A patient has elevated TSH but normal T4 and T3.
By standard definition any elevation of TSH indicates hypothyroidism. Usually this elevated level of TSH corresponds with a decrease in T4. That is the way it normally works in the body.
In this case it may not be a thyroid problem at all.
One of the things we look at in all our patients is dysglycemia (abnormal blood sugar).
If you have been reading my posts for a while you will recall the concept of the functional range for blood tests.
Often, the patient's glucose (blood sugar) is considered normal on their blood teat bacause it is still in the "normal" range. In actuality the glucose may be trending high (pre-diabetes).
And guess what?
Pre-diabetes causes many of the same symptoms as low thyroid.
So most patients that go to the doctor with fatigue and the doctor sees elevated TSH then they immediately get put on thyroid hormone.
The underlying blood sugar problem never gets fully investigated and the patient continues to suffer with symptoms because a lab marker was treated and not the patient.
That is why we take a whole person approach and make sure we understand the problems and mechanisms so we can help our patients feel and function well.
So if you are continuing to suffer with thyroid symptoms then maybe it is time to work with someone who is going to spend the time to get to the root of the problem.
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References:
Indian J Endocrinol Metab. 2012 Nov-Dec; 16(6): 958–961