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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Fluctuating TSH levels
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Fluctuating TSH levels
by Bella0628, Sep 15, 2009 01:07PM
What would cause fluctuating TSH levels?
June labs:
Total T3 = 120
Free T4 = 1.4
TSH = 5.64
July labs:
Free T3 = 301
Free T4 = 1.1
TSH = 3.73
No medication adjustments were made during this period. I am only on Synthroid 88 mcg, no other medications. Since I was started on Synthroid in 2005, the only lab that has been abnormal is the TSH .. T3/T4 have ALWAYS been in normal range. Adjustments to my Synthroid have been made based on TSH only which has never been higher than 9. I did test positive for antibodies and have an enlarged thyroid gland with some small subcentimeter nodules which are characteristic of Hashimotos.
Should I even be on Synthroid at this time?? It seems to make me extremely "wired" after I take it. Any further testing that you could suggest?
June labs:
Total T3 = 120
Free T4 = 1.4
TSH = 5.64
July labs:
Free T3 = 301
Free T4 = 1.1
TSH = 3.73
No medication adjustments were made during this period. I am only on Synthroid 88 mcg, no other medications. Since I was started on Synthroid in 2005, the only lab that has been abnormal is the TSH .. T3/T4 have ALWAYS been in normal range. Adjustments to my Synthroid have been made based on TSH only which has never been higher than 9. I did test positive for antibodies and have an enlarged thyroid gland with some small subcentimeter nodules which are characteristic of Hashimotos.
Should I even be on Synthroid at this time?? It seems to make me extremely "wired" after I take it. Any further testing that you could suggest?
Doctor's Answer
by Mark Lupo, M.D., Sep 15, 2009 06:52PM
, Sep 15, 2009 06:52PM
You have hashimoto's with subclinical hypothyroidism. Likely the synthroid is necessary, but could consider an alternate such as levoxyl as sometimes one brand is better tolerated than anohter. Target TSH in general is 0.3-2.5 for hypothyroidism. No further testing would help clarify or add to this evaluation.
