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What Does The Following Thyroid Test Results Suggest?

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Posted on Mon, 29 Sep 2014
Question: Dear Dr,

My mother (65 yrs old) has been monitoring her thyroid gland levels over past 2 years. Results of T3 and T4 has been always within normal range. TSH has been fluctuating little bit above 4.

Five month ago, her readings were TSH 6 and T3 and T4 is normal.

After less than two months, her TSH levels showed a sudden rise to 16 . We repeated the test again after 3 weeks and her results are as follows:

TSH 14.2 [0.2 - 4]
T3 4.0 [3.5 - 6.5]
T4 11.6 [9-23]
normal antibodies test.

She has been under alot of stress over the past five months.
She has been advised to start the Synthroid 50 mg medications.

My questions are:
1. Does she need Synthroid even with normal T4 and T3 levels or could the rise in TSH be symptom for another hidden thing ?

2. Does the high TSH levels (while everything else is normal) indicate adernal fatigue ?

2. In case she does need to take a hypothyroidism medication, Can the thryoid-extract from animals be used as a replacement for the Synthroid ?
doctor
Answered by Dr. Shehzad Topiwala (2 hours later)
Brief Answer:
Thyroid

Detailed Answer:
1 When I see someone like your mother in my practice, I typically tend to offer treatment with levothyroxine. Synthroid is one type of brand name levothyroxine.
The only exceptions are if she has severe untreated osteoporosis or irregular heart rhythm problems or chest pains from coronary heart disease.

2 Rarely when the adrenal gland is not functioning adequately, the TSH can rise and it does come back down to normal once the adrenal insufficiency is properly treated. Diagnosing adrenal insufficiency is challenging. An 8 m serum cortisol (blood) test is a good way to start

3 Animal extract is not recommended by thyroid experts. Levothyroxine alone suffices.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (12 hours later)
Dear Dr,
Thanks for your response.

Is the levothyroxine/Synthroid the only available option ? Alot of patients we know who went onto it complaint that severe symptoms started to appear after taking the medicine and it became hard to adjust the right dose and slowly their health and life style deteriorated completely.
doctor
Answered by Dr. Shehzad Topiwala (9 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Levothyroxine alone has been proven to be sufficient for the treatment of hypothyroidism. Expert guidelines have repeated reinforced the same fact over the years.
Generally it is preferable to adhere to one brand to ensure consistency from batch to batch of pills, although I do prescribe generic when my patients have cost constraints.
Endocrinologist are well aware of the anti-levothyroxine propaganda and are unimpressed by products that profess superiority. We follow strong scientific evidence only
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. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Does The Following Thyroid Test Results Suggest?

Brief Answer: Thyroid Detailed Answer: 1 When I see someone like your mother in my practice, I typically tend to offer treatment with levothyroxine. Synthroid is one type of brand name levothyroxine. The only exceptions are if she has severe untreated osteoporosis or irregular heart rhythm problems or chest pains from coronary heart disease. 2 Rarely when the adrenal gland is not functioning adequately, the TSH can rise and it does come back down to normal once the adrenal insufficiency is properly treated. Diagnosing adrenal insufficiency is challenging. An 8 m serum cortisol (blood) test is a good way to start 3 Animal extract is not recommended by thyroid experts. Levothyroxine alone suffices.