Thyroid-stimulating hormone (TSH) is secreted by cells in the front part of the pituitary gland. This tiny area in the brain regulates the thyroid gland’s key endocrine function by stimulating the production of thyroxin, the primary thyroid hormone.
TSH is the primary hormone your doctor tests to determine if your thyroid gland is functioning correctly. Too much TSH means the pituitary gland is trying to get a sluggish thyroid gland to work better. Too little means enough thyroxin in your body, so TSH remains low until more is needed.
If the TSH is too high, you have a condition called hypothyroidism or an under-functioning thyroid gland. If it’s shallow, you have an overactive thyroid gland or hyperthyroidism.
Recommended TSH Levels May Not Be Right
Clinical chemists and doctors decided decades ago that healthy people with normally functioning thyroid glands have TSH levels within a range of 0.450 to 4.500 mIU/L (and some labs go as high as 5.000 mIU/L). In clinical shorthand, the diagnostic range is rounded to 0.4-4.0.
When diagnosing underactive thyroid function, most conventional physicians consider TSH levels above 10 mIU/L as thyroid failure and levels between 5–10 mIU/L as mild hypothyroidism. If your TSH is 4.0-4.5, your conventional doctor won’t diagnose hypothyroidism or treat you.
In recent years, however, clinical scientists and practising physicians have found that the standard range is too broad. Many people have symptoms of low thyroid function even when their TSH is well below the upper level of the standard reference range.
The TSH Controversy
A debate ensued between conventional MDs, physician members of the American Association of Clinical Endocrinologists, and the National Academy of Clinical Biochemistry. It wasn’t too long afterwards that integrative medical doctors added their opinion. Each group suggested a slightly different range from the others, but all agreed that the upper limit was set too high.
Naturopathic doctors (ND) have their own view. NDs practice personalized medicine taking into account individual variations, genetic tendencies, as well as age and gender differences. The naturopathic profession developed integrative therapies, but MDs took the credit. Early in the TSH controversy, NDs read the scientific literature and found that at least 60 percent of patients taking Synthroid do not have TSH levels in the normal range. They also found that many patients with TSH levels above 2.0 have symptoms associated with an underactive thyroid gland.
Symptoms of Low Thyroid Function:
- Unexplained fatigue
- Dry, rough and scaly skin
- Pale and cold skin
- Hair falling out, and coarse brittle hair
- Sensitivity to cold
- Decreased sweating even during exercise
- Constipation
- Difficulty losing weight
- Depression
- Muscle weakness
- Unexplained muscle and joint pain
A study in 2000 published in the Annals of Internal Medicine found that older women with subclinical hypothyroidism were twice as likely to have blockages in their arteries than women with normal TSH levels.
In 2008, a study in JAMA found that those with subclinical hyperthyroidism were more likely to have irregular heart rhythms. These findings suggested to doctors that tighter TSH ranges were advisable.
Along with more accurate TSH testing, narrower ranges were recommended, and integrative medicine doctors were in agreement.
Optimal TSH
What’s the best TSH level for your body? There is no magic TSH level that fits all. There are individual variations and some general guidelines. When you get tested, ensure your TSH level is within the standard laboratory ranges.
If your level is too high or too low, discuss treatment options with your doctor. If your TSH level falls between 3.5-4.5, but you have many of the symptoms of hypothyroidism, find an integrative medicine practitioner who will help you achieve a level within the desirable range.
Remember, individual variations matter. Some people’s optimal TSH may have to be in a very tight range of 1.0-1.5.
Successful treatment for hypothyroidism may involve thyroid hormone replacement therapy but also requires supportive nutritional supplementation, including trace minerals like iodine and selenium. Other therapies, including acupuncture, may be necessary to help restore normal thyroid gland function.
Thyroid disease is common. The thyroid gland seems tired with age, exposure to infection, stress, and toxic chemicals in the air, water supply, and food chain. Remember, hypothyroidism is a very treatable condition. There is no reason to go untreated or to get inadequate treatment.
Have you suffered from thyroid problems? What did your doctor advise? Please share your story.
