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Probably nothing, it was reacting to something (in my case, I had a bad infection that we assume caused the rise), and now that has gone, it's coming back down.
99% of cases are routine; very rarely some exotic genetic abnormaility of thyroxine metabolism is seen and may require the help of an endocrinologist....An acute thyroiditis may occur after some routine viral infection and give odd-ball test results. By the time the tests are repeated, the values may have changed again, even returned to normal, confusing the doc.
Quote:
Originally Posted by Middlin
Biotin, prescription medications, supplements, diet, pregnancy, fasting or not fasting can all effect the results. Take your medication at the same time every day and stay consistent with testing with same lab and fasting or not
True, but usually don't change the results by much to force a start or change in medications. It is a good idea to take your meds at the same time every day (AM vs PM, not setting a stop watch for accuracy) and to test the same time each time.
In regards the OP's original problem-- an unexpected result, especially that far out of line, in the absence of symptoms, deserves re-testing for verification....The repeat test did show a marked change in the TSH, but still pretty high. (I have to wonder if we're really dealing with one of those acute thyroiditis problems and not a chronic hypothyroid situation.)...
The OP was given a dose of thyroxine a little above the average dose to start-- probably 95% of pts require 100ug for maintenance (and no, it doesn't depend very much at all on body weight)...With a TSH that far out of line, the wisest choice would have been to start a very low dose and titrate up every few weeks (yes, it does take several weeks for a new dose to equilibrate) until the TSH gets to the low end of the normal range....Giving too much too fast could tax the CV system and cause problems in those with bum coronaries &/or a tendency to tachyarrhythmias.
Most symptpms pf undr-active thyroid are common complaintts of everydat life-- fatigue, weight gain etc. The signs & symptoms that are unique to hypothyrpoidism don't occur until the disease has gone unrecognized & untrearted for a very long (yrs) time....not to mention they often progress so slowly that they go unnoticed.
The main advantage of taking Armour vs synthetic thyroxine, like the advantages of eating organic food, seems to be its impact on mental health. There are some potential problems with using the Armour preps, but both can be used successfully. Whatever floats your boat.
I don't really understand why you would not take a medicine that provides something you would have naturally anyway - T4. But to each their own.
It costs me $2.36 every 3 months (brand name rx). Yes my insurance is good but it is not a significant problem to take it or pay for it and of course if I started testing funny we would change it but that just hasn't ever happened.
My maintenance dose is over 100 so I guess I am in the 5%. Not overweight.
99% of cases are routine; very rarely some exotic genetic abnormaility of thyroxine metabolism is seen and may require the help of an endocrinologist....An acute thyroiditis may occur after some routine viral infection and give odd-ball test results. By the time the tests are repeated, the values may have changed again, even returned to normal, confusing the doc.
True, but usually don't change the results by much to force a start or change in medications. It is a good idea to take your meds at the same time every day (AM vs PM, not setting a stop watch for accuracy) and to test the same time each time.
In regards the OP's original problem-- an unexpected result, especially that far out of line, in the absence of symptoms, deserves re-testing for verification....The repeat test did show a marked change in the TSH, but still pretty high. (I have to wonder if we're really dealing with one of those acute thyroiditis problems and not a chronic hypothyroid situation.)...
The OP was given a dose of thyroxine a little above the average dose to start-- probably 95% of pts require 100ug for maintenance (and no, it doesn't depend very much at all on body weight)...With a TSH that far out of line, the wisest choice would have been to start a very low dose and titrate up every few weeks (yes, it does take several weeks for a new dose to equilibrate) until the TSH gets to the low end of the normal range....Giving too much too fast could tax the CV system and cause problems in those with bum coronaries &/or a tendency to tachyarrhythmias.
Most symptpms pf undr-active thyroid are common complaintts of everydat life-- fatigue, weight gain etc. The signs & symptoms that are unique to hypothyrpoidism don't occur until the disease has gone unrecognized & untrearted for a very long (yrs) time....not to mention they often progress so slowly that they go unnoticed.
The main advantage of taking Armour vs synthetic thyroxine, like the advantages of eating organic food, seems to be its impact on mental health. There are some potential problems with using the Armour preps, but both can be used successfully. Whatever floats your boat.
Thank you for taking the time to share a detailed reply. I don’t have any of the symptoms related to acute thyroiditis. I am puzzled at what is causing the high TSH and even more puzzled at the change in values, everything else remaining the same.
Thank you for taking the time to share a detailed reply. I don’t have any of the symptoms related to acute thyroiditis. I am puzzled at what is causing the high TSH and even more puzzled at the change in values, everything else remaining the same.
OK-- back to basic physiology--> TSH goes up either when there's an abnormal secretion of TSH (TSH-secreting pituitary adenoma or lung tumor- both exceedingly rare) or when the thyroid is not responding to TSH adequately. In the former case, T4 will be high; in the latter T4 will be normal or low .... This is why a T4 level should always be obtaned with the TSH to put it in context. Docs younger than me seem to think the newer "highly sensitive TSH" test means it's all you need to get-- ok for screening asymptomatic pts, but not for diagnosis & management.
If you look up "acute thyroiditis" they'llrobably talk about a specific diagnosis that's causing over-active thyroid symptoms. I was using the term in a more general way-- a virus screws up the thyroid/pituitary to give results that don't make sense unless you consider the temporary inflammation. Those abnoral tests go back to normal over the course of days or weeks.
Did you ever have a normal TSH test in the past for comparison-- it's possible, although improbable, you're "8 ft tall"-- statistcally abnormal compared to the population, but normal for you.
The concern is not about money. It is about taking unwanted medication if there is a chance it is not needed in the first place.
It seems pretty clearly needed if your TSH is that high but I am not a doctor.
But my point was mostly to reassure you that it is inexpensive and easy to take without a lot of side effects that you might get with other medicines like statins or blood pressure medicine. . IME of ~ 40 years this is a non-event. You get overdosed on blood pressure medicine you pass out. . . not fun.
OK-- back to basic physiology--> TSH goes up either when there's an abnormal secretion of TSH (TSH-secreting pituitary adenoma or lung tumor- both exceedingly rare) or when the thyroid is not responding to TSH adequately. In the former case, T4 will be high; in the latter T4 will be normal or low .... This is why a T4 level should always be obtaned with the TSH to put it in context. Docs younger than me seem to think the newer "highly sensitive TSH" test means it's all you need to get-- ok for screening asymptomatic pts, but not for diagnosis & management.
If you look up "acute thyroiditis" they'llrobably talk about a specific diagnosis that's causing over-active thyroid symptoms. I was using the term in a more general way-- a virus screws up the thyroid/pituitary to give results that don't make sense unless you consider the temporary inflammation. Those abnoral tests go back to normal over the course of days or weeks.
Did you ever have a normal TSH test in the past for comparison-- it's possible, although improbable, you're "8 ft tall"-- statistcally abnormal compared to the population, but normal for you.
Thanks again for the details, very much appreciated. T4 in both the tests was at 0.6. Never did a thyroid test in the past, since I have never felt the need because of lack of symptoms. Even this time, it was as part of routine annual checkups which I hadn’t gotten done in years!
My cholesterol came high too, not sure if there is any correlation. (No significant weight changes over the years and I am not over weight). Attached my numbers to see if they ring a bell. Thanks again for your time!
Thanks again for the details, very much appreciated. T4 in both the tests was at 0.6. Never did a thyroid test in the past, since I have never felt the need because of lack of symptoms. Even this time, it was as part of routine annual checkups which I hadn’t gotten done in years!
My cholesterol came high too, not sure if there is any correlation. (No significant weight changes over the years and I am not over weight). Attached my numbers to see if they ring a bell. Thanks again for your time!
Total chol : HDL ratio-- ~4:1 = "normal" risk for arteriosclerosis.Chol numbers do seem to be higher when the thyropid is under-active. Correcting the thyroid status may bring them down a little, but normal is normal.
TSH considerably elevated and Free T4 slightly low-- classic hypothyroidism.. They can do fancy tests to determine if it's Hashimoto's vs burned out Grave's Dis or some other less common parthology. No need to. Treatment is the same regardless-- T4 supplements...safe, cheap and easy to take and monitor.
Your TSH is pretty high, suggesting your thyroid has been struggling to keep up for a long time, possibly years. The effect that has had on you has progressed slowly-- kinda like watching yoourself age as you look in the mirror every morning-- you don't notice the changes from day to day...or else you're just tougher than a two dollar steak and don't complain....No need to rush the treatment-- start with lower doses of Synthroid and work your way up month by month until your T4 is in the normal range and your TSH is low normal-->
Younger docs seem to think that the TSH should be treated to "normal"--- That would mean your pituitary still thinks it needs to stimulate the thyroid to get the T4 up higher...Doesn't make physiological sense and is relying on a sluggish, diseased thyroid to do its part. Just give full replacement doses.
Hello doctor! Thanks again for taking the time to reply! What would be a good dosage of Levithroxine (that’s what my doc prescribed) for the new TSH which is ~21?
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