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Feeling extreme fatigue, tiredness, full body and joint pains. Is tsh 0.0008 level normal?

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Hi sir,
I have a extreme fatigue, tiredness, full body and joint pains. i gone for master health checkup.
hemoglobin and all the things are normal
but my tsh level is 0.0008. Pls advice it is normal. or it's under normal
if it is not normal the above symptoms are caused by tsh?

Awaiting for your valuable answer
Posted Sat, 6 Oct 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 38 hours later
The TSH is definitely abnormal. If you are on pain killers like opioid analgesics and steroids (such as prednisone) then the TSH can sometimes be low without any true medical problem. If you are not on these medications, then the TSH is strongly suggestive of an overactive thyroid called 'hyperthyroidism'. Uncommonly it can also be 'Secondary hypothyroidism' ie an underactive thyroid due to pituitary/hypothalamus problems. These are the 2 most important causes. However there can be other reasons also which an endocrinologist can help ascertain. This is best achieved by a formal consultation in person with an endocrinologist.

The next step typically involves doing further laboratory tests like Free T4, Total T3, T3 resin uptake, repeat TSH and TSI (Thyroid Stimulating Immunoglobulins), CBC with differential, Complete Metabolic panel including electrolytes, liver and kidney functions tests, prolactin) and likely a radioactive iodine 123 uptake and scan test. This will allow proper diagnosis and guide treatment options that may include either a pill or radiation or surgery depending on the cause. Sometimes it is only due to temporary bruising of the thyroid gland ('thyroiditis') and this often recovers spontaneously with only symptomatic treatment.
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