Diagnosing Hypothyroidism – Under-active Thyroid

Author: Henry Sobo, MD
Sharp Again Advisory Board Member

In 2003 the American Association of Clinical Endocrinologists released new guidelines which narrowed the “normal range” of the test called TSH –thyroid stimulating hormone-which is used by doctors to diagnose thyroid problems. It was their judgment that many Americans who could benefit from treatment were going undiagnosed. By narrowing the acceptable range that indicates normal thyroid function, possibly millions of Americans would receive thyroid medication benefiting them. The idea was not acted upon, and to this day, many physicians feel that people are not getting the necessary treatment that would improve their symptoms of hypothyroidism. Common symptoms are fatigue, weight gain, and constipation. Also, since thyroid affects every cell and organ in the body, there may be many other associated problems such as high cholesterol, infertility, muscle weakness, and osteoporosis.

The “normal” range for the TSH test is between 0.4 and 4.5; the higher the number, the more likely the condition of hypothyroidism exists. The American Association of Clinical Endocrinologists suggested that the upper limit of the normal range should be 3.04. A person who has been told by their doctor that their thyroid is normal, and yet finds that they have a TSH test above 3, with associated symptoms of hypothyroidism, should discuss with their physician whether thyroid treatment is appropriate. If the physician is unwilling to institute a trial of treatment, it may be wise to seek a second opinion.