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Questions for Dr. Kennedy
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TSH levels
Posted by: Nora
Date: April 29, 2002 1:11 AM

Since July of last year my TSH serum levels have been dropping. In July the level was at 1.18, Oct. 1.00, Nov. 0.98, Dec. 0.86, Feb., 0.85 and now in April 0.77. My T3 is at 29.1 in April and my T4 is 9.9. I have been told my TSH level is normal, however, it is dropping and I have had some symptoms that are anxiety, fatigue, nervousness from time to time. I have been told my readings are normal, however I don't think it is normal for TSH level to be dropping. I went to an endocrinologist in November and I am due to go for another opinion. I have never taken thyroid medication and I have no other health problems except high cholesterol, and blood pressure which will go up when I am stressed.



Edited 3 time(s). Last edit at May 8, 2009 6:36 PM by Dr. Kennedy.

RE: TSH levels
Posted by: Ron Kennedy, M.D.
Date: April 29, 2002 1:40 AM

A Danish study looked at monthly thyroid levels - T4, T3, free T4 index, and TSH of 16 healthy men with over a period of 12 months. They found each individual had different variations of their thyroid function, around unique "set points." Each person had his own normal level, and people tended to fluctuate slightly within their own range. These findings led to the possibility that thyroid test result within a laboratory's "normal range" is not necessarily normal for a particular individual. The researchers concluded the distinction between subclinical and overt thyroid disease (abnormal serum TSH and abnormal T4 and/or T3) is arbitrary, because the patient's normal set point for T4 and T3 within the reference range is illustrative and needs to be taken into account. The most important thing to evaluate in thyroid disorders is the patient's clinical condition. Supporting lab studies are excellent to have, but clinical condition should outrank lab values, especially when lab values are on the cusp. While your T3 and T4 are in the normal range, the important test is not mentioned (free T3). This fraction of T3 correlates better than any other measurement with metabolic rate. Ask for that test.



Edited 2 time(s). Last edit at May 8, 2009 6:37 PM by Dr. Kennedy.



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