 will be most telling of all your Thyroid labs.

I also urge you to do some research on this site below, it may be one the best when it comes to Thyroid education and health.

http://www.stopthethyroidmadness.com/

Thanks for the responses guys. Seems like the more I study thyroid the less of a grasp I have on it. The whole brain levels vs. body levels part is quite complicated and seems like it will be tough to treat simultaneously. I will certainly check RT3 and see how it compares to FT3.