TSH range....?

[TennesseeNP123]

Okay, so I'm a new FNP and wanted to get some feedback from other NPs about diagnosing/treating thyroid disease...I distinctly remember being taught by a guest speaker, who was an endocrinology NP, that the normal range for TSH is 0.3-3.0.

The office I'm working in used a wider range, something like 0.5-4.5.

After doing some quick research online, I'm even more confused bc there doesn't seem to be a lot of agreement on which range to use...? What's up?? Any insight you all can share would be much appreciated on which range to use for practice... :)

[studentnurserachel]

Are you working in FP or endocrinology? My experience with this is that if someone is symptomatic, or seems to be, endo will medicate at TSH levels that are high normal on lab range, where FP probably wouldn't, I think there are different reference ranges depending on the lab, my current lab normal range is about what you said, 0.5-4.5, and personally, I don't consider thyroid replacement unless they are out of that range.

[BostonFNP, APRN]

I second that this is likely dependent on the setting you are practicing in. In adult primary care I treat above 4.5. I have colleagues in OB that treat at 2.5-3 in pregnant women.

[TennesseeNP123]

Thanks for the feedback!! And yes, I'm in primary care....I've heard similar things where endo will follow TSH on a more tight schedule than primary care....Thanks!