TSH level of 30.6???

Question

I just had a physical today and my doctor called me back a few hours later and told me I had to make an appointment with an endocrinologist immediately, that I had a TSH level of 30.6.

My appointment is on Friday, but what should I expect? Any questions I should ask? Should I be worried?

I had a thyroid storm five years ago. Levels have been normal since then, and I wasn't placed on any medication. Nobody to this day knows why the thyroid storm happened, and I haven't had any symptoms of anything since - which is why this is really bizarre that its happening again.

Any thoughts?

Answer 1

TSH itself doesn't tell much, other than what the pituitary gland measures of thyroid hormones or lack thereof.  Sometimes the pituitary gland measures incorrectly, so it's not always accurate.

Otherwise, a TSH reading that high indicates minimal thyroid function.  (By the way, for others reading this, the reference range is 0.34 - 4.82 mcIU/m[L?])  But you indicate a lack of symptoms.  Testing your T3 & T4 levels would be more helpful.  You can order blood tests through various web sites.

What to expect?  Expect an endocrinologist will be going by the textbook.  They esteem TSH values, sometimes making it the only requested test in suspected endocrine problems (as the American Association of Clinical Endocrinologists have been instructed to do by their textbooks).  They may look for signs of hypothyroidism & suggest T4 replacement through levothyroxine or synthroid.  The body can convert T4 to T3, which is more bioavailable (more usable), but it requires sufficient iodine, tyrosine, & selenium to do so.  If your thyroid has failed/is failing, these medications may not be enough.  T3 is more bioavailable than T4, & is part of Cytomel/Armour.  Many doctors view Armour as a "primitive" medication because it is glandular extract from pigs.  However, hypothyroid patients, especially those who had their thyroids removed, tend to do best on Armour.  

If it can be determined that your thyroid gland no longer functions sufficiently, ask your doctor what he/she thinks about Armour & other medications.

There are some exceptional endos, but most I've encountered have been mediocre.  If you presented with signs & symptoms but your blood results did not indicate obvious extremes (below or above the reference range), they often tend to write the person off as having psychosomatic illness & prescribe antidepressants/anti-anxiety meds.

One endo I can recommend is Dr. Mariano in Monterey, CA.  He pays quite a bit of attention to thyroid levels.

Here's a site to visit: http://www.stopthethyroidmadness.com/   A friend of mine from one of Yahoo groups recommended this site.  He has found it helpful since a car accident damaged his pituitary gland & consequently through off all of his hormones (including thyroid hormones).  Also check out the thyroid groups in Yahoo groups.  You can learn much (especially tidbits that doctors forget to mention) from those groups.

Worry never solved anything, but increased information may help allay your fears.  I wish you well.