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Normal TSH level?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Normal TSH level?

My normal weight is usually around 118 lbs and I am now up to about 160. I have been gaining weight very badly rapidly but have been eating less. The docs did my TSH level and it came out to be 4.94 but he told me this is normal. I don't know whats going on so could someone tell me if this level is normal or what they think could be happening. Thanks alot for the help.
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The TSH alone does not explain the weight gain but is is a bit higher than many of us consider normal.  Would repeat TSH along with antibodies and if TSH still >4 esp with positive antibodies would treat to a goal TSH around 1.0.  A rare cause of rapid weight gain is Cushings (cortisol excess) ask your doc to consider a test for this.  Otherwise meds (esp some anti-seizure, anti-depressants, and anti-psychotics) can do this.  Nother common cause is pre-diabetes/insulin resistance.  Unless there is an obvious cortisol/thyroid/medication issue - then all weight loss seems to boil down to eating less than you burn...
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The normal range for TSH, updated by the AACE (American Association of Clinical Endocrinologists), is roughly 0.3 to 3.0 but most labs have not adjusted to the revised range. Even beore this revision, many labs were using "4.5" as the high-normal.
Your TSH is hypothyroid level. Did they check you for "thyroid antibodies"? If not, I would ask that this be included in your next blood tests, it will reveal whether it is "autoimmune" disease of the thyroid causing your hypothyroidism (most common cause), also called "Hashimoto's".
If you have any other results you can add to your post, it might be helpful for the forum Dr..
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I was feeling awful when my TSH was 4.5 and was also told by my family doc I was absolutely normal...that the TSH test was absolutely perfect in telling thyroid function. Well when my TSH hit 15 I went to see an endocrinologist who told me he most definitely would've started treatment with my TSH of 4.5. Don't give up...get a doctor who will treat you. You are hypo.
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Thank you guys. I thought that my TSH was high but I even asked the doctor I worked for and he said it was normal. I know I need treatment because I'm not feeling well at all...I guess I'll have to wait and see another doc. Thanks again.
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Avatar_n_tn
I have had thyroid problems since the mid-90s.  The most recent TSH test came back 0.02., which was low.  My physician changed my dosage from .050 mcg to 0.25.  Is this correct? I know the TSH indicates the amount of hormone working to keep the thyroid going, but this seems very low.
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Avatar_n_tn
Your Dr. likely saw the 0.02, which is below normal, as indication you were going hyperthyroid which can happen when taking too high a dose of thyroid replacement medication (toxicity) however, 0.25 would be a higher dose than 0.050, unless you meant "0.50".
If he put you on lower dose, it's to correct over-medicating you.
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My TSH level got up to 36.13 before I started meds for it.  I've been on the meds for one month (new labs this Fri).  The question I have is when is the best time to take it?  I saw on the bottle that you should take it on an empty stomach.  Should I take it last thing at night or first thing in the am?  Thanks, Valorie
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DR mark says you should take it first thing in the morning & not eat at least 30 min-1hr afterward. Do not take it with Calcium supplements or antacids or meds for your stomach such as Prilosec, Reglan, etc. because they can effect the absorption. Those medicines can be taken later in the day, Getting your TSH down may take a bit so don't get discouraged. What thyroid supplement are you on? Is your Dr. also checking your Free T=3 & Free T-4 also? They are important, too.
                                    Jean
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DR mark says you should take it first thing in the morning & not eat at least 30 min-1hr afterward. Do not take it with Calcium supplements, iron, antacids or meds for your stomach such as Prilosec, Reglan, etc. because they can effect the absorption. Those medicines can be taken later in the day, Getting your TSH down may take a bit so don't get discouraged. What thyroid supplement are you on? Is your Dr. also checking your Free T=3 & Free T-4 also? They are important, too.
                                    Jean
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I just had my specialist appointment today and was told my TSH level was 23 but my other tests were fine. They are not sure what is happening but I have been put on a dose of 300mg Thyroxine, which to me seems to high. I am not keen on taking such a high dose for too long as I have read about the side effects of taking such a dose.
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Avatar_n_tn
NAT71,

I don't doubt that 300mg of thyroid medication is what you will eventually need (I am on that, well actually 3 grains of Armour and 75mg of t4) and I am 5'5, 122lbs. I do think that they need to start you out slower. The body needs time to adjust or you  are going to fatigue the adrenals (not fun). I would get your script (see if the pharmacist will give you 100mg pills), start at 100mg and see how it goes. If you need to cut the pills in half and back down, then you will be able to. I do recommend however, that you find someone who will prescrie Armour thyroid first. T4 "only" protocols do not work.
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Avatar_f_tn
nat71,


What type (brand) of thyroxine are you taking.  The different types of L-thyroxine sodium are Synthroid, Levothroid, unithroid, & Levoxyl.  It usually is only dispensed in mcg.'s (micrograms) not mg.'s (milligrams). They come in 137mcg., 150mcg., 300mcg.

Plain L-thyroxine comes in Levothroid, Levoxyl, Synthroid, Unithroid.  88mcg., 112mcg, 137mcg., & 175mcg,,

Just wondered...I take it your on LEVOTHYROXINE 300 MCG TABLET
This medicine is a green, round, scored tablet imprinted with "EM 300".

                                  Jean
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Avatar_n_tn
Hi everone
It would scare you to know my level of TSH.First, I didn't know I was hypothyrodist. It is only when i wanted to be pregnant that i found out. When I had the test my TSH was 85!!!!!!I started with Eltoxin 50 and then the doctor put me on 100. The strange thing is that my neck got swollen after taking the medicine.It is the middle and the right side of my neck!! I thought you are supposed to have less symptoms when you are on medication!!!! So confused and scared.
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Avatar_f_tn
I have never heard of Eltoxin but I take it for granted it is a synthetic thyroid hormone replacement. What type of Dr. are you seeing? A family physican, an endocrinologist, or OB doctor?
Did they test your free t-3, free t-4, & thyroid antibodies? With a TSH as high as that, & just being newly diagnosed, I think I would see an endrocrinologist to get a handle on it.
especially if you plan on getting pregnant in the near future. You should not get pregnant until you get your labs back in the normal range or you could have a miscarriage.
My TSH was that high this last summer & I could barely function.
That happened after treatment for hyperthyroidism,
The neck swelling you are talking about is called a goiter(enlarged thyroid). The fact that it happened when you started medication is probably coincidental. It happens with thyroid disease, hypo or hyper.
Each time you have lab done it's your right to have a copy of it & it's a good idea to keep them for reference for yourself & further treatment.
The endocrinologist that answers questions on this forum is gone right now but probably will be back soon. I'd post your questions to him too.              God Bless, Jean
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Did like your answer to the question on having the neck swelling after beginning med. So clear and accurate -- and reassuring. Couldn't help but say YAY to you. ~ : )
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Avatar_f_tn
You can learn more about thyroid disease & goiters at this site www.suite101.com.
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This is a better link. Takes you right to the page.  :http://www.suite101.com/welcome.cfm/hypothyroidism
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Thank you very much for your reply. I think your right about the fact that i need to see a specialist. The problem is the medical system is very complicated where I live.It actually took me ages to get someone prescribe me something. In fact It is Eltroxin 100 mcg, I guess similar to Thyroxin.I heard that the swell means that medication isn't adequate. My question is how long would it take someone to get TSH of 85??! possibly long time !! And how long would it take my hormones to be balanced supposing I'm on the right track? Thank you again. You have no idea how good it feels when you think there is someone you can share your worries with.
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Avatar_f_tn
I copied this info from an educational thyroid forum @ suite 101: the swelling you are refering to occurs when your thyroid is trying to produce more hormone. So just the fact that you are very hypo can cause the thyroid gland to swell. The replacement hormone has nothing to do with it @ this point.
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Goiter occurs in both hyperthyroidism and hyperthyroidism. There are many more people with hypothyroidism than hyperthyroidism. Therefore, goiter is more likely to caused by hypothyroidism.

In hypothyroidism, goiter occurs when the thyroid cells enlarge in their efforts to trap more iodine and produce more hormone. In hyperthyroidism, goiter occurs as thyroid cells store more thyroid hormone and become swollen or enlarged.

Both types of goiter will resolve as the thyroid condition improves. This can take some time, and in hypothyroidism goiter can persist longer if there is scar tissue.
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It took 6-7 months to get my thyroid levels within normal limits. Your doctor will increase the dose slowly until your levels are where they should be. That will be your maintance dose @ that point & they will check your levels every 6 months -1 yr. after that. Until then, I hope they are checking your levels every 6-8 wks. & increasing the dosage according to the result.
Be sure to get copies of your labs. This is very important for your benefit & for future treatment.
Like I said earlier, I don't know where your from, but your doctor should be checking your free t-3 & free t-4 along with your TSH. Also an initial check of your thyroid antibodies wouldn't hurt either to see if an autoimmune condition is causing your hypothyroidism.
Do you have a national health care plan where you live? Is that why your having such a hard time getting treatment?
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Hi Jean
Thanks for the precious information. The problem isn't that i have no insurance the problem is that it is useless. The miserable fact that you are sick  here means you have to wait for ages till you see a doctor and then he looks at the test and gives you a minute thinking you are ignorant and know nothing about what you are going through.In fact i saw a (specialist) who gave me an appointment for a thyroid test in a month and a half and another appointment to see him with the results in 2 1/2 months.He told me i need to take my pills and wait for an hour b4 i can eat anything, which is good coz i didn't know i had to do that  and so my body won't benifit from the medication, he said.Thank you so much for taking it seriously dear.
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just wanted to post that there is a new site I have checked out at www.stopthethyroidmadness.com.  It has a lot of thyroid and adrenal information and also has thyroid forums where patients share information and answer questions.
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hi there
just got my lab results back tsh 1.11 and negative antibodies told this is normal so why do i have a bulky thyroid and nodules and feel like rubbish is this normal????
hope to hear from someone
thanks ace
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Hello,
Im new here but ive been reading all your postfor a few weeks now. i have recently found out i have high tsh...6.42 as of last check on 1-3-06 and a few years ago my other doctor told me it was a little high also, but he would check it next time. and i never really understood about thyroids and what they can make you feel like. so i never thought much of it. well i decided to have blood work again on 1-1-06 with my new doctor because my Cholesterol was a problem in the past...244 & Triglicerides (triglycerides) i beleive were 600's . well i dont eat fatty foods,greasy fried beaff or pasta.so it couldnt be from that and im 5'9 and weigh 190 and in desent shape.non. smoker to. and i read up on that being hypo can cause this to happen and my family doc. neversaid anything about that.but for about 7-8 years i have had a real battle with anxiety and slight depression and in the last 3 months really bad depression thoughts and feeling doomed with death, i feel realy sick to stomach alot. and i get really bad hot flashes when slepping and any other time.. are these symtoms (symptoms) of thyroids and if so will others please tell me what kind of symptoms your having. because the thougnts and feelings i go through are freakin me out and then all of a sudden i will feel ok for a couple days. and my doctor ( endo) gave me a prescription for ( synthroid 0.05 mg ) i havent started them yet because ive read up on them and i dont like meds with alot of side effect, are they good?? or should i ask for an all natural prescription & do they make one?? thanks and please help if possible ...
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Avatar_n_tn
Hi there.

what you are saying sounds like typical symptoms of hypothyroid which is the mainly represented in higher TSH level and lower T3.A higher TSH level here means that your thyroid stimulating hormone is struggling to stimulate your gland to work,but i guess the figure you are saying isn't too bad. i believe your doctor was right when he put you on medication and 0.05 sounds about right to me. please start taking it and take it first thing in the morning. you can have your breakfast after about an hour or little less of taking your medicine as this period of time helps your stomach to absorb the pill. Needless to remind you that the longer you wait  without medication the higher the rate will be , meaning it will go worse.By the way I suffer from thyroid disorder too but my case is waaaaaaaaay worse, luckily you need a smaller dose and shorter time for your hormone to be balanced. have a quick recovery!
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Hi Jean

I have been on Eltroxin for about 10 weeks so far. I started with 50 and now I am on 100. My doctor said my body wasn't benefiting from it because i used to eat right after taking the pill.I started to take it the right way three weeks ago. My irregular periods were the reason why i checked my thyroid in the first place and of course being unable to conceive.My periods are worse now after taking the pills, so painful and always late for 5-6 days after the regular time. Does that mean anything to you? When i want to check my TSH and T4 do i have to be fasting? DO i take my dose before the test or should that affect the results???
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I have been experiencing night sweats for about6-9 months now, have seen my OB/GYN for possible perimenopause and a rhematologist for a possible connective tissue disease.
I have also started having middle body weight gain despite eating the same and exercising the same.  Granted, I am getting older, I am 34, but I can not handle this anymore.  I know something is not right but no one can seem to find out the cause of the weight gain or the terrible night sweats.  I do not know what my TSH level is because I have not actually seen the results of my blood work but I have been told that everything is normal.  I have been taking 20mg of Paxil for 3 years now. I know that it can cause weight gain, but after taking it for such a long period of time?  I have an appointment scheduled with an endocrinologist at the end of the month but I'm afraid I'll go crazy by then.  I don't know what I'll do if she cannot find any cause for these symptoms.  Is if possible to try a synthetic thyroid hormone if your TSH levels are near the high end and see if that solves the problems or does that cause even worse problems?  Any comments are much appreciated!
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past 3 monthe i ahve been having insomnia,diarrhea 3 times only in the am, and just not feeling myself. my GP says its my nerves, GYN says menopause,Rheumo says maybe Fibro because my muscles are sore,ENDO says increase my synthroid from .25 to .50. My TSH is 3.I still dont feel well so i went on Lexapro a few weeks ago.  NO ANSWERS>  help. I felt better when TSH was 4.5
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61536_tn?1340701763
Did you consider the possibility of low hormones, such as happens when you're entering pre-menopause?  Yes, you're very young for that to be happening, but it's not unheard of to start having symptoms young.

Gaining weight from Paxil after being on it so long is next to nil as far as that being a cause.  I think SSRI weight gain is due to habits/mood affected by the medication more so than the actual medication itself.

Night sweats could be anything, including anxiety, but any symptoms causing you distress need evaluation regardless of their cause.

Something to consider with exercise is variation of your routine.  If you've begun to gain weight on your usual routine, your body just may not be challenged enough.  It's best to always throw in variations so your body can't "adapt" and start gaining weight at your new fitness level.

On the bright side, it's a few days closer to the end of the month now.  I hope you find some resolution to this and feel better real soon.
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