Article: The first thyroid test that is generally taken by physicians is the TSH. TSH stands for "Thyroid Stimulating Hormone," which is created by the pituitary gland and stimulates the thyroid to create and release hormones T4 and T3.  TSH can be thought of as the metaphorical "engine" of the thyroid gland, in that it determines the amount of thyroid hormone that is synthesized and then released from the thyroid into the body. A normal value for TSH is between 0.4 – 4.0 mIU/L.  If your TSH is in this range, that is a good sign; however, a normal TSH value does not completely rule out thyroid problems. TSH values on the high end of normal can indicate potential thyroid problems that are evolving. Most thyroid problems require two or more tests to detect and diagnose, given the complex interplay of the various hormones that contribute to thyroid function. Your doctor may order more tests, even if your TSH is normal, if he still suspects that you may have a thyroid problem. TSH tells the thyroid to produce more T4 and T3, which are the hormones released from the thyroid (at the command of TSH) to act throughout the body. If your thyroid is underactive, then it is not releasing enough much T4 and T3, and so your pituitary gland will release more TSH to try and compensate.   Thus, a high TSH may be a sign of hypothyroidism (a condition in which your thyroid gland is producing insufficient amounts of hormones). You will need further testing, however, to further investigate and to confirm such a diagnosis. In addition to a high TSH reading, hypothyroidism also presents with many clinical indications. Tell your doctor if you are experiencing any of the following signs or symptoms, which may be suspicious for hypothyroidism:  Increased cold sensitivity Fatigue Unexplained weight gain Unusually dry skin Constipation Muscle aches and stiffness Joint pain and swelling Depression and/or other mood changes A slower than normal heart rate Thinning hair Changes to your menstrual cycle Slowed thinking or speaking On the other hand, if you have a very low TSH reading, it may be your body's response for your pituitary to produce less TSH due to an excess of thyroid hormone in the body (T3 and T4). As such, a low TSH may be an indication of hyperthyroidism (excess production of thyroid hormone).  Again, further blood tests will be required to confirm such a diagnosis. A TSH reading alone can point your physician down a certain path, but in itself it is usually not diagnostic. Hyperthyroidism presents with many clinical indications, in addition to a low TSH reading. Tell your doctor if you are experiencing any of the following signs or symptoms that may be indicative of hyperthyroidism:  A faster than normal heart rate Unexplained weight loss Increased appetite Sweating A tremor, often in your hands Anxiety, irritability, and/or other mood changes Fatigue More frequent bowel movements An enlarged thyroid gland (which can be felt in your neck, and is called a "goiter") Trouble sleeping Eyes that bulge or protrude more than they normally do (this sign is present in a certain type of hyperthyroidism called Grave's disease — specifically, the eye abnormality is called "Grave's ophthalmopathy") If you have been diagnosed with a thyroid disorder and are receiving ongoing treatment for it, your doctor will likely advise that you receive regular TSH tests to check in on and confirm the effectiveness of your treatment. Ongoing monitoring can also ensure that your TSH level is within the target range.  The treatment for hypothyroid and hyperthyroid conditions are very different. The target range for thyroid treatment is normally a TSH between 0.4.–4.0 mIU/L, although this may vary depending upon the type of thyroid disorder you have. You will likely receive more frequent monitoring at the start of your treatment, until you settle into a routine where your TSH becomes quite consistent (at which point less frequent monitoring may be appropriate, usually about once every 12 months).
What is a summary of what this article is about?
Check to see if your TSH reading is in the normal range. Interpret the possible meanings of a high TSH reading. Look out for signs and symptoms of hypothyroidism. Evaluate the possible meaning of a very low TSH reading. Take note of signs and symptoms of hyperthyroidism. Use your TSH value to monitor ongoing thyroid treatment.