High TSH Levels: Lab Interpretation for New Nurse Practitioners

[@foodgroupie158]

Thank you so much for taking the time to help your fellow NPs out!!

[@RealWorldNP]

You're so welcome!!

[@marbelz.p6018]

Winner of a video, been searching for "what blood tests show thyroid problems?" for a while now, and I think this has helped. Ever heard of - Mabammeston Bewildering Method - (just google it ) ? It is a good exclusive guide for discovering how to say goodbye to hypothyroidism without the normal expense. Ive heard some amazing things about it and my co-worker got great results with it.

[@mauronicolascanseco1643]

This is just superb, I been tryin to find out about "should subclinical hypothyroidism be treated?" for a while now, and I think this has helped. Have you ever come across - Liyenry Straightforward Leverage - (Have a quick look on google cant remember the place now ) ? It is a good one off product for discovering how to stop your hypothyroidism problem minus the hard work. Ive heard some awesome things about it and my neighbour got excellent success with it.

[@bluecurlygirl]

@@marbelz.p6018 Go check out Dr. Westin Childs for a comprehensive list of blood tests to get done. They MUST include reverse T3. A lot of docs disregard it saying it is unimportant but it is absolutely VITAL. Also ongoing thyroid issues can affect so many other things in the body. Vitamin D, hormones, iodine levels, blood sugar ... the list goes on. Dr. Childs give some really good solid information and plenty of studies to back it up too. Far better than the advice given here.

[@teddychannel4701]

Love your teaching style and I’m learning so much from your videos

[@RealWorldNP]

Awesome! Thank you!

[@PrincessAisha2006]

I am really excited for the lab interpretation class! When can we expect it!? Great video again, helps reinforce the topic esp this is soo common in primary care.

[@RealWorldNP]

Thanks so much!! I'm hoping for a mid-November, limited first-edition class, with the full launch after the holidays! I'll keep you posted!

[@Meechka]

Hey total T4 is still an important test if Ft4 is low. You Shouldn't rule out the usefulness of a Total T4 test just because 99% of it is bound to transport proteins. If Ft4 is low and Total T4 is low it tells you there is something wrong with the overall production of T4. Likely there is something wrong with the Thyroid. If Ft4 is low and Total T4 is normal, then it tells you the problem isn't in the production of the hormone but is likely in the transport proteins or binding globulins. Then Testosterone, estrogen, or cortisol levels as well as birth control, cortisone meds, prednisone or estrogen replacement could be the cause of the problem. Just prescribing T4 meds such as synthroid without looking deeper into the cause of the problem is no longer acceptable to patients. SO YES, TOTAL T4 is still a valid test to be running. You need to know what is the cause of the problem. Quit letting pharmaceutical run schools dictate how you treat the patient. Just prescribing meds based on incomplete lab work is not acceptable to those of us who have a health issue.

[@RealWorldNP]

Thanks for the input!

[@aprilg3299]

I was told to go with standard dosing as well. I usually do

[@RealWorldNP]

Thanks for watching :)

[@liufox1292]

This was great, I have been researching "hyperthyroid vs hypothyroid tsh levels" for a while now, and I think this has helped. Have you ever come across - Mabammeston Bewildering Method - (do a google search ) ? It is a good one of a kind product for discovering how to say goodbye to hypothyroidism without the hard work. Ive heard some unbelievable things about it and my brother in law got excellent results with it.

[@hibye564]

Identify the changes in TSH and TRH secretion that you would expect to see in a patient with hypothyroidism due to iodine deficiency, can you please explain this question?

[@RealWorldNP]

Hypothyroidism due to iodine deficiency is extremely rare in adults, but the clinical findings and lab results would be the same as in other causes of hypothyroidism, and patients may have a goiter as well.

[@Tonnie31]

Thank you your videos are sooo helpful

[@RealWorldNP]

You're so welcome!! I'm so glad :)

[@usamaragab4516]

Thanks Very informative talk Go on...

[@RealWorldNP]

Thank you!

[@Tonnie31]

Thank you so much Liz this was very helpful

[@RealWorldNP]

Glad it was helpful!

[@lisahuang9384]

Thank you Liz. Your videos have been very helpful to me. If a patient has repeated elevated Tsh in 2 months, but normal free T4 and total t3, and they are asymptomatic. How often do you ask the patient to come back and check her thyroid? Thank you

[@RealWorldNP]

Hey there - for safety and legal reasons, I can't advise on specific patients. I do, however, want you to know that our Lab Interpretation Course is launching within the next week. I hope you think about checking it out!

[@bluecurlygirl]

Dr. Westin Childs has videos on exactly this. You should check out his channel. Hope this helps. If your TSH is above 2.5 you should be getting treatement. Even if your T3 and T4 are normal.

[@MonicaDiaz-ju4cj]

Do you have a video for hyperthyroidism?

[@RealWorldNP]

I teach it in my Lab Course - www.realworldnp.com/labs -check it out!

[@johnmontana18]

If thyroid is not producing, is the TSH useless?

[@RealWorldNP]

Not necessarily. The goal should be to find out the cause to determine next steps.

[@olexiia934]

Hi, What are the optimal levels for TSH, T3 free, T4free and other thyroid biomarkers@

[@RealWorldNP]

Hi there! It depends on the reference range of the specific lab the sample is being sent to! Also, Total T3 is the test of choice for T3, NOT free T3. Free T4 is the test of choice for assessing hypothroid when it comes to T4 assessment.

[@olexiia934]

@@RealWorldNP I don’t mean the lab range. It’s very broad. For example for my TSH I like to see around 1.2 to 2.4 that’s the optimal range. However, 4.3 is still good range according to the labs. U can not be healthy if your TSH is 4.3!!

[@divinedigitalpro]

I received my results and wast tested for TSH w/reflex to FT4 is 0.83 Is that normal?

[@RealWorldNP]

Hi Andrea! I am sorry, but for legal and safety reasons I can't advise on your case. I always refer people back to their primary care provider who know your history.

[@gary-gt-tsang]

Thank you Liz, your videos have been very helpful and informative. I have a case that I am not sure. A 35yo female has 14 lbs gain over 10months. States she has been eating a lot during covid. Denies constipation, hair thinning, brittle nail, or cold intolerance, does endorse usual 8days menstruation with 2 extra spotting days after intercourse with her spouse in the past 2 months. Her tsh Twas 5.1normal free t4 and total t3. has ldl 150. Hdl and triglycerides normal. Does not feel depress. Would you start treatment on her? Does hypothyroidism cause sudden or gradual weight gain? Thank you

[@RealWorldNP]

Hey there - I am sorry I can't advise on this due to safety and legal reasons, but if you are interested, our Lab Interpretation Course will be launching in the next week. We hope you'll check it out!

[@donnac716]

Is treatment required for TSH 4.700?

[@RealWorldNP]

I am so sorry, but for legal and safety reasons, I can't advise on this specific case.

[@wendye2916]

I would love to know more about fatigue work up.

[@RealWorldNP]

Totally!! I plan to do a fatigue video, stay tuned!

[@queenaura1]

Yes, very interested on the workup for this as well. It's such a general complaint but so common as well!

[@wonderstv1694]

THANQ

[@RealWorldNP]

You're welcome! Thanks for watching

[@user-ws8ie8gx6n]

Could you do hyperthyroidism

[@RealWorldNP]

Hey! So I actually have hyperthyroidism already inside the Lab Interpretation Crash Course if you'd like to join us there! It's at www.realworldnp.com/labs , and comes with reference cheat sheets and algorithms for practice.

[@yingkionglab8143]

👍👍👍👍👍

[@RealWorldNP]

Thanks!

[@deepalikulkarni9173]

Nice info. How to contact you?

[@RealWorldNP]

You can reach out to us at [e-mail] with any questions

[@akhilaakhi8917]

Tsh level above 100.what should i do😥

[@RealWorldNP]

I am sorry, but for legal and safety reasons I can't advise on your specific case.

[@DarkoFitCoach]

Go to a doc and get urself medication to speed up thyroid and correct that horrible tsh

[@lisailg5947]

Love the information. However, your speech is so fast it is difficult to understand.. Could be the speakers? Not certain, but when explaining it would greatly help to slow down and not abbreviate please. Those of us rubies need clear explanations. Lol..

[@RealWorldNP]

Hi! There is a gear looking icon underneath the video that allows you to speed up or slow down the video. These were made a while ago, and since then, I have worked to slow down my speech. In any case, try the gear to slow it down - hope it helps!

[@LarryCleveland]

I usually speed up videos 1.5x Glad to not half to here. I listen fast and read slow lol

[@mariaelenaavila4761]

You talk too fast....

[@RealWorldNP]

At the bottom of the video screen is a symbol that looks like a gear, a circle with ridges, click on that and you can slow down any video to a speed that works for you. I made this video a long time ago, and have worked weekly on the speed of my speech to make it better. Thank you for your input.