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Why TSH Thyroid Test Can Be Misleading

TSH testing is the standard test when it comes to screening for Thyroid disease. Unfortunately, there are many problems with the TSH test. In this article, you will learn why TSH Thyroid Test Can Be Misleading.


In this blog post, I will explain why this common thread exists among people who seek natural treatment methods for Thyroid.

Understanding Optimal TSH Levels – see video below.

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The symptoms and signs of low thyroid function most often cited are:

  • Fatigue
  • Weakness
  • Weight gain or increased difficulty losing weight
  • Thinning hair on scalp/hair loss
  • Cold intolerance (you can’t tolerate cold temperatures like those around you)
  • Muscle cramps and frequent muscle aches
  • High Cholesterol
  • Constipation
  • Depression
  • Irritability
  • Memory loss
  • Inability to concentrate
  • Abnormal menstrual cycles/Heavy period
  • Infertility
  • Decreased libido

There are many other signs and symptoms of thyroid malfunction which you can read about on my thyroid page. For even more information, read my thyroid eBook (use the form to your right to request a free copy) Having thyroid symptoms without having abnormal thyroid tests is more common than you might think. I know I was surprised when I started helping people with this conundrum.

Most often the first thyroid marker tested is TSH, which stands for Thyroid Stimulating Hormone. This hormone is made by your master gland, the pituitary gland, and essentially tells the thyroid gland to kick up its production of thyroid hormones T4 and T3.

Often, TSH is normal and will fluctuate up and down, especially when you have the most common cause of low thyroid symptoms in North America. Reportedly 90% of thyroid symptom sufferers are due to an autoimmune process called Hashimoto’s.

Recently I was reviewing tests submitted from a man who came from out of state with vertigo and tinnitus as his main health complaint. The blood tests he brought in were sparse, but showed a normal TSH. This man’s test results came with the following statement regarding thyroid testing:

I feel the described thyroid testing protocol is fundamentally flawed. I have found that patients with thyroid symptoms often have normal blood TSH levels, even when compared to the tighter optimal functional range as recommended by the Endocrine Society (which is 1.8-3.0 mIU/L).

As you can see in the March issue Expert Review of Endocrinology and Metabolism, Hashimoto’s autoimmune Thyroiditis can exist with normal TSH levels.


Strategically, like other health care practitioners who use the functional medicine approach, I always look at all 10 thyroid tests and often find several thyroid markers out of range. An example of such out of range testing is shown below:


As you can see, the standard TSH and T4 markers are normal, however free T3 (fT3) and Thyroid Binding Globulin (TBG) and Thyroid Peroxidase Antibodies (TPO – Ab) are all out of range. This particular patient actually has Hashimoto’s (an autoimmune condition affecting the thyroid gland) and a problem with low levels of the protein that carries thyroid hormones in the blood stream (TBG).

If a doctor ONLY ordered TSH and T4 on this patient, they would have told the patient that their tests are normal. This is why only testing TSH can be misleading.

I have written other posts that explore the reasons Hashimoto’s is triggered by various substances, and environmental factors, which I recommend you read and share.

See Other Recent Post!

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