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What Does A Low TSH Level Indicate?
Question: My wife got into thyroid problem after her first delivery that was cesarian as child was not in proper position. In XXXXXXX 2013, it was 6.73 ulU/mL (0.55-4.78). She started taking Thyroid 25 as per doctors prescription
In August 2013, it was 5.640 so still on higher side
In Sep 2013 her thyroid came 4.188 that was within range. However after 2 months it was again on the higher side of range.
About 3 months back, doctor asked her to increase the dosage to Thyroid 50 s her weight was increasingly a lot and she had other problems also.
We got her TSH tested again recently 2 weeks back and found that now TSH is on lower side. TSH, Ultrasensitive, Serum is 0.24 ulU/mL (range is 0.55-4.78)
We are confused as to what does lower TSH now mean? Does that mean a completely different problem? What are the problems she will face due to this? What treatment she should have? When we asked a doctor, he said just reduce the dosage from Thyroid 50 to Thyroid 25. However he did not explain whats happening. Please explain whats happening and what we should do?
In August 2013, it was 5.640 so still on higher side
In Sep 2013 her thyroid came 4.188 that was within range. However after 2 months it was again on the higher side of range.
About 3 months back, doctor asked her to increase the dosage to Thyroid 50 s her weight was increasingly a lot and she had other problems also.
We got her TSH tested again recently 2 weeks back and found that now TSH is on lower side. TSH, Ultrasensitive, Serum is 0.24 ulU/mL (range is 0.55-4.78)
We are confused as to what does lower TSH now mean? Does that mean a completely different problem? What are the problems she will face due to this? What treatment she should have? When we asked a doctor, he said just reduce the dosage from Thyroid 50 to Thyroid 25. However he did not explain whats happening. Please explain whats happening and what we should do?
Brief Answer:
She is over replaced. Needs dose reduction
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Your wife is having Subclinical hypothyroidism - a small decrease in thyroid gland function. Here TSH will be slightly elevated. The treatment given is thyroid hormone replacement ( thyroxine - Thyroid 25 or 50 mcg).
TSH is thyroid stimulating hormone, the levels will go up when thyroid hormones in blood is low. This will come to normal (0.5-3 miu/ml) when we are adequately replaced with thyroxine ( Thyroid ). If the dose we are getting is higher, the TSH will drop further, which has happened in your case. So low TSH is not a new disease.
Since TSH now is low you need to decrease the thyroxine dose to 25 mcg. If TSH go up, then we have to change the dose to 25 and 50 mcg alternate days.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
She is over replaced. Needs dose reduction
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Your wife is having Subclinical hypothyroidism - a small decrease in thyroid gland function. Here TSH will be slightly elevated. The treatment given is thyroid hormone replacement ( thyroxine - Thyroid 25 or 50 mcg).
TSH is thyroid stimulating hormone, the levels will go up when thyroid hormones in blood is low. This will come to normal (0.5-3 miu/ml) when we are adequately replaced with thyroxine ( Thyroid ). If the dose we are getting is higher, the TSH will drop further, which has happened in your case. So low TSH is not a new disease.
Since TSH now is low you need to decrease the thyroxine dose to 25 mcg. If TSH go up, then we have to change the dose to 25 and 50 mcg alternate days.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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