TSH 9.5 T4 IN NORMAL RANGE

[manyana]

Hi
i am a 43yr old female and have been taking 125mcg thyroxine since 1999 with no problems

in 2005 i lost 2 1/2 stones in weight and improved my diet and exercise - my thyroxine was still 125mcg but i started getting ectopic heartbeats (atrial only)in the hundreds a day and eventually some short runs of atrial flutter - constantly felt like i was buzzing and had frequent loose bowels

doctors reduced my thyroxine and it is now down to 75mcg - my symptoms have all disappeared except i still get the occasional ectopic beat daily (1 Or 2 day) and i have only gained 4 pounds in weight - if i increase the dose the ectopics become more frequent

my doctor (ordinary gp) has said its ok to keep me on 75mcg to keep the ectopics at bay and that although my TSH at 9.5 is abnormal my T4 is within the normal range  - so it could all be the normal for me - although unusual

i just wanted to check that having a TSH of 9.5 is not doing me any harm in any other way eg upping cholesterol etc?

is it worse to have a TSH of 9.5 or to have frequent ectopics?

i do not want to have the ectopics obviously as they do cause me anxiety but i also dont want to do myself more harm than good by leaving my TSH high

many thanks for your help

[Fran71]

Hi there,
I'm glad your symptoms have disappeared. I know palps can be awfully annoying...I suffer from PVCs and sinus tachy, very well controlled with a small dose of beta blocker (Inderal). Have you ever tried a beta blocker for your palps?

I was so glad to read in your other post that your small cancer didn't require treatment. I had ultrasound done every 6 months for a period because my endo saw something which might be a nodule, but it never grew in size and remained unchanged so now he wants me to have ultrasound once a year. I hope that's enough to catch any cancer in time...I read thyroid cancer is usually cured though!

I found out I have Hashi because I had palps and the thyroid is often a cause for heart problems so I got checked. Now the endo says that since I'm still euthyroid the thyroid cannot cause the palps. My cardio, on the other hand, says that I already have a thyroid disorder even with normal values, so that might contribute. Who should we believe? The fact is, I know of many people with elevated antibodies and normal thyroid function who suffer from palps!

I hope your palps get better. I would talk about the BB with your doctor if they get too annoying.

Good luck

Fran

[seamoon_lady]

Hi all I also have Hashimotos; I was diagnosed in October after having 1/2 of my thyroid removed for a large nodule.  Ironically I have had palpitations for about three years and they have never found a reason (told it could be anxiety attacks).  My thyroid levels have always been within the normal range....but after having my thyroid out I was put on 88 mcg of generic Synthroid.  I was also diagnosed a couple of years ago with Fibromyalgia which has been very dibilitating for me.  After being put on the Synthroid my heart palp have increased; however the pain of the Fibromyalgia has disapeared.  Although the palpitations are annoying, being pain free is a dream.  Has anyone else experienced anything similar?

Thanks you all

[Fran71]

Hi Lynne,
I've been tested every 6 months since 2003 and my TSH is always in the middle of the range. I know I have Hashimoto's because I have very high antibodies, and ultrasound confirmed thyroiditis though my thyroid is not enlarged yet.
Great you had no side effects till now!!! Did they check your antibodies? I think this way you could know if you have Hashi.

Good luck to you too and thanks for your replies!

Fran

[Fran71]

Hi Lynne! Thanks for your reply.
Yes my PVCs are benign too. The BB is just to relive symptoms. I suffer from PVCs and sinus tachycardia. On bad days I can have thousands of PVCs. That's why, after taking the BB only as needed, my cardio suggested I take it daily because I ended up at the ER one night with terrible arrhythmia, still benign anyway. Now I feel wonderful.  I know what you mean - I was very reluctant to go on the BB daily, but I feel goodknowing that it's just for the symptoms, and in any case it's not bad for my body. I too take propranolol, 20 mg daily but I can increase to 40 or even 60 if needed. I'm very worreid about when I go hypo and need to take thyroid hormones. I wonder what will happen to my arrhythmia. Do you know if there are people with Hashimoto's who remain euthyroid for long? Do all eventually go hypo?

10 mg propranolol is really a very tiny dose. Some people take 80 mg daily or more! If it helps you, I think you can take it safely without worrying you're taking too many meds. But I know what you mean. Premature beats can be a real pain, though we know they're harmless. It's a tricky situation...Maybe taking the 10 mg will allow you to increase the thyroid med a little and get your tsh down a bit.

Good luck to both of us! :-)

Fran

[manyana]

hi fran

i dont know re the euthyroid thing - is your tsh staying steady or getting higher every time you are tested?

i dont even know if i have hashimotos!! its never really bothered me as the thyroxine worked like a dream till i lost weight!! i never had any side effects at all - maybe i should put the weight back on - fatter and more unhealthy but had no heart or thyroid problems!!

anyway good luck with everything

take care
lynne

[manyana]

hi - i have had my heart checked by a cardiologist - i had to wear a 24 hour monitor - everything checked out normal - just pacs

i never had any problem with the thyroxine for 6 years and then when i lost weight it all started! i have been told that if you lose weight then you will most likely need less thyroxine and bcuz mine was not adjusted i was taking too high a dose for my new bodyweight - which sent me hyperthyroid - hence all the symptoms

now however - i cant seem to get above 75mcg without having a big increase in pacs which is unacceptable to me - i do have a beta blocker - propranolol 10mg - which i can take whenever i need it - i hardly ever take it though - altho i does work well when i have in the past

i am reluctant to increase the thyroxine and then due to that have to take a daily beta blocker - i dont really want to take 2 lots of  medication when i really only need one - if you see what i mean! as my doc says the pacs are benign anyway

i wish you luck with you hashimotos and fingers crossed it will be a long time before you have to take any thyroxine

take care lynne

[Fran71]

Hi,
your post is very interesting. I've been diagnosed with Hashimoto's years ago but I'm still euthyroid. I realize I'm very likely to end up hypothyroid sooner or later. I suffer from sinus tachycardia and ventricular ectopic beats - everything checked and benign but I'm worried they will increase once I start hormones for hypothyroidism. I'm on a small dose of beta blocker daily and it has helped enormously. I figure that when I start taking the hormones I might need to increase the BB.
Maybe you could ask your doctor if you could try a BB along with the hormones. That might be a way to bring your tsh down and keep your PACs at bay.
Just a suggestion. BBs are very safe meds and they really make a difference for me.

Take care

Fran

[Mark Lupo, M.D.]

A TSH of 9.5 with normal T4 is subclinical hypothyroidism - there is some evidence that this has a negative cardiac/cholesterol impact and also can cause fatigue/brain fog (cognitive dysfunction).  

A TSH of 4-5 may be a reasonable target for you.  The dose of 88mcg may be logical.  If the ectopic beats continue a formal cardiac evaluation may be warranted as I would not want the subclinical hypothyroidism to be a "treatment" or "mask" for an underlying electrical problem with the heart.