Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Unstable TSH levels
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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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Unstable TSH levels

I had papillary cancer. Thyroid was removed and ablated several years ago. Since then I've had unstable TSH levels ranging from .012 to 13.0. along with typical symptoms. I usually have TSH checked every 6 months or so. I am a 53 year old female in otherwise fairly good health. Anyone have any ideas as to why?
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Common reasons for fluctuations: interfering meds, change in estrogen status (menopause/meds), supplements which change absorption, getting different brands/generics of thyroid meds, missing doses.  Go over your med list and supplements with your thyroid specialist to see what may be the cause.  Also, avoid generic thyroid meds and stick with one brand.
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My personal thought is that you should have blood tests more often, especially with a history of cancer and fluctuating TSH.

As to the possible why's -- there are many possibilities -- here's seven.

FIRST, do you ever eat foods that interfere with thyroid hormones:

Do you ever eat foods with soy in them?(soy burgers, tofu, etc.)
Or nuts?
Or, do you eat "cruciferous" vegetables -- that is raw brussels sprouts, raw cauliflower, raw broccoli, etc.

Such foods can oppose thyroid hormones, and can raise the TSH.  

Eaten here and there -- and in large amounts they could cause ups and downs. If they are eaten in consistently, small amounts each day, the  routine blood tests should handle that.

SECOND, does your activity level vary a lot?  Our level of activity can affect how much thyroid hormone we need.  Do you ski in the winter and then lay off activity in the summer? Or, vice versa.

THIRD, do periods of stress affect your TSH levels?

FOUR, do you ever have times when you don't sleep well? Then, it's possible that your TSH may not go up as much.

FIVE, do you get your TSH tests at the same time of day, before taking any meds, exercising or eating?  Consistency is important because TSH can vary with time of day -- altho not as much as you report.

SIX -- there are probably many other possibilities -- including the season and the temperatures in your area.

SEVEN -- do you take meds at the same time? always with the same routine -- that can make a difference. There are also meds that can affect thyroid hormones.

I'll see if someone else can come up with some others -- while you reflect on these.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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