Joris Bartstra, doctor and journalist, answers reader questions
I (woman, 57 years old) am healthy but have a busy job. Due to complaints, I had my thyroid values determined twice: TSH 4.2 and after 3 weeks 4.8 with a T4 of 14.1. Should a trial treatment with thyroid hormone be considered?
That’s a tricky question. A lack of thyroid hormone causes complaints such as fatigue, muscle weakness, sluggishness, memory problems, in short, all things that you also get when you are overloaded or not feeling well; what can be good if
you get older and the stress at work increases.
The thyroid gland makes the thyroid hormone T4, which is converted in your body tissues into T3: the most effective form. The production of T4 is ‘regulated’ by the thyroid stimulating hormone (TSH). This is made by the pituitary gland. The most sensitive test for the thyroid is measuring the TSH, because when there is a shortage of thyroid hormone, the pituitary gland tries to correct this by increasing the TSH.
The normal value of the TSH is lower than 4. The normal value of T4 is 9 to 24. When, like you, the T4 is normal, but the thyroid gland needs extra stimulation in the form of a slightly elevated TSH, you call this a subclinical hypothyroidism.
There is much debate about how to approach this. Most and the best conducted studies show that it doesn’t help you. However, there are also studies that do show some benefit, especially for your cognitive functioning and your mood. According to the guideline of the general practitioners, you can therefore do a test treatment with thyroid hormone in the event of persistent complaints, but the TSH must then be higher than 6. In your case I would therefore see whether there is something to improve about the stress and if the complaints If it hasn’t passed in a few months, I’d get another shot.
Sources):
- Plus Magazine
