Yes, absolutely. It’s more common than most people realize.
TSH stands for Thyroid Stimulating Hormone, but here’s what many people don’t know, TSH is actually a measure of how the pituitary gland is signaling the thyroid. It’s not a direct measurement of how well your thyroid is functioning or how your cells are using thyroid hormone.
Even though doctors have relied on the TSH test for decades, it doesn’t always reflect what’s actually going on in the body. This is why many people experience clear signs of hypothyroidism including fatigue, weight gain, brain fog, cold hands and feet, but they’re told everything is “normal.”
That was true for me, and it’s true for many people I’ve worked with.
How Common Is Undiagnosed Hypothyroidism?
Depending on the source, it’s estimated that up to 20 million Americans have a thyroid disorder, and many more may go undiagnosed. Hypothyroidism affects women more than men, and 1 in 8 women will develop a thyroid disorder in their lifetime.
You probably know someone with undiagnosed hypothyroidism. They’re the friend who’s always tired, can’t lose weight, wears a sweater in summer, and struggles to focus or remember words. Maybe that person is you.
If you’ve been told your thyroid is “fine” based on TSH but still feel off, there’s a reason for that—and you’re not alone.
Why TSH Can Be Misleading
TSH is not always reliable. Here are a few reasons why:
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TSH can fluctuate up to 200% during the day.
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The “normal range” varies between labs and is still debated.
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TSH doesn’t measure how much active thyroid hormone (T3) is available to your cells.
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It doesn’t show whether your body is converting T4 (inactive hormone) into T3 (active hormone).
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It doesn’t detect thyroid resistance or adrenal issues, both of which can affect how thyroid hormone works in your body.
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In some cases, people have low thyroid function but still show a normal or even low TSH.
If your doctor is relying on TSH alone, they might miss what’s really going on.
What Happens When Hypothyroidism Goes Untreated?
When TSH is used as the only test, many people get misdiagnosed or not diagnosed at all. That means years of symptoms like fatigue, brain fog, weight gain, depression, low libido, hair loss, and poor sleep. It also means years of being told it’s “just stress” or “all in your head.”
For me, that meant years of going from doctor to doctor, being told my thyroid was fine, but continuing to suffer from symptoms. I knew something was wrong, but my labs didn’t show it. So I was dismissed. When I finally got diagnosed with hypothyroidism, I spent another decade trying every type of thyroid medication trying chasing thyroid lab test numbers but continuing to suffer from symptoms.
If you’ve been in that position, you know how frustrating and hopeless it can feel.
What To Do If Your TSH Is Normal But You Have Symptoms
If you suspect low thyroid function, here are a few steps I recommend:
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Request a full thyroid panel, not just TSH. This should include:
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Free T3
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Free T4
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Reverse T3
- TSH (as a reference range)
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Thyroid peroxidase (TPO) antibodies (for Hashimoto’s)
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Track your body temperature. Your thyroid controls temperature regulation, and low body temperature is one of the most reliable signs of low thyroid function. A waking temperature below 97.8°F and an afternoon temperature below 98.6°F can point to hypothyroidism.
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Pay attention to symptoms. Symptoms matter. Energy, focus, temperature, mood, digestion, skin, sleep are all measurements your thyroid is either working well or not. If your thyroid labs are “normal” but you feel anything but normal, trust what your body is telling you.
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Work with someone who takes a full-picture approach. If your doctor refuses to run these tests or dismisses your concerns, it may be time to find a new healthcare provider. It’s not your job to convince a doctor who isn’t open-minded. And you deserve to have someone on your team who will help you.
The Role of Body Temperature
I talk about temperature a lot in my work because it was the missing piece for me. Where lab testing failed me, tracking my body temperature saved me.
When I finally started tracking my temperature, I realized I wasn’t just “a person who’s always cold.” My body temperature was consistently below 97°F. That’s a sign the thyroid is underactive, even if TSH says otherwise.
Once I learned how to support my thyroid and adrenals the right way, my temperature came up, and so did my energy, mood, and metabolism. Everything started to make more sense.
If This Sounds Familiar, You’re in the Right Place
This is exactly why I created the HypoHero™ Thyroid Protocol to help people who are still dealing with low thyroid symptoms even when the labs look normal.
The protocol teaches you how to track your temperature, understand your symptoms, and support your thyroid with minerals, without chasing lab results or constantly adjusting medication.
If you’ve felt ignored, frustrated, or like you’ve tried everything and nothing works… this is a new approach that actually makes sense.
Click here to learn more about the HypoHero™ Thyroid Protocol and how it can help you feel like yourself again. 👉 Take the HypoHero Thyroid Symptom Quiz
1 comment
Join the conversationTabitha Lumbee Duarte - October 7, 2016
hey lizz, i feel like im suffering from hypothyroidism. i had test done, but of course my doc said everything looks normal. for awhile ive been STRUGGLING to lose weight (even though i go to the gym) im freezing even though the degrees are at 76 to 78F i wake up feeling like i didnt sleep a wink. for most of my life ive dealt with depression and anxiety. here lately things have taken a turn for the worse though.. my hair seems to be falling out and is thin my nails are thin and brittle and peeling. ive become more and more forgetful. i could be talking about a subject then my mind fogs and i forget what i was talking about. i feel pretty helpless right now. the thing that scares me more than anything is losing all of my hair. my doc is sending me to a dermatologist, but i dont know if they will be able to help me…