Extremely high tsh - 707

[lmag]

My TSH levels came back extremely high-- 636 about 4 months ago.  The doctor had me re-tested since they had never seen a TSH that high.  I had more bloodwork done and the levels were even higher, TSH of 707.   The doctor also said she had never seen anything that high...but no one seemed too worried about it. I saw an endocrinologist.  They just put me on 200 mcg of synthroid...I tested again after 8 weeks and I went down to 0.08 -- the complete opposite end of the spectrum.  They are working to adjust my dosage to get me in the normal range now....last test I was at 0.05.  At any rate, I felt tired when I had such high TSH levels, but nothing like what most people report experiencing at lower tsh levels.  I was still running 3-5 times a week, and up with my baby multiple times a night as I am breastfeeding.  I'm wondering why I was not so extremely fatigued, depressed, etc.  Also -- I think I am now pregnant again...just 4 weeks.  Anyone know what danger this could put the baby in...having a very unregulated TSH level?  I know it will still take time to get it regulated...until then, is the baby in any danger?

[Mark Lupo, M.D.]

The TSH was very high -- I would be interested in knowing that the T4 and T3 levels were also very low to make sure there was not a lab error or interfering substance in the blood.  But with current TSH testing, this is probably not the case and you have hypothyroidism.  This may be post-partum thyroiditis given that your are nursing (ie, a recent baby) -- but we usually keep women on synthroid until reproduction is finished then see if long-term medications are needed.  

So keeping TSH around 0.5 - 1.5 during pregnancy is suggested -- but a slightly low TSH is common in the first trimester.  Lowering the dose a bit may be needed but work closely with the endocrinologist.

It's amazing that some patients do so well with such a high TSH -- I have seen several with similar stories.

[OldMother]

Was your T3, T4 or any thyroid hormones abnormal? (TSH being from the pituitary gland)  Running several times a week, up all night and breastfeeding is not a common combination of activities for people getting their TSH tested (I would think).  How bout talking with a breastfeeding support group and seeing what their experiences are with synthroid and TSH test levels, if you haven't already.