{"id":151725,"date":"2023-11-02T08:29:55","date_gmt":"2023-11-02T12:29:55","guid":{"rendered":"https:\/\/effectsofanxiety.net\/?p=151725"},"modified":"2023-11-01T19:55:52","modified_gmt":"2023-11-01T23:55:52","slug":"high-tsh-levels-what-should-you-do","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/151725","title":{"rendered":"High TSH Levels: What Should You Do?"},"content":{"rendered":"<div class=\"jetpack-video-wrapper\"><iframe loading=\"lazy\" title=\"High TSH Levels: What Should You Do?\" width=\"660\" height=\"371\" src=\"https:\/\/www.youtube.com\/embed\/D8eqHtEqyI4?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\r\n\r\n&nbsp;\r\n\r\nHey there, this is Dr. Ruscio. I just want to share a quick update regarding\r\nthe thyroid TSH and why you should be careful in terms of what you are told you\r\nshould do about an elevation of your TSH. You’ve hopefully heard some of my criticisms\r\nof the field of functional, natural, and integrative medicine regarding how overzealously, we’re\r\ninterpreting small perturbations and findings on thyroid labs.\r\n\r\n&nbsp;\r\n\r\nThis certainly includes people I work with\r\nin the clinic. I just had a patient this morning\r\nand she had previously a TSH of 6.3. So the cutoff on most labs is 4.5. So she was according to the conventional lab\r\nranges, slightly elevated. This is known as subclinical hypothyroid. When that minimum elevation of TSH is paired\r\nwith normal T4, this is known as subclinical hypothyroid, meaning you’re not a true hypothyroid. This is so crucially important because\r\nthe data here are fairly clear in showing that most of these cases will spontaneously\r\nremit or will spontaneously, all on their own with no treatment or therapeutics or support,\r\ngo back to normal.\r\n\r\n&nbsp;\r\n\r\nNow, what was so interesting here is that\r\nwhile working with me, she was also doing some local testing with her NP, her nurse\r\npractitioner. I advised her not to be too quick to act on\r\nthis 6.3, this elevated TSH paired with normal T4 and also normal T3. Let’s retest in a month or two, especially\r\ngiven the fact that she has been improving symptomatically. As the data suggests, you will likely see\r\nnormality or normalization of your TSH.\r\n\r\n&nbsp;\r\n\r\nSo what do you know, about two months later? Her TSH has now gone into the normal range\r\nof 3.6, from 6.3, and T4 and T3 are still normal. All the while she has continued to improve\r\nsymptomatically. To contrast this with what I think\r\nneeds to be amended in the field, her NP wanted to put her on thyroid hormone at that initial\r\nvisit with the elevated TSH. What a travesty that would have been, because\r\nonce you put someone on thyroid hormone, the repeat testing doesn’t tell you if they no\r\nlonger need the hormone, because all of the levels have been paved over by the hormone\r\nthat the person is now taking orally.\r\n\r\n&nbsp;\r\n\r\n<img decoding=\"async\" src=\"https:\/\/images.pexels.com\/photos\/8458927\/pexels-photo-8458927.jpeg?auto=compress&amp;cs=tinysrgb&amp;h=650&amp;w=940\" \/>\r\n\r\nSo this is a crucially important situation\r\nwhere we don’t want to be too quick to act to put people on thyroid hormone without giving\r\nadequate time to see if, especially at these subclinical findings, again – high TSH, normal\r\nT4 according to the conventional ranges – normalizes all on its own at your next retest. The trajectory of these two different patient\r\nscenarios is so different. The one patient from the more, what I would\r\nargue, the overzealous camp will be put on thyroid hormone in some cases for years until a provider\r\nhas enough common sense to go back and check this.\r\n\r\n&nbsp;\r\n\r\nOr, as in this case with a more reserved and\r\nkind of circumspect approach, no medicine was started and a retest a couple of months later\r\nfound she was back into the normal range. We stopped her from going on a medication\r\nostensibly for years that she would not have needed. If you’re concerned about this, double check\r\nand get a second opinion to make sure that you’re A) not on thyroid hormone that you\r\ndon’t need to be or B) that perhaps you are given thyroid hormone too quickly, based upon\r\nthis lab work, that didn’t justify that approach. Now, according to the philosophy of some providers,\r\nsubclinical hypothyroidism does justify the use of medication.\r\n\r\n&nbsp;\r\n\r\nAlthough the data here are clear that there\r\nis almost no benefit shown when those who have that pattern of high TSH and normal T4\r\ngo on thyroid hormone. Almost no benefit has been documented unless\r\nyou’re very young, you are pregnant or are struggling with infertility, or your TSH is\r\nwell above 10. These are important nuances to understand\r\nin navigating the conversation around thyroid, which is all too often vilified or positioned\r\nas a cause of all symptoms. It may well be, but we don’t want to force\r\nupon someone thyroid hormone when the labs don’t justify that because that can\r\nlead someone to be on medication they don’t need.\r\n\r\n&nbsp;\r\n\r\nThis also distracts from actually determining\r\nwhat underlying cause is leading to the symptoms that you’re having. So again, I would encourage you to double-check. Don’t stop taking the medication until you\r\ncheck with your provider, but if you’re suspicious that your provider is being a bit overzealous,\r\ndouble-check. It may be well worth it. Okay. That is our show. Hopefully, this helps.\r\n\r\n<a href=\"https:\/\/www.youtube.com\/watch?v=D8eqHtEqyI4\" target=\"_blank\" rel=\"noopener\">As found on YouTube<\/a>\r\n\r\n<a href=\"https:\/\/jvz4.com\/c\/335985\/319641\">Explaindio Agency Edition<\/a> FREE Training How to Create Explainer Videos &amp; SELL or RENT them! Join this FREE webinar | Work Less &amp; Earn More With <a href=\"https:\/\/jvz4.com\/c\/335985\/319641\">Explaindio AGENCY EDITION<\/a>\r\n\r\n<a href=\"https:\/\/jvz4.com\/c\/335985\/319641\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/i.ibb.co\/HNmg3Ln\/OIP-48.jpg\" alt=\"OIP-48\" border=\"0\" \/><\/a>","protected":false},"excerpt":{"rendered":"<p>&nbsp; Hey there, this is Dr. Ruscio. I just want to share a quick update regarding the thyroid TSH and why you should be careful in terms of what you are told you should do about an elevation of your TSH. You’ve hopefully heard some of my criticisms of the field of functional, natural, and &hellip; <a href=\"https:\/\/effectsofanxiety.net\/archives\/151725\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">High TSH Levels: What Should You Do?<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":151722,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[816,483],"tags":[61033,61073,34580,61049,61039,61044,61046,61047,61051,61042,61054,61070,61058,61072,61067,61060,61076],"class_list":["post-151725","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-environment","category-media","tag-dr-ruscio","tag-elevated-tsh-levels","tag-functional-medicine","tag-high-levels-of-tsh","tag-high-tsh-levels","tag-high-tsh-levels-and-pregnancy","tag-high-tsh-levels-but-normal-t4","tag-high-tsh-levels-causes","tag-high-tsh-levels-symptoms","tag-high-tsh-levels-treatment","tag-thyroid-tsh-levels-high","tag-tsh-level-high-but-t3-and-t4-normal","tag-tsh-levels-and-fertility","tag-tsh-levels-explained","tag-tsh-levels-high","tag-tsh-levels-normal-range","tag-tsh-test-levels"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2023\/11\/htmlF_IMG_6542e03df25c5.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/151725"}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=151725"}],"version-history":[{"count":2,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/151725\/revisions"}],"predecessor-version":[{"id":151738,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/151725\/revisions\/151738"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/151722"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=151725"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=151725"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=151725"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}