15 doctors weighed in:
I was told I was hypothyroid and my TSH was 4.22. Should I start medication or is there an alternative?
15 doctors weighed in

Dr. Mark Deutsch
Surgery - Plastics
5 doctors agree
In brief: Hypothyroidism
As physicians we treat patients not lab values.
There are many reasons to start thyroid hormone replacement with a TSH in the elevated range. Symptoms of fatigue; weight gain; changes in hair, skin, and nails; an cold intolerance are common in patients with hypothyroidism and could be improved with initiation of thyroid homone replacement.

In brief: Hypothyroidism
As physicians we treat patients not lab values.
There are many reasons to start thyroid hormone replacement with a TSH in the elevated range. Symptoms of fatigue; weight gain; changes in hair, skin, and nails; an cold intolerance are common in patients with hypothyroidism and could be improved with initiation of thyroid homone replacement.
Dr. Mark Deutsch
Dr. Mark Deutsch
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Dr. Susan Wingo
Internal Medicine - Endocrinology
5 doctors agree
In brief: Maybe
A TSH of 4.22 is high-normal.
Reasons to treat with thyroid hormone would include pregnancy, symptoms (feeling cold, constipation, fatigue, recent weight gain), presence of a goiter (enlarged thyroid), or family history of hypothyroidism. Otherwise, waiting to see if this progresses makes sense before starting what is likely to be lifelong treatment.

In brief: Maybe
A TSH of 4.22 is high-normal.
Reasons to treat with thyroid hormone would include pregnancy, symptoms (feeling cold, constipation, fatigue, recent weight gain), presence of a goiter (enlarged thyroid), or family history of hypothyroidism. Otherwise, waiting to see if this progresses makes sense before starting what is likely to be lifelong treatment.
Dr. Susan Wingo
Dr. Susan Wingo
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Dr. Soroosh Armandi
Anti-Aging Medicine
5 doctors agree
In brief: Symptoms?
Tsh alone is not diagnostic.
Besides your TSH is not high, its close to cut off. Illness, meds, and stress can make TSH abnormal, however, your thyroid hormones maybe normal. That's known as subclinical hypothyroidsim. Subclinical hypothyroidism should only be treated if patient has symptoms and can benefit from thyroid hormone replacement! otherwise i wouldnt worry about it.

In brief: Symptoms?
Tsh alone is not diagnostic.
Besides your TSH is not high, its close to cut off. Illness, meds, and stress can make TSH abnormal, however, your thyroid hormones maybe normal. That's known as subclinical hypothyroidsim. Subclinical hypothyroidism should only be treated if patient has symptoms and can benefit from thyroid hormone replacement! otherwise i wouldnt worry about it.
Dr. Soroosh Armandi
Dr. Soroosh Armandi
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5 doctors agree
In brief: Abnormal TSH
You can start checking also the iodine, and using t3-t4, like armour.Be sure have a thyroid ultrasound, others hormones levels, r/o cyst/nodule.
Check if you are using diuretics , those can increase the tsh.A complete medical review checking autoimmune , pinneal gland , check with your pcp or endocrinology sp.

In brief: Abnormal TSH
You can start checking also the iodine, and using t3-t4, like armour.Be sure have a thyroid ultrasound, others hormones levels, r/o cyst/nodule.
Check if you are using diuretics , those can increase the tsh.A complete medical review checking autoimmune , pinneal gland , check with your pcp or endocrinology sp.
Dr. Lourdes Margarita Landron-Garcia
Dr. Lourdes Margarita Landron-Garcia
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Dr. Shabbir Hossain
Internal Medicine
3 doctors agree
In brief: Perhaps not hypo
The TSH is a very sensitive test to assess thyroid status.
4.22 is normal by most cutoffs. I would look to other reasons to explain your symptoms if your TSH is normal. If your doctor is convinced you are hypothyroid i'd repeat the test to make sure it's not a lab error. Taking extra thyroid supplements when your TSH is normal could give you hyperthyroid symptoms and thats not healthy.

In brief: Perhaps not hypo
The TSH is a very sensitive test to assess thyroid status.
4.22 is normal by most cutoffs. I would look to other reasons to explain your symptoms if your TSH is normal. If your doctor is convinced you are hypothyroid i'd repeat the test to make sure it's not a lab error. Taking extra thyroid supplements when your TSH is normal could give you hyperthyroid symptoms and thats not healthy.
Dr. Shabbir Hossain
Dr. Shabbir Hossain
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1 doctor agrees
In brief: Medical criteria
For the last few years lab and md are in discussion the maximum TSH .
Some md are considering no more than 3.5 , and the target with treatment no more than 2.If the patient is presenting symptoms and signs related to thyroid gland have to be address. The medical history is important and relevant , together with other test patient will be advise better. Is true the TSH value is to sensitivity.

In brief: Medical criteria
For the last few years lab and md are in discussion the maximum TSH .
Some md are considering no more than 3.5 , and the target with treatment no more than 2.If the patient is presenting symptoms and signs related to thyroid gland have to be address. The medical history is important and relevant , together with other test patient will be advise better. Is true the TSH value is to sensitivity.
Dr. Lourdes Margarita Landron-Garcia
Dr. Lourdes Margarita Landron-Garcia
Thank
Dr. Su Fairchild
Integrative Medicine
In brief: Depends
Please make sure you get thyroid antibodies, iodine, selenium, b12, and iron levels checked also.
http://drfairchild.blogspot.com/2012/12/proper-thyroid-testing.html over 4 is definitely not a normal tsh. Make sure it is not hashimoto's.

In brief: Depends
Please make sure you get thyroid antibodies, iodine, selenium, b12, and iron levels checked also.
http://drfairchild.blogspot.com/2012/12/proper-thyroid-testing.html over 4 is definitely not a normal tsh. Make sure it is not hashimoto's.
Dr. Su Fairchild
Dr. Su Fairchild
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Dr. Michael Rothman
Internal Medicine
In brief: TSH range
Some scientific studies show that the opitmal range for TSH is 0.
8-2.1 in fact a TSH >2.5 is associated with Insulin resistance, as the TSH increases (above 2.5) the LDL goes up and the HDL goes down. You definitely need to be treated for this or your long term health will suffer.

In brief: TSH range
Some scientific studies show that the opitmal range for TSH is 0.
8-2.1 in fact a TSH >2.5 is associated with Insulin resistance, as the TSH increases (above 2.5) the LDL goes up and the HDL goes down. You definitely need to be treated for this or your long term health will suffer.
Dr. Michael Rothman
Dr. Michael Rothman
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