# Trying to understand TSH (and why doctors love it so much..)



## Scanders (Sep 9, 2015)

I'm just trying to understand the timing of TSH in relation to symptoms. Doctors order TSH as a primary test now for dosing my levothyroxine. It's quite the struggle to get additional tests ordered, such as FT4 and FT3. I think I make headway, and then the orders go back to just TSH. Anyway, with a range of .30-4.5, my TSH has been:

3/20/18 1.74 (increased levothyroxine from 50mcg to 75mcg)

4/25/18 0.39 felt great! FT4 here was 1.1, up from .8 (.7-1.5) left levo dose alone

6/14/18 0.16 MD didn't like this slightly low result. I didn't know it was being drawn and had taken levo. FT4 still was only 1.2. MD reduced dose to 75mcg 6 days per week, which seemed reasonable since I had noticed a little change. Still averaged 64 mcg/day. (And perhaps if I understand this timing of results, I may have already resisted this change?)

7/30/18 1.90 I think this is a big jump in 6 weeks for what seemed like a small dose decrease. She didn't order FT4 this time, but did suggest adding a half tab of 75 on the seventh day for average of 70 mcg/day when I complained about increased hypo symptoms.

Is that 1.90 more reflective of what was happening 6 weeks ago? I had onset of bad brain fog late June, early July. I'm trying to work out the timing of the symptoms in relation to the TSH as I'm trying to have meaningful dialogue with my provider, but the brain fog makes me sound more than a little disjointed. She did put orders in for FT4 and FT3 next time--turns out if was only TSH with reflexive FT4 this time, and of course, TSH was squarely in the middle of the range, which she again considered perfect. Sigh...

Thanks!


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## Pamzilla13 (Sep 9, 2013)

Your doctor is treating your numbers, not you. If you felt great at TSH 0.39 and FT4 1.1, why change it? your TSH was still in range....so to her its about numbers, not about you feeling well...

Get rid of this doctor!


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## Lovlkn (Dec 20, 2009)

Find a new doctor in a different practice or "group".

Some doctors live and die by TSH alone - they usually don;t have thyroid disease and are doing what they were taught in school which apparently is only related to TSH.

My son went to a MD, I asked for FT-4 and FT-3 along with antibodies for him and all the doc would run was TSH. I paid out of pocket to have the tests I requested run and they were all positive for TPO, TSI but thankfully negative for Thyroglobulin.


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## Scanders (Sep 9, 2015)

When I felt great we didn't change anything. Not until that darn TSH went a smidge low to .16, and I had noticed a "change" in how I was feeling. My bad for fessing up to that. Next time it's close, I think I make an adjustment, or not if it was recommended and I'm not feeling it, and plead forgiveness later. I need to trust myself more.

Anyway, she is leaving practice soon, so there will be a different provider. I am starting a new job, so most likely will be switching to a new group as this one will be out of network unless I take the high-high deductible. (Although I'm not done with the reconstructive eye surgeries yet, so I'm not entirely sure what I'll do. I mean--so close to the end of that part of the journey that it's hard to switch at this point.)

Anyway, the 1.90 is reflective of 6 weeks ago, in that I would see symptoms of hypo 6 weeks ago or so? Or is there no way to tell without the FT4? I'm just trying to better understand the timing of the symptoms.

Thanks!


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