The Case:  Linda was having trouble with anxiety and sleep Routine blood work revealed a very high TSH (thyroid stimulating hormone) and she was given a medication to treat hypothyroidism. Linda wondered why she didn’t have many of the typical symptoms for hypothyroidism and worried that going on medication might be the wrong move.   Even though Linda was happy to have an answer, something didn’t add up. She was told to get on the medication, regardless of whether she showed typical symptoms or not. Linda wasn’t convinced. That’s when she came to see me.    The Investigation Linda was right to question her results and her treatment even though her numbers were very high. I knew I needed to figure out the root cause of her elevated TSH and determine if there might be a way to get her back into optimal range.    Normal Range for Thyroid Stimulating Hormone (TSH)  The regular lab range for TSH is between .5 and 4.5, but the more functional range that we want to aim for is really between 1.8 and 3 if not medicated. Linda’s TSH was at 19, which was why her doctor was immediately alarmed.    Evaluating Thyroid Markers or Why You Need To Test All Thyroid Markers In order to truly evaluate the thyroid, it is very important to test all of the thyroid markers (as I explained in Episodes 27 & 28). We ran a second blood test with TSH and all the thyroid hormones as well as all 3 antibodies: TPO, thyroglobulin, and TSI antibodies. When the results came back with high TSH (even higher than before!), the interesting thing was that the other actual thyroid hormone markers were completely normal. Linda’s T3 and T4 were at optimal levels. Typically, when those thyroid hormones drop, the body’s signal to correct that would be raising the TSH. We were able to see here that the other hormones had not dropped in the first place, so that was not the reason the TSH was up.    High TSH with High Thyroid Antibodies  In Linda’s case, she didn’t have typical hypothyroid or slow thyroid symptoms and her thyroid hormones were normal. Her TPO antibodies however were 529, which is quite high. Her thyroglobulin antibodies were also slightly elevated at 42 and her TSI antibodies were negative. TSI antibodies are representatives of Graves disease, so she didn’t have that, but TPO and Thyroglobulin antibodies are representative of Hashimoto’s. Linda’s results were positive for TPO and Thyroglobulin, which showed us that she had Hashimoto’s.    Hashimoto’s and Thyroid Inflammation When there is Hashimoto’s there can also be thyroid inflammation. I have found that when the thyroid is inflamed, the TSH can go up without it triggering any low thyroid hormones. This is not what the textbooks say in typical cases, but as we know here at Health Mysteries Solved, many of us are not textbook cases, and issues can be complex!   Misdiagnosed Hypothyroidism  Our bodies have tons of feedback loops and when all the loops work like they are supposed to, then we can follow a textbook pathway to healing. But, in many cases, there are other issues at play from stress to autoimmunity to toxicity, to the foods that we eat. It’s not uncommon that the feedback loops may not work the way we think they should. In this case, High TSH is showing inflammation of the thyroid rather than an actually slow thyroid. This not only explains why she didn’t have hypothyroidism symptoms, but also that the inflammation could have actually been triggering the anxiety and sleep issues.    Medication when Necessary I was so happy that I met Linda so that we could work on the inflammation. In her case, medication was actually not necessary because her thyroid hormones were normal.  Even though I am always trying to find natural solutions, I am not anti-medication when truly necessary. Especially when it comes to thyroid medication. As some of you may know, I take a small dose of compounded thyroid medication because I have hypothyroidism. My perspective is that when the thyroid truly is slow, medica