What a normal TSH means at 60
Your lab prints a range and your result falls inside it, so the thyroid gets crossed off. Dr. Martin's objection is not the number you got. It is how much room there is inside the word normal.
Dr. Martin on the range itself:
Dr. Martin, The Doctor Is In, Episode 605Before the TSH numbers, and by the way, there's a broad range of TSH.
Dr. Martin, The Doctor Is In, Episode 605It is eternity between low and high TSH numbers, I mean that.
Two women can both be told normal and be nowhere near each other. He says that is why he reads the number a little differently, and why after enough years he can look at a thyroid result and say you probably have a sluggish thyroid. But more than anything else, he says, he is interested in the symptoms.
What TSH measures, and what it does not
This is the piece almost nobody is told. TSH stands for thyroid stimulating hormone, and the clue is in the word stimulating. It is an instruction, not an output.
He walks the chain through. It starts in the hypothalamus, goes to the pituitary, and the pituitary tells the thyroid to get moving. Only then does the thyroid release T1, T2, T3, T4 and calcitonin.
Dr. Martin, The Doctor Is In, Episode 605The thyroid does nothing on its own, and your thyroid is very finicky.
His word for the thyroid is a puppet, on strings held by the hypothalamus and the pituitary. Measuring the instruction from the brain is not the same as measuring what the gland delivered, and it is a long way from measuring what your cells actually received.
"It is eternity between low and high TSH numbers, I mean that."
Dr. Martin, The Doctor Is In, Episode 605Where the test came from, and why 1975 matters
Dr. Martin, The Doctor Is In, Episode 605But, anyway, the TSH test was developed in 1975.
He asks the obvious follow up. What did doctors do before that? They looked at symptoms. Dry skin, brittle nails, the weight, the cold, the exhaustion.
His worry is what happened to that skill once a number existed. He says physicians have been hijacked, by the drug companies and by the lab, and that the lab became king. He is careful with it: he is not saying the lab does not matter, he ran plenty of lab work himself. He is saying it should not be the only witness called.
The instruction he gave the people who worked with him for years was one line. Symptoms are more important than the lab.
T4 to T3, the conversion the number never shows
Here is where a normal TSH can sit on top of a thyroid that is not delivering.
Dr. Martin, The Doctor Is In, Episode 605But what your thyroid needs to work at 100% is T3.
T4 has to be converted into T3, and T3 is the one he calls the most important thing in your body. If that conversion is not happening properly you can be slow, cold and exhausted while the signal from your pituitary reads perfectly ordinary. The TSH number does not show the conversion at all.
He names what he thinks blocks it, and the first one is aimed squarely at women. Too much estrogen against your progesterone, which he calls estrogen dominance, and he says menopause does not take you off that list. Second, a fatty liver, because he says what gums up your liver is going to gum up your thyroid. Third, and this one surprises people, not eating enough cholesterol, because your body needs it to make and to carry hormones.
Why a normal number and real symptoms sit together
He says this was the number one condition misdiagnosed in his office, and that the people walking in were often ahead of the paperwork. Doc, I think it is my thyroid, but my doctor says no.
Then he makes the comparison that explains the gap, and it is the sharpest thing he says on the episode.
Dr. Martin, The Doctor Is In, Episode 605Like the thyroid, they developed a medication for your TSH, and it can regulate your TSH, but you don't even feel any better.
He is not telling anyone to stop a prescription, and he says so in the same breath: am I telling you not to take your medication? No, I am not. His point is narrower than that. A medication that moves the number has moved the number. Whether you feel better is a separate question, and it is the question he wants asked.
What to ask for alongside TSH
None of this is a diagnosis, and none of it is a reason to change anything your own doctor has you on. It is the wider picture he would want in front of him before calling a thyroid fine.
- The symptoms written down first, since he ranks them above the lab
- Where inside the range the number actually sits, not just whether it is inside it
- Whether anything has been done about the T4 to T3 conversion, which TSH does not show
- The estrogen and progesterone picture, since he names estrogen dominance as the first blocker
- The liver, because he says a fatty liver gums up the thyroid with it
That is also why he says the thyroid never acts on its own, which is worth reading next: the thyroid never acts on its own.
Common questions
What is a normal TSH for a 60 year old woman?
There is a standard lab range, and Dr. Martin's issue is that it is very wide. He says it is an eternity between the low and the high TSH numbers, so he reads the result alongside the symptoms rather than on its own.
Can you have thyroid symptoms with a normal TSH?
In his experience, constantly. He says that combination was the number one misdiagnosed condition in his office, especially in women.
Why does TSH not show the whole thyroid picture?
Because TSH is the signal from the pituitary, and the body runs on T3. The number does not show whether your T4 is converting into T3.
When was the TSH test developed?
1975, he says. Before that, doctors worked from symptoms, which is the habit he thinks got lost once a number was available.
Read next: Thyroid Issues For Older Women: What Slows It Down and Hypothyroidism After 60: What Changes.
Where Thyroid Support fits
Martin Clinic's Thyroid Support is the one he points at when the aim is the conversion and the load on the thyroid rather than the number on the page.
60-day money-back guarantee. Estrogen is the first blocker he names, and that is Hormonal Support Formula.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
