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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes TSH Levels Fluctuating Between High And Low?

Hi there! I am a 37 yr old woman and have had an under active thyroid since I was 16. After I had four children, my thyroid flip flopped from over to under and vice versa. I just had lab work and my TSH is 163. Dr said very low. Does that mean I am extremely under active again? Dr told me to take 137mcg of Synthroid daily and he will recheck my labs in four wks from now. What do you think?
Fri, 16 Jan 2015
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Endocrinologist,  's  Response
Hi,

Welcome to HCM. I had gone through your question and understand your concerns.

A TSH of 163 shows that you are not taking enough thyroid hormones now.
Since you are having long lasting hypothyroidism, you should take thyroxine life long (Synthyroid). The fluctuation in dose can be due to 3 things:

1. Inadequate dose

Your body requirement may be high. Thyroxine is a replacement treatment, that means you body is not producing it so you are replacing it. If your body requirement is 150 mcg and you are taking only 100, your TSH will never be normalized. Never stop the thyroxine (synthyroid) when your TSH is normal.

2. Improper intake

This is the most common cause. Follow this check list
a. Purchase tablet only in full bottle/ strips - not as loose tablets
b. Keep the tablets in sun protected area
c. Take the medication in morning empty stomach. Take tea/ coffee/
food only after 1 hour
d. Never miss a tablet. If you miss take twice the dose next day.

3. Decreased drug absorption

This could be due to gastritis, mal absorption or taking some medicines like calcium or milk/ food along with synthyroid.

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist
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What Causes TSH Levels Fluctuating Between High And Low?

Hi, Welcome to HCM. I had gone through your question and understand your concerns. A TSH of 163 shows that you are not taking enough thyroid hormones now. Since you are having long lasting hypothyroidism, you should take thyroxine life long (Synthyroid). The fluctuation in dose can be due to 3 things: 1. Inadequate dose Your body requirement may be high. Thyroxine is a replacement treatment, that means you body is not producing it so you are replacing it. If your body requirement is 150 mcg and you are taking only 100, your TSH will never be normalized. Never stop the thyroxine (synthyroid) when your TSH is normal. 2. Improper intake This is the most common cause. Follow this check list a. Purchase tablet only in full bottle/ strips - not as loose tablets b. Keep the tablets in sun protected area c. Take the medication in morning empty stomach. Take tea/ coffee/ food only after 1 hour d. Never miss a tablet. If you miss take twice the dose next day. 3. Decreased drug absorption This could be due to gastritis, mal absorption or taking some medicines like calcium or milk/ food along with synthyroid. Hope I have answered your question. If you have any further questions I will be happy to help. Regards Dr Ajish TP Consultant Endocrinologist