TSH Should NOT be the Gold Standard ...... - Thyroid UK

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TSH Should NOT be the Gold Standard ......

PaulRobinson profile image
10 Replies

Ok here we go again. More research that show us what we have known for years about the value of the TSH laboratory test. At last these guys seem to be catching up:

See my book Facebook page for the last blog post I put up there: facebook.com/recoveringwitht3

Best wishes,

Paul

p.s. for those without Facebook please see the link: recoveringwitht3.com/blog/t...

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PaulRobinson
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rosetrees profile image
rosetrees

Interesting. I'll read that again in more depth. My problems with the TSH test are fourfold:

1) It measure a substance produced by the pituitary. The test doesn't tell you if the pituitary is functioning well enough to produce the required level of TSH

2) The job of TSH is, as its name suggests, to stimulate the thyroid to produce the necessary level of hormones. If the TSH is doing the job it is designed to do, then you should feel well regardless of the level (unless it's so high the thyroid can't respond)

3) - closely allied to 2) above. You will only feel unwell if the thyroid is unable to respond adequately to the TSH or your pituitary isn't producing enough TSH

4) Ranges. The ranges are produced by taking the average of a set of samples sent to the lab and then applying (I think) 2 standard deviations. There is no scientific basis for 2 standard deviations, it's just a mathematical game. Bare in mind too that the samples will have been taken from patients with a higher chance of being ill, since that will be why the samples were taken in the first place. So the ranges are just mythological. The equivalent of sticking a finger up to the wind, rotating three times and then prostrating yourself to an unknown deity.

PaulRobinson profile image
PaulRobinson in reply to rosetrees

2 and 3 aren't right. But I may have misunderstood your points because you say that you have a problem with TSH.

2. Adequate TSH is NO guarantee of feeling well. Proper levels of FT3 active in the cells and a host of other things working right (the gut, iron, B12, cortisol, HPA axis ....... the list is long) should enable someone to feel well. TSH certainly doesn't.

3. Even if the thyroid responds then because of my answer just now then there is no guarantee of good health.

I suspect you didn't mean to be quite so positive about TSH in your points 2 and 3 above.

rosetrees profile image
rosetrees in reply to PaulRobinson

Oh dear - I thought I was agreeing with you! I'm don't doubt there are dozens of issues that can affect whether or not the TSH is even remotely helpful. Those are the gripes that I have about the test.

I don't doubt for a moment that there are a whole list of other things. Your experience is far, far more extensive than mine. I'm just a beginner.

helvella profile image
helvellaAdministratorThyroid UK in reply to rosetrees

The ranges are supposed to be set using people who are unequivocally not suffering any thyroid issues. For example, negative for antibodies, not taking any thyroid hormones, etc.

The more careful screening of contributors to range setting was a significant factor behind the very widespread reduction in upper bounds of TSH ranges across many countries a number of years ago (can't remember exactly when but this century).

Rod

rosetrees profile image
rosetrees in reply to helvella

Watch this video at 5.55 thyroiduk.healthunlocked.co...

rosetrees profile image
rosetrees

Should have added to 2) - you will also feel unwell if you can't convert T4 to T3 effectively, in which case the TSH test tells you nothing

PaulRobinson profile image
PaulRobinson in reply to rosetrees

Even if you convert OK then you can still be unwell. Even decent FT3 and low rT3 is no guarantee of proper thyroid hormone action. There are tons of ways the thyroid hormones can be disrupted.

Thyroidmeg profile image
Thyroidmeg

My doc won't test to see if I'm converting? I was told tsh normal so I am

Converting fine

PaulRobinson profile image
PaulRobinson in reply to Thyroidmeg

TSH has no information about whether you are converting at all. You can give him the research article that my blog post refers to. He is utterly wrong.

Issy profile image
Issy

TSH relates top primary hypothyroidism alone.

There is also secondary hypothyroidism, and "central" or "peripheral" hypothyroidism - the one the NHS refuses to notice.

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