What Does My Blood Test Report Indicate?

Posted on Fri, 4 Aug 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 4 Aug 2017 Answered on

Thu, 24 Aug 2017 Last reviewed on

Question : I had blood work done this week prior to my Wellness exam which is Monday, August 7. My test results were posted on "My Chart". I am concerned about my TSH results. My value was 5.45 and the standard range, according to the printout is 0.450-4.500. Does this mean I'll have to take thyroid medication? This is the first time my Dr has tested for this.

Answered by Dr. Binu Parameswaran Pillai (13 minutes later)

Brief Answer:
Likely sub clinical hypothyroidism

Detailed Answer:
Good day
Noted your question. I gather that, on a routine testing your blood reports showed mild elevation of TSH. It is common for TSH to go up at your age and normal TSH range for people above 75 years is not clearly defined. Most doctors beleive this mild elevation of TSH is protective to slow down the metabolism. The next step in your case would be to order for full thyroid function tests like Free T4, TSH and Anti TPO Antibody. Based on these results we need to decide on treatment. If your free T4 is normal and if anti TPO Antibody is negative, you wouldn't require any treatment and we will have to repeat another rest after three to six months.
Regards
Binu

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Binu Parameswaran Pillai (16 minutes later)

Thank you XXXXXXX I was not aware that it is common for TSH to go up at my age.
I will discuss this with my doctor on Monday. Since I had never been tested for this in the past, and because I saw my results were out of normal range, I got concerned and did not want to wait until Monday to hear my Doctor's explanation.
We'll see if he orders further tests, as you suggested.

Thanks again for answering my question.
XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Sublinical hypothyroidism doesn't always need treatment.

Detailed Answer:
Thanks for the reply. The TSH range in children is clearly different to the adult range of TSH. Similarly, Endocrinology community now recognize that TSH level is little higher in elderly population as well.

Most doctors will not want to treat a slightly elevated TSH in an elderly person if the Free T4 is normal and if there is no thyroid gland enlargement. Slight elevation is said to be an adaptive mechanism at this age to reduce metabolism. I am sure that your doctor will order a complete thyroid test including a free T4 and decide further.

If the TSH was more than 10 or if the free T4 is low, treatment is surely needed.
Regards
Binu

Above answer was peer-reviewed by : Dr. Remy Koshy