Disease screening tsh is higher

If the physical examination shows that TSH is only slightly higher than the upper limit of the reference value (usually within 0.5-2μIU/ml), and T3 and T4 are completely normal, and there are no hypothyroidism-related discomforts such as cold sensitivity, hair loss, edema, and constipation, in more than 90% of cases, immediate medication is not required. Prioritize the temporary triggers and then reexamine. There is no need to panic.

I just met a 27-year-old e-commerce operator in my clinic last week. When she came in with the physical examination report, her eyes were red. The TSH test showed 4.7. The upper limit of the reference value is 4.2, which is 0.5 higher. She went to Baidu at 3 o'clock the night before and even wrote the script for herself that she would have to take Euthyrox for the rest of her life and not be able to conceive a child.

To be honest, this situation is too common. Many people don't know about TSH. Its full name is thyroid stimulating hormone. To put it bluntly, it is the "messenger" sent by the pituitary gland to the thyroid gland. When the thyroid gland slows down, it rises, urging the thyroid gland to secrete more thyroxine. It is the most sensitive indicator of thyroid function. It can reflect fluctuations several months earlier than T3 and T4. It must be the first to jump at the slightest sign of trouble.

In many cases, this slight increase is not a problem with the thyroid at all, but just a temporary fluctuation. Think about it, did you stay up three days and nights in a row to catch up on projects a week before the physical examination? Did you eat half a box of kelp and two or three drunken crabs the day before? Did you take ibuprofen when you have a cold or fever? Even the hormonal fluctuations before a girl’s period can push TSH higher. I met a 24-year-old boy before. He ate two kilograms of drunken shrimp at a work party. It was found that his TSH spiked to 6.1. He stopped eating high-iodine foods and slept well for a week. When he checked again, it returned to 3.2. Nothing happened.

Of course, there are still differences in how to deal with this slightly elevated subclinical hypothyroidism in the industry. Older senior doctors may be inclined to intervene early with low-dose Euthyrox to bring TSH back to the normal range and avoid subsequent decline in thyroid function. ； But now more young specialists will be more conservative. After all, it is an indicator that fluctuates temporarily, and they cannot just start taking long-term medication just for the sake of a few tenths of an increase.

However, there are exceptions that need to be mentioned separately. If you are preparing for pregnancy or are already pregnant, then this standard must be tightened immediately. No matter how high it is, you must find an endocrinologist for evaluation as soon as possible. The requirements for TSH during pregnancy are much stricter than ordinary people. Adjusting it early will not affect the development of the baby. Also, if the thyroid peroxidase antibody is also found to be high during the reexamination, or you have begun to have obvious sensitivity to cold, feel sleepy even after sleeping 10 hours a day, or gain an unexplained weight gain of five or six pounds, then don’t hold on, follow the doctor’s advice and intervene if necessary.

My general advice to this type of patients is, don’t rush to prescribe medicine when they are diagnosed for the first time. Go back and adjust your work and rest for half a month. Don’t show off kelp, seaweed and wakame all at once, and don’t stay up all night checking your phone. After 1-2 months, recheck thyroid function and antibodies. Most people can return to the normal range after recheck. The e-commerce girl who came here crying before changed her habit of staying up late to change plans. She also went hiking twice on weekends. A month later, her TSH was 3.1 and she went to join the company happily.

In fact, too many young people now have a slightly higher TSH in their physical examinations. Most of them are caused by stress and disordered work and rest. Don’t be scared to death when you see the arrow on the report, and don’t take it seriously and put off re-examination. After all, the physical examination indicators are to remind you of your health, not to issue you a verdict. It’s just a little higher. Adjustments should be made, and re-examination should be done. The sky is not falling.