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Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications.

However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows.

Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range.

This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.

In recent years, The National Academy of Clinical Biochemists indicated that 95% of individuals without thyroid disease have TSH concentrations below 2.5 μIU/L, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3- 3.0 μIU/ml (1)

However, most labs have not adjusted that range in the reports they provide to physicians, and have kept ranges as lax as 0.2-8.0 μIU/ml. Most physicians only look for values outside of the “normal” reference range provided by the labs, and may not be familiar with the new guidelines. Thus many physicians may miss the patients who are showing an elevated TSH. This is one reason why patients should always ask their physicians for a copy of any lab results.

Functional medicine practitioners have further defined that normal reference ranges should be between 1 and 2 μIU/ml, for a healthy person not taking thyroid medications. Anecdotally, most patients feel best with a TSH between 0.5-2μIU/ml

It’s important to remember that reference ranges may not be applicable to everyone. What is normal for one person may be abnormal for the next. Reference ranges take into account the average values of 95% of the population. Thus, not everyone falls within the “normal” reference range. If you are in the 5%, you may experience symptoms of hypothyroidism or hyperthyroidism with TSH values that are considered normal. All doctors are taught the old adage “treat the patient and not the lab tests,” but unfortunately not many conventional doctors seem to follow this advice.

For more information on TSH, other tests and how you can take charge of your own health (including a letter for your physician), go to http://www.thyroidrootcause.org/1/post/2013/09/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but.html

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