I posted before to the effect that everyone with fatigue should get their TSH measured and use the reference range TSH < 2.0 to judge for themselves whether or not they are hypothyroid (a TSH of 2.0 or greater indicates hypothyroid). You can go here for info on this: http://www.lef.org/protocols/appendix/blood_testing_02.htm?source=search&key=TSH reference range I have included the relevant exerpt below, but first, I also wanted to cite this interesting find at the Weston Price website: http://www.westonaprice.org/food-features/living-with-phytic-acid This web page is all about phytic acid and how it interferes with mineral absorption...including zinc absorption. (A single bread role can, depending on phytate content, prevent the absorption of 82% of the zinc in the diet!). Zinc is required to make thyroid hormone. Indeed, I have read thyroid websites where zinc has been compared to a dial to turn up the thyroid. (Of course this only works if there are no other deficiencies...my doctor has me taking 1g. tyrosine per day to get enough of it to make thyroid hormone since I don't eat enough protein, for example). If you read the above paper on phytates, which is very interesting, you will find that rye bread is the lowest phytate bread, significantly lower than other types, and that whole wheat bread is the highest phytate bread (and therefore what we have read all our liveabout whole wheat bread being the healthiest is not true). An enzyme called phytase, increased by sprouting wheat, or by fermenting, breaks down phytic acid. Unfortunately my father is on kidney dialysis and it is important for those with end stage renal disease to note that when phytase (such as found in sprouted wheat bread and sourdough and rye) breaks down phytic acid, it leaves more absorbable phosphorus (which kidney dialysis patients cannot excrete). So high phytase grain products are healthier for us, but not for everyone. Here is the relevant info from the Life Extension website on TSH reference range. I think many of you will find you are hypothyroid by this ACCURATE reference range (as I am). This ACCURATE reference range says you are hypothyroid if your TSH falls RIGHT IN THE MIDDLE of the "standard reference range". Here is the excerpt: [An example of flawed reference ranges can be seen in blood tests used to assess thyroid status. A long-standing controversy rages over the best way to diagnose thyroid deficiency. Most conventional doctors rely on thyroid blood tests whereas alternative physicians look for signs and symptoms of thyroid deficiency. An article in the August 3, 2002 issue of the British medical journal Lancet challenged conventional medical wisdom regarding the use of standard reference ranges in diagnosing and treating thyroid deficiency. According to the researchers, the problem with thyroid blood tests may be faulty reference ranges that fail to reflect what the optimal level of thyroid hormone should be in a particular individual (Dayan 2002). The standard blood test used to determine thyroid gland hormone output is the thyroid-stimulating hormone (TSH) test. When a deficiency in thyroid hormone occurs, the pituitary gland releases TSH to signal the thyroid gland to produce more hormones. When the TSH level is in the “normal range,” doctors usually assume that the thyroid gland is secreting enough thyroid hormone. The question raised by the Lancet article’s authors, however, was whether the current reference range for TSH reflects optimal thyroid hormone status. The TSH reference range used by many laboratories is 0.35–5.50 mIU/mL (milli international units per milliliter). A higher TSH level indicates a thyroid hormone deficiency (because the pituitary gland is over-signaling TSH to compensate for low levels of thyroid hormone in the blood). Any reading of more than 5.50 mIU/mL alerts a doctor to a thyroid gland problem and the possibility that thyroid hormone therapy may be warranted. The trouble is that the TSH reference range is so broad that most doctors will interpret a TSH reading as low as 0.35 to be as normal as a 5.50 reading. The difference between 0.35 and 5.50, however, is 15.7-fold, a range of values far too great to indicate optimal or even normal thyroid function. A review of published findings about TSH levels reveals that readings greater than 2.0 may indicate health problems relating to insufficient thyroid hormone output. One study showed that individuals with TSH values greater than 2.0 have an increased risk of developing clinically significant thyroid deficiency during the next 20 years (Vanderpump 1995). Other studies show that TSH values greater than 1.9 indicate risk of autoimmune disease of the thyroid gland (Hak 2000). A more startling study showed that TSH values greater than 4.0 increases the likelihood of heart disease in postmenopausal women (Hak 2000). Another study showed that administration of thyroid hormone lowered cholesterol in patients with TSH ranges of 2.0–4.0 but had no cholesterol-lowering effect in patients whose TSH value was in the 0.2–1.9 range (Michalopoulou 1998). It also showed that in people with elevated cholesterol, TSH values of 2.0 or greater could indicate that a thyroid deficiency is the culprit, causing excess production of cholesterol, whereas TSH levels at or below 1.99 would indicate normal thyroid hormone status. Doctors routinely prescribe cholesterol-lowering drugs to patients without properly evaluating their thyroid status. Based on the evidence presented to date, it might make sense for doctors to investigate a thyroid deficiency (based on a TSH value greater than 1.9) before resorting to cholesterol-lowering drugs. In a study to evaluate psychological well-being, impairment was found in patients with thyroid abnormalities who were nonetheless within “normal” TSH reference ranges (Pollock 2001). The authors of the Lancet study stated, “The emerging epidemiological data begin to suggest that TSH concentrations above 2.0 (mU/L – milliunit per liter) may be associated with adverse effects.” The authors prepared a chart based on previously published studies that provides guidance when interpreting the results from TSH blood tests. Here are three highlights from their chart that may be useful in understanding what your TSH values really mean: TSH values greater than 2.0: increased 20-year risk of thyroid deficiency and increased risk of thyroid-induced autoimmune attack (Vanderpump 1995) TSH values greater than 4.0: greater risk of heart disease (Hak 2000) TSH values between 2.0 and 4.0: cholesterol levels decline in response to thyroxine (T4) therapy (Michalopoulou 1998) Despite these intriguing findings, the Lancet authors stated that more studies were needed to define an optimal TSH range, suggested as 0.2–2.0 instead of 0.2–5.5 (mU/L). Note: These optimal reference ranges are now expressed in mIU/mL, so the ideal range according to this epidemiological data is 0.35–2.1 mIU/mL. If you have depression, heart disease, high cholesterol, chronic fatigue, poor mental performance, or any of the many other symptoms associated with thyroid deficiency, you may want to ask your doctor to “defy the reference ranges” and try a different thyroid replacement therapy.] ------ I have a friend who is a male nurse in Canada who pointed out Canadian studies that also show TSH > 1.9 is abnormal. The evidence is there. Also I have discovered that thyroid hormone is required to turn inactive ubiquinone (CoQ10) into active ubiquinol (CoQ10). And ubiquinol is required in the Kreb cycle to produce energy. So that is the mechanism by which low thyroid makes you tired. (I wondered why my Metametrix OATS test showed low CoQ10 when I had been supplementing 100mg/day for 20 years, the answer appears to be that I have low thyroid and could not convert the form I took to the active form. I hope this helps a few people. It helps me. I thought I'd pass it on.