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Why TSH Thyroid Test Can Be Misleading

The Thyroid-Stimulating Hormone (TSH) test is a common blood test used to assess thyroid function. While TSH levels are a valuable marker of thyroid health (when done with other thryoid markers), there are situations in which the TSH test may be misleading or provide an incomplete picture of thyroid function. In today’s article, I’m going to review a few reasons why the TSH test may not always provide a comprehensive assessment of thyroid health and be misleading.(*),(*),(*)

6 Ways the TSH Test is Misleading and Fails You 

6 Situations In Which the TSH Thyroid Test is Misleading

You’re having symptoms of low thyroid function, hair loss, brain fog, constipation, fatigue, weight gain, anxiety, depression….. but your doctor insists that your thyroid test results are within “normal range,” so your thyroid is fine right? Not exactly.

Consider this when it comes to thyroid disease and woman.  Its estimated one in five women aged 60 and older has some form of thyroid dysfunction, yet a huge number of these women will go undiagnosed by their doctors. If this sounds familiar, stay tuned and let’s review some of the reasons you struggle with classic thyroid symptoms depsite a normal TSH test.

1.Patterns of Thyroid Dysfunction

In some cases, individuals may have symptoms of thyroid dysfunction (such as fatigue, weight changes, or mood disturbances) even if their TSH levels fall within the “normal” range. This can occur in conditions such as subclinical hypothyroidism, thyroid underconversion or Low T3, thyroid hormone resistance, elevated reverse T3  or some other pattern of thyroid dysfunction most doctors never test for. I have an entire ebook on thse patterns of thryoid dysfunction overlooked by your docotr. I encournage you to download this Thyroid ebook here.

2. Fluctuations in TSH Levels:

TSH levels can fluctuate throughout the day and in response to various factors such as stress, illness, medications, and changes in sleep patterns. TSH levels tend to follow a diurnal (daily) rhythm, with higher levels usually observed during the night and early morning hours, and lower levels during the day. This normal variation can result in fluctuations in TSH levels within a 24-hour period. Physical or emotional stress can impact TSH levels. Stress hormones released in response to stress can influence the hypothalamic-pituitary-thyroid axis, leading to changes in TSH secretion. Certain medications, such as corticosteroids, dopamine agonists, lithium, and some anti-seizure drugs, can also affect TSH levels. It is important to inform your healthcare provider about any medications you are taking when undergoing thyroid function testing.

If you feel there is more to your thyroid story, Contact us today!

3. Secondary or Tertiary Hypothyroidism:

In some cases, low TSH levels (rather than high) may indicate dysfunction at the level of the pituitary gland (secondary hypothyroidism) or hypothalamus (tertiary hypothyroidism), rather than a primary thyroid problem. In such cases, relying solely on TSH levels may miss the underlying cause of thyroid dysfunction. This is why running a comprehensive Thyroid panel is so important when you have thyroid disease or have unresolved thyroid symptoms. I talk more about this in my Thyroid Ebook.

Is Your Doctor Missing Something When It Comes To Your Thyroid

If you feel there is more to your thyroid story, Contact us today!

4. Conversion Issues:

Thyroid conversion issues are by far one of the most common reasons patients have all the classic thyroid symptoms but a normal TSH. Its also missed 95% of the time. Heres why… TSH is a marker of thyroid function mainly at the pituitary level and does not provide information on the actual levels of active thyroid hormones (T3 and T4) in the body. Some individuals may have issues with the conversion of T4 (inactive thyroid hormone) to T3 (active thyroid hormone), leading to symptoms of hypothyroidism despite “normal” TSH levels. In order to identify this thyroid conversion issue, you need to have both T3 and Free T3 markers done. Most doctors and endocrinologists don’t like to test these markersa and so this pattern of thyroid dysfunction goes undiagnosed.

5. Autoimmune Thyroid Conditions:

Hashimoto’s disease, also known as Hashimoto’s thyroiditis, is an autoimmune condition where the immune system attacks the thyroid gland, leading to inflammation and thyroid destruction over time. The symptoms of Hashimoto’s disease includes

Symptoms of Hashimoto’s disease
  • Unrelenting fatigue.
  • Feeling the cold.
  • Constipation.
  • Swollen face.
  • Dry, coarsened skin.
  • Dry hair that is prone to breakage, hair loss.
  • Voice changes, such as persistent hoarseness.
  • Fluid retention (oedema)

These symptosm look alot like hypothyroidism dont they! In autoimmune Hashimoto’s thyroiditis, TSH levels can fluctuate as the immune system attacks the thyroid gland. Its not uncommon to see Normal TSH, High TSH and Low TSH in patients with Hashimotos. Whats important is whats happening with the levels of Thyroid hormones- Total T3, Free T3, Total T4, Free T4 and reverse T3. If you have Hashimotos I encourage you to read this article

  1. Identifying your Autoimmune Triggers
  2. Complications of Untreated or Mismanaged Hashimotos Thyroid disease

6. Individual Variability:

Each person may have a unique set point at which they feel their best, which may not always align with what is considered a “normal” TSH range. Some individuals may have symptoms of hypothyroidism or hyperthyroidism even if their TSH levels are within the conventional reference range.

Importantance of Proper Thyroid Testing- going Beyond TSH

Accurate diagnosis is crucial in medicine to determine the most effective treatment for thyroid patients. Unfortunately, a one-size-fits-all all-treatment approach which includes thyroid replacement, seems to be the only tool in the 21st century medical toolbox. The overwhelming majority of patients with thyroid dysfunction suffer from one or more thyroid patterns that are missed with standard thyroid testing. These dysfunctional thyroid patterns, don’t show up on your usual thyroid testing and can often show up with a normal TSH.

10 Steps To Supporting Your Thyroid Naturally

Some Additional Articles We Recommend Reading

  1. Ingredients Binders and Fillers in Thyroid Medication
  2. Low T3 Explained. What You Should Know About this Thyroid Hormone
  3. Adrenal Fatigue and Thyroid: How Are They Connected?
  4. The Stress Hormone Cortisol and Blood Sugar
  5. Iron Deficiency and Hypothyroidism- How Iron Anemia Shuts Down The Thyroid
  6. Functional Medicine and the BIG Picture Approach
  7. The Truth and Facts About Autoimmune Disease

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