The TSH will fluctuate a little during the day -- your levels though appear to represent a consistent increase - suggesting a need for a dose adjustment. May be worth exploring adding additional cytomel (eg 5mcg 2x/day) -- this will require a decrease in synthroid.
Along with getting these great responses from the expert forum - along this Dr Lupo posting - you may want to include your question on the thyroid community board. Many there can be very informative also.
TSH that keeps going up is not fluctuation, but rather going more hypo. Fluctuation would be TSH level going up and down and down and up - back and forth like that.
I wouldn't jump the gun too fast. That is to say, adjust your dose before giving the new dose it at least 6 weeks for its effects. You might not think a dose from 88 to a 100 is enough, but it very well can be speaking from experience. I was on a 100 which brought my TSH level out of Labs hyper range. Went to 88 and became out of Labs hypo range, so there can be a difference between the two doses. It takes the full 6 to 12 weeks before feeling the effects and you need to give it its full time. The best is to go low and slow to prevent the ping pong roller coaster effects like I've been going through, for it takes twice as long to get where you want to go - your goal level. Good luck with the new endo.
GL,
Just my personal opinion
as a Graves' Patient.
Thanks. Your response helps. So, if my TSH scores consistantly keep going up, it is because I'm getting more and more hypo and it is not simply a natural fluctuation of my TSH. I happen to be going to my Endo tomorrow and I am going to insist on an increase in either my Synthroid or Cytomel. I'll go back in six weeks to see where I stand then, but I don't want to stay like this for 4 more weeks before increasing. I need an increase now.
I have to say, I've had Graves for nearly 30 years now and I've never been kept in this condition before! My Endo is way too conservative and if she is not going to treat my symptoms and she wants to treat me as a lab score, then I may have to go back to the drawing board and find a new Dr. This is so depressing.
Joyce
From what I have read, yes it does, however it does not occur during the time we are tested so we are not aware of it. I believe I read between 9 PM and 2 AM and the difference of TSH concentrations is 1 to 4 mU/L.
Sleep prevents the further rise in TSH and reflects in the presence of increases in TSH to 5-10 mU/ml during sleep deprivation. Remaining awake on a constant routine, TSH levels remained elevated throughout the nighttime hours. I'd think it would be the other way around because with my sleep issues I feel more hyper. Hope this answers your question.
GL,
Just my personal opinion
as a thyroid Patient.
Does anyone know the answer to this "TSH fluctuation" question?