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Thyroid

TSH (Thyroid Stimulating Hormone)

In the UK, the standard clinical (NHS) reference range for TSH (Thyroid Stimulating Hormone) is 0.4-4.0 mIU/L, with 1.0-2.0 mIU/L considered the performance-optimised range. A result within these ranges suggests typical status; only a qualified clinician can interpret an individual reading.

Thyroid stimulating hormone is produced by the pituitary gland and signals the thyroid to produce T3 and T4 — the hormones that regulate metabolism, energy production, and body temperature. TSH operates on an inverse relationship: high TSH indicates the thyroid is underperforming (hypothyroidism), while low TSH suggests overactivity (hyperthyroidism).

Last reviewed: 11 June 2026


Optimal Ranges

What is the optimal range for TSH?

Clinical (NHS) Range

0.4-4.0 mIU/L

mIU/L

Performance-Optimised Range

1.0-2.0 mIU/L

mIU/L

TSH (Thyroid Stimulating Hormone) reference ranges (UK)
RangeValueUnit
Clinical (NHS) reference range0.4-4.0 mIU/LmIU/L
Performance-optimised range1.0-2.0 mIU/LmIU/L

The clinical range defines what is considered medically “normal” — broad enough to cover 95% of the population. The performance range reflects where research and clinical experience suggest most people feel and function at their best. A result in either range suggests typical status and is not a diagnosis; any individual reading should be interpreted by a qualified clinician.


Why It Matters

Why TSH matters for performance

The thyroid is the body's metabolic thermostat. Even mildly elevated TSH — subclinical hypothyroidism — can cause fatigue, weight gain, cold intolerance, and depression that is frequently misattributed to ageing or overtraining. For men, thyroid dysfunction also impacts testosterone production and cardiovascular health. Standard clinical ranges for TSH are very broad (0.4-4.0 mIU/L), meaning you can be symptomatic at 3.5 and be told everything is 'normal'. Functional optimisation aims for a tighter range where most people feel their best.


Symptoms

What are the symptoms of low or high TSH?

Low / Deficiency

  • Low TSH (hyperthyroid symptoms):
  • Unexplained weight loss
  • Rapid heart rate and palpitations
  • Anxiety and tremors
  • Heat intolerance and sweating

High / Excess

  • High TSH (hypothyroid symptoms):
  • Fatigue and sluggishness
  • Unexplained weight gain
  • Cold intolerance
  • Dry skin and hair loss
  • Depression and brain fog
  • Constipation

Dietary Sources

Which foods support TSH levels?

Iodine-rich foods (seaweed, cod, dairy)Selenium-rich foods (Brazil nuts — 2-3/day)Zinc-rich foods (oysters, beef, pumpkin seeds)Tyrosine sources (chicken, turkey, eggs)Iron-rich foods (supports T4 to T3 conversion)

Supplementation

How do you improve TSH levels?

Selenium (200 mcg/day as selenomethionine) is the most evidence-based thyroid support nutrient — essential for T4 to T3 conversion and thyroid peroxidase function. Iodine supplementation (150-300 mcg/day) only if deficiency is confirmed — excess iodine can worsen thyroid conditions. Zinc (15-30 mg/day) supports thyroid hormone synthesis. Avoid soy isoflavones and excessive cruciferous vegetables if thyroid function is compromised. If TSH is persistently above 4.0, GP referral is recommended.


Testing

How is TSH tested in the UK?

TSH is measured from a blood sample. With Helvy, that means a finger-prick kit taken at home and posted to a UKAS-accredited UK laboratory, with results in around 5 days, reviewed by a qualified clinician. Your result is reported against both the clinical range (0.4-4.0 mIU/L) and the performance-optimal range (1.0-2.0 mIU/L), so you can see not just whether you are “normal” but whether you are optimal. If you make a change, retest after 8-12 weeks to confirm it worked.


Research

Key study

Selenium supplementation in patients with autoimmune thyroiditis

Toulis KA, Anastasilakis AD, Tzellos TG, et al.

Thyroid (2010)

DOI: 10.1089/thy.2009.0351

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This content is for educational purposes only and does not constitute medical advice. Your data suggests areas for optimisation, but any concerns should be discussed with a qualified healthcare professional. If your results flag values outside safe ranges, we recommend consulting your GP.