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What Causes Abnormal Thyroid Hormone Levels While On Immunoglobulin Treatment?
Posted on
Fri, 2 Dec 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 2 Dec 2016
Answered on
Thu, 29 Dec 2016
Last reviewed on
Question : In spite of taking synthesis.137mg and liothyronine 10 much my TSH has climbed to 12.61 and my T4 is 0.87. My thyroid values were easily controled For years . I was Diagnosed with Common Variable Immune Diffidency 18 months ago and started IV immunoglobulin could this cause my thyroid values to be so unmanageable? Or is there something about the diagnosis it self? Please help I am so tired of not feeling well. thank You
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your challenges with thyroid management.
Liothyronine is not recommended by thyroid experts. Levothyroxine such as the synthroid you are on is sufficient to control TSH and bring it in target range.
It is possible the immunoglobulin treatment may be affecting your thyroid status. Regardless, adjusting the synthroid dose properly should get you to goal.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your challenges with thyroid management.
Liothyronine is not recommended by thyroid experts. Levothyroxine such as the synthroid you are on is sufficient to control TSH and bring it in target range.
It is possible the immunoglobulin treatment may be affecting your thyroid status. Regardless, adjusting the synthroid dose properly should get you to goal.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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