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Thyroid (Expert Forum)
High TSH and T4 1 year after thyroidectomy
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
High TSH and T4 1 year after thyroidectomy
by EmeraldFlame, Apr 15, 2006 12:00AM
I'm 41 and female. I was diagnost with papillary thyroid cancer and had my thyroid removed a year ago. I had a small tumor on my isthmus. What brought me to the doctor was typical thyroid symptoms such as being cold, very tired and weak, hair falling out and biggest concern to me was rapid weight gain (now at 150 pounds in two years). I'd ramained the same weight for 10 years and was even dieting and still gained. However, all my (very extensive)tests came back normal aside from high cholesterol and slightly elevated T4. They did find the cancer though so they did the surgery.
Now it's a year later and I'm still gaining weight and feeling awful. I'm currently on 350MCG Synthroid. They keep upping my synthroid but I'm still not at normal TSH (6.19 in Jan and 4.9 now) The strangest part right now though is that my T4(free) is also above normal at 2.3.
I can't find anywhere that talks about TSH and T4 both being elevated. I also really want the weight gain to stop and to feel better. Any ideas on either of these problems?
Now it's a year later and I'm still gaining weight and feeling awful. I'm currently on 350MCG Synthroid. They keep upping my synthroid but I'm still not at normal TSH (6.19 in Jan and 4.9 now) The strangest part right now though is that my T4(free) is also above normal at 2.3.
I can't find anywhere that talks about TSH and T4 both being elevated. I also really want the weight gain to stop and to feel better. Any ideas on either of these problems?
Doctor's Answer
by Mark Lupo, M.D., Apr 16, 2006 12:00AM
, Apr 16, 2006 12:00AM
If the T4 and TSH are both consistently elevated -- there are a few scenarios that could be the cause. 1) Lab error 2) interfering substances in the blood (antibodies) that cause lab error 3) thyroid hormone resistance and 4) TSH secreting pituitary tumor.
These are ALL UNLIKELY. Would make sure you are not taking anything that interferes with absorption (ie iron, calcium, high fiber meals, certain meds) within 4 hours of the synthroid dose. Would screen for celiac sprue which may cause decreased absorption.
Also consider changing to another brand to see if that helps -- like levoxyl.
Also consider cytomel (ie 12.5mcg 2x/day) in combo with synthroid (or levoxyl).
These are ALL UNLIKELY. Would make sure you are not taking anything that interferes with absorption (ie iron, calcium, high fiber meals, certain meds) within 4 hours of the synthroid dose. Would screen for celiac sprue which may cause decreased absorption.
Also consider changing to another brand to see if that helps -- like levoxyl.
Also consider cytomel (ie 12.5mcg 2x/day) in combo with synthroid (or levoxyl).
Other health problems I have are:
Asthma
High cholestrerol(take lipitor)
Slightly high blood sugars(take Metformin 1000mg)
Osteo Arthritis (take Nebumetone and am mostly imobile since weight gain and weakness started)
Tachycardia (Heart rate regularly runs around 90)
Low blood pressure
syncopy (occational since childhood)
PCOS (hysterectomy 12 years ago and still have ovaries)
http://www.altsupportthyroid.org/t3/t3exp3pr.php
I've been where you''re at, so many of us have been, and it's critical you find out how to help yourself, because too often, you have to fight the system to get well Good luck.