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What Does My TSH Level Indicate?
Brief Answer:
Provide more information.
Detailed Answer:
Hello ,
Welcome to HCM,
I have read your query,
TSH level 19.65 is high and it is indicative of hypothyroidism.Your wife may need to increase the dose of thyronorm.
But before going into further discussion,I would need some more information,
1) Since how many years your wife is taking thyronorm?
2) What was the TSH level when she was diagnosed with hypothyroidism first time?(if you have past medical reports)
3) Is she taking thyronorm on empty stomach or with meal?
4) Are you doing regular follow-up at your treating doctor? Or is he/she titrated the thyronorm dose previously?
5) How many times you are checking thyroid testing in a year?
Please answer these questions,I will guide you accordingly after that.
Regards,
Dr.Sandip Kabra
Provide more information.
Detailed Answer:
Hello ,
Welcome to HCM,
I have read your query,
TSH level 19.65 is high and it is indicative of hypothyroidism.Your wife may need to increase the dose of thyronorm.
But before going into further discussion,I would need some more information,
1) Since how many years your wife is taking thyronorm?
2) What was the TSH level when she was diagnosed with hypothyroidism first time?(if you have past medical reports)
3) Is she taking thyronorm on empty stomach or with meal?
4) Are you doing regular follow-up at your treating doctor? Or is he/she titrated the thyronorm dose previously?
5) How many times you are checking thyroid testing in a year?
Please answer these questions,I will guide you accordingly after that.
Regards,
Dr.Sandip Kabra
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
The reply of questions as desired is given as under:
1) Since how many years your wife is taking thyronorm?---- !0 years
2) What was the TSH level when she was diagnosed with hypothyroidism first time?(if you have past medical reports)--- TSH was 8
3) Is she taking thyronorm on empty stomach or with meal? ---- Taking on empty stomach.
4) Are you doing regular follow-up at your treating doctor? Or is he/she titrated the thyronorm dose previously? --- Initially the dose was 50 mcg, since about two years the does is 100 mcg & for about 6 months the does is 125mcg.
5) How many times you are checking thyroid testing in a year?
-- Thyroid checking is done in a span of about 6 months.
Please advice further course of action
1) Since how many years your wife is taking thyronorm?---- !0 years
2) What was the TSH level when she was diagnosed with hypothyroidism first time?(if you have past medical reports)--- TSH was 8
3) Is she taking thyronorm on empty stomach or with meal? ---- Taking on empty stomach.
4) Are you doing regular follow-up at your treating doctor? Or is he/she titrated the thyronorm dose previously? --- Initially the dose was 50 mcg, since about two years the does is 100 mcg & for about 6 months the does is 125mcg.
5) How many times you are checking thyroid testing in a year?
-- Thyroid checking is done in a span of about 6 months.
Please advice further course of action
Brief Answer:
Need to increase the dose.
Detailed Answer:
Hi,
welcome again and thanks for providing more information,
It is possible to have only TSH value is elevated while thyroid hormone T3 and T4 are within the normal range because of the reason is,
i) Pituitary resistance to thyroid hormone, means that even when you have adequate thyroid hormone in blood, the pituitary does not react to it properly and continues to push out more TSH.
ii) Another possible reason is the presence of a pituitary adenoma which could be pushing out TSH irrespective of the cause.
In both of these you could have sufficient thyroid hormone (means normal T3,T4) but still have a high TSH level.
You can discuss these two possibilities with your treating doctor.
Since the early TSH was around 8,means she had been taking lesser dose according to the requirement and because of which her TSH level is still raised.
In my opinion, considering very high TSH value inspite of taking 100 mcg dose, I will want to start the dose 200 mcg to your wife and to go for thyroid test again after 1 month to titrate the dosage accordingly. Means if TSH will come down after 1 month,we can reduce the dose of thyronorm.
One more thing it might require some time to stabilize the exact dosage initially but once the dosage will be set then there will be no issue with elevation TSH.
Check thyroid profile on every alternative months till the TSH values comes within normal range.
Also,Thyroid tablet (Thyronorm) must be taken on empty stomach to get maximum absorption as food might interfere with its absorption. So,Ideally it is taken after 2 hours of having meal or before 45 minutes of meal.
Means it is best not to eat anything for at least 1 hour after taking thyronorm.
Hope this detailed answer will be helpful.
Regards,
Dr.Sandip Kabra
Need to increase the dose.
Detailed Answer:
Hi,
welcome again and thanks for providing more information,
It is possible to have only TSH value is elevated while thyroid hormone T3 and T4 are within the normal range because of the reason is,
i) Pituitary resistance to thyroid hormone, means that even when you have adequate thyroid hormone in blood, the pituitary does not react to it properly and continues to push out more TSH.
ii) Another possible reason is the presence of a pituitary adenoma which could be pushing out TSH irrespective of the cause.
In both of these you could have sufficient thyroid hormone (means normal T3,T4) but still have a high TSH level.
You can discuss these two possibilities with your treating doctor.
Since the early TSH was around 8,means she had been taking lesser dose according to the requirement and because of which her TSH level is still raised.
In my opinion, considering very high TSH value inspite of taking 100 mcg dose, I will want to start the dose 200 mcg to your wife and to go for thyroid test again after 1 month to titrate the dosage accordingly. Means if TSH will come down after 1 month,we can reduce the dose of thyronorm.
One more thing it might require some time to stabilize the exact dosage initially but once the dosage will be set then there will be no issue with elevation TSH.
Check thyroid profile on every alternative months till the TSH values comes within normal range.
Also,Thyroid tablet (Thyronorm) must be taken on empty stomach to get maximum absorption as food might interfere with its absorption. So,Ideally it is taken after 2 hours of having meal or before 45 minutes of meal.
Means it is best not to eat anything for at least 1 hour after taking thyronorm.
Hope this detailed answer will be helpful.
Regards,
Dr.Sandip Kabra
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
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