Just wanted to post a correction to the TSH levels - your doc may try to insist that the old, outdated guidelines (.5 to 5.5 or 6.0) are just fine, but they aren't!

The AACE came out with new guidelines in 2003 (just a month ago or so I guess!) that indicate anything out of the range of .3 to 3.04 is indicative of thyroid disease and should be treated.

I will try to copy the article here:


OVER 13 MILLION AMERICANS WITH THYROID DISEASE REMAIN UNDIAGNOSED

~January is Thyroid Awareness Month~
2003 Campaign Encourages Awareness of Mild Thyroid Failure, Importance of Routine Testing
NEW YORK - January 2003 - Did you know that 1 in 10 Americans - more than the number of Americans with diabetes and cancer combined1,2, - suffer from thyroid disease, yet half remain undiagnosed1? In order to counteract this lack of awareness and educate the public about the prevalence of thyroid disease, diagnosis, and treatment, the American Association of Clinical Endocrinologists (AACE) continues its annual thyroid awareness campaign. The 2003 campaign, Hiding in Plain Sight: Thyroid Undercover, launched today in conjunction with AACE's annual sponsorship of Thyroid Awareness Month.

New clinical guidelines published by AACE in November 20023 not only enable doctors to more easily identify patients with thyroid disease, but also provide treatment standards. Using a simple blood test called the thyroid stimulating hormone (TSH) test, any physician can determine whether someone is suffering from an overactive or underactive thyroid - in many cases, even before patients begin to experience symptoms4.

Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range5 . Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.04. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now.

"The prevalence of undiagnosed thyroid disease in the United States is shockingly high - particularly since it is a condition that is easy to diagnose and treat," said Hossein Gharib, MD, FACE, and president of AACE. "The new TSH range from the AACE guidelines gives physicians the information they need to diagnose mild thyroid disease before it can lead to more serious effects on a patient's health - such as elevated cholesterol, heart disease, osteoporosis, infertility, and depression."

If the thyroid gland doesn't work properly, neither do you. The thyroid gland, a butterfly-shaped gland located in the neck just below the Adam's apple and above the collarbone, produces hormones that influence essentially every organ, tissue and cell in the body6 . If thyroid disease is left untreated, it can lead to such complications as elevated cholesterol levels and subsequent heart disease, infertility, muscle weakness, osteoporosis and, in extreme cases, coma or death7 .

Thyroid disease is of particular concern to women, since they are five to eight times more likely than men to be diagnosed with the condition8. The elderly are also at increased risk for the disease - by age 60, as many as 17 percent of women and nine percent of men have an underactive thyroid9. Thyroid disease is also linked to other autoimmune diseases, including certain types of diabetes, arthritis, and anemia10. For example, 15 to 20 percent of people with Type 1 diabetes, as well as their siblings or parents, are at a greater risk of testing positive for a thyroid disorder11.

Eighty percent of patients diagnosed with thyroid disease have hypothyroidism (underactive thyroid)12. Common symptoms of hypothyroidism include: fatigue, forgetfulness, depression, constipation, and changes in weight and appetite4. The good news is that this serious condition is easily treatable by taking a levothyroxine sodium pill once a day to restore thyroid hormone to its normal level4. Once a patient is stabilized on medication, switching brands or dosage is not recommended unless otherwise directed by their physician4.

"Because the symptoms of thyroid disease are somewhat vague or subtle, patients often don't know they should be asking their doctor for a TSH test," said Gharib. "In fact, many patients have said they didn't realize they were ill until they began treatment and started feeling more energetic and healthy."

Although mild hypothyroidism can often be treated by a primary care physician, AACE recommends that certain types of hypothyroidism patients see an endocrinologist:

Patients of age 18 years or less
Patients unresponsive to therapy
Pregnant patients
Cardiac patients
Presence of goiter, nodule, or other structural changes in the thyroid gland

Presence of other endocrine disease
While the TSH blood test is the most sensitive and accurate diagnostic tool for thyroid disease, AACE also recommends that patients perform a simple self-examination called the Neck CheckTM. This easy, quick self-exam, unveiled by AACE in 1997, helps Americans detect if they have an enlarged thyroid gland and should speak with their doctor about further testing.

For step-by-step instructions on how to perform the Neck CheckTM, or to view the new AACE clinical guidelines for hypothyroidism and hyperthyroidism, visit the AACE web site at www.aace.com.

The American Association of Clinical Endocrinologists (AACE) was established in 1991 and is the country's largest professional organization of clinical endocrinologists. Its membership consists of more than 4,200 clinical endocrinologists devoted to providing care for patients with endocrine disorders. The association strives to improve the public's understanding and awareness of endocrine diseases and the added value of the clinical endocrinologist in the diagnosis and treatment of these diseases.


Thyroid Awareness Month is supported through an unrestricted grant from Abbott Laboratories.

1National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States. National Institutes of Health, et al, 1997
2Johns Hopkins Urban Health Institute, Special Projects, Johns Hopkins University, 2001
3AACE Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism, Endocrine Practice, Vol. 8, No. 6, Nov/Dec 2002.
4Rosenthal, M. Sara The Thyroid Sourcebook, Lowell House, Los Angeles, 1996 (pp. 37-38)
5Wood, L.C. Your Thyroid: A Home Reference, Ballantine Books, New York, 1995 (p.229)
6Wood L.C. Your Thyroid: A Home Reference, Ballantine Books, New York, 1995 (pp. 1-3)
7Singer P.A. Treatment Guidelines for Patients With Hyperthyroidism and Hypothyroidism, JAMA 1995: 273: 808-812.
8Wood L.C. Your Thyroid: A Home Reference, Ballantine Books, New York, 1995 (pp. 216-217)
9Wood L.C. Your Thyroid: A Home Reference Ballantine Books, New York, 1995 (pp. 179)
10Wood L.C. Your Thyroid: A Home Reference Ballantine Books, New York, 1995 (pp. ?)
11Adams A, Walston J, Silver K. Autoimmune Disease Risk in Families with Type 1 Diabetes, www.genetichealth.com 10/27/01
12Hollowell study

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