TSH Result Meaning — Underactive or Overactive Thyroid

TSH is the pituitary hormone that tells the thyroid to work. Its relationship with thyroid function is inverted, which catches people out: a HIGH TSH means an UNDERACTIVE thyroid, because the body is shouting at a gland that is not responding.

Reference ranges

Normal0.4 – 4.0 mIU/L
High TSHSuggests an underactive thyroid (hypothyroidism)
Low TSHSuggests an overactive thyroid (hyperthyroidism)
PregnancyNarrower ranges apply by trimester

Reference ranges vary between laboratories and methods. Always read your result against the range printed on your own report.

Seek care urgently if

What a high result can mean

Hypothyroidism

The commonest cause. Fatigue, weight gain, feeling cold, dry skin.

Hashimoto's thyroiditis

Autoimmune damage to the thyroid — the leading cause worldwide.

Iodine deficiency

Still relevant in parts of Nigeria.

Recovering illness

TSH can be transiently raised after acute illness.

Under-treated known hypothyroidism

Suggests the dose needs review.

What a low result can mean

Hyperthyroidism

Weight loss, palpitations, heat intolerance, tremor.

Graves' disease

The commonest cause of an overactive thyroid.

Toxic nodule

A single overactive lump in the gland.

Over-treatment

Too high a dose of thyroid replacement.

Early pregnancy

TSH normally dips in the first trimester.

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What happens next

TSH alone is a screening result. Free T4 — and sometimes T3 — establishes how significant it is. A thyroid ultrasound is added where the gland is enlarged or a nodule is felt.

Thyroid Function Test Thyroid Ultrasound Full Blood Count

Other results people look up

This page explains what a result can mean in general terms. It is not a diagnosis and cannot account for your history, medication or examination. All visits to Mascot Healthcare are by appointment — Mon–Sat, 9AM–5PM, 52 Sholanke Street, Akoka, Yaba, Lagos.