What Causes High TSH Levels?

Posted on Fri, 3 Oct 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 3 Oct 2014 Answered on

Tue, 28 Oct 2014 Last reviewed on

Question : I have Hashimoto´s thyroiditis. I have been taking Eutirox 75mcg for a couple of years. A year ago my TSH was 2.3. The only change in my life in the last year is I got married and I started going to frequent zumba classes (4-5x/wk), and now my TSH is 10.3. Free T4 is 1.19. My gynecologist saw the results and suggested I increase to 88 or 100 (he didn´t seem very sure.) But I am leaving for a 6 month trip to Asia and will no longer be doing zumba. I wonder if my levels might return to normal since I won´t be doing intensive exercise, and so even an increase to 88 could be too much?? I´ve recently moved and no longer have a dr. who treats me.

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Two options

Detailed Answer:
Good day,

Noted your concern.
The dose of Euthyrox ( levothyroxine) is based on your body weight. There are 2 options for you now
1) Recheck the TSH ad Free T4 after 6 weeks and then decide

2) If you are panning for pregnany, increase the dose of Euthyrox now to keep TSH < 2.5.

I feel, an increase to 88 mcg is quite okay now. Once you change the dose, we need to recheck the TSH and Free T4 after 6 weeks.

Please let me know your weight .
HAve you done an anti TPO test ( anyi microsomal antobody) yet?

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 hours later)

Thank you for your answer.
I weigh 56kg.
I had anti TPO test done in 2005- results were 96.
I am not trying to get pregnant at this time (BCP-marvelon), but had hoped to try after returning from my trip.

Thank you.,

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Levothyroxine dose

Detailed Answer:
Thank you for the reply.
Since you weigh 56 kilos, the total Levothyroxine dose requirement is around 95 micrograms(mcg) daily. This is required if your body is not producing any hormone at all. In early stages of hashimoto's thyroiditis, there is only partial thyroid destruction by autoimmunity. Hence we only need to replace small amounts of levothyroxine. However, if the autoimmune destruction continues, the remaining thyroid cells also will get destroyed and in that case, we need the full replacement dose. Anti TPO of 96 is high, but not extremely high.

You will feel better if the TSH remains at 2.5 to 3 range and the Free T4 in upper half of normal. Hence it is good to increase the dose to 88 mcg now and recheck TSH and Free t4 after 6 weeks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar