Why is the TSH test and its 'normal range' critical?

What is the TSH test

The TSH test (developed in the early 1970s) is the most widely used of a number of different thyroid tests. It measures how well your thyroid gland is carrying out its function, producing the proper amount of a thyroid hormone called T4.

The normal range

The TSH test results run from almost zero into the hundreds. Currently, the recommended normal range is considered to be a result between .3 and 3.0. But many laboratories don't use the latest 3.0 upper bound. Some use 4.5 and others 5. In Europe, some countries use 2.0 Yet in most doctors' eyes, this test divides those who may have hypothyroidism (with results above 3 or 4.5 or 5) from those who don't (below 3, 4.5 or 5). If you are above 3.0 (or 4.5 or 5.0 depending on your doctors testing lab), your doctor could order additional tests to determine why your thyroid may not be producing enough thyroid hormone. If additional test are not ordered, it is probable that the elevation above 3.0 (4.5 or 5.0) was not considered significant enough to warrant the additional tests. In other words, it is your physician's judgment to act on and interpret whether your results are normal (you don't have hypothyroidism or you do.

Do doctors consider your symptoms in making that important decision? Some do, but a surprisingly large number look at the test and the test only. Is that wrong? There is a growing number of medical practitioners and sufferers who say it is a huge failing of our near fanatical reliance on tests rather than clinical judgment.

If your test is sufficiently normal, then what?

If, based on your TSH test, and possibly others, your physician concludes you do not have hypothyroidism he or she may look elsewhere for the source of each symptom, or at least the most bothersome ones. They also might wonder if some of the symptoms, depending on which ones you have, might be caused by depression or a high stress level. Or you might get a response like, You know, we're all getting a little older.

If your physician treats some or all of the most bothersome symptoms one at a time and you are satisfied with the results, then your problem is solved.

If not, you may want to seriously consider Wilson's Syndrome as a possible cause of many or all of your symptoms. Wilson's Syndrome may affect far more adults than any other cause of low thyroid but few physicians know about, or accept it yet. By treating it appropriately you may find yourself on the road Back-to-Health.