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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
TSH still high
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.
TSH still high
by momoffour573, Nov 01, 2009 04:42PM
Dr. Lupo,
Since my TT in July for papillary carcinoma I have went from feeling perfectly fine to absoulutely horrible. I understand that it does take a while to get your levels of synthroid just right, however, it seems that maybe something is being overlooked. My last TSH level was 14.8 and my synthroid was increased from 225 to 250. The main issue I am having is with muscle and joint pain. From all that I have read, this seems to be a fairly high dose. I would like to know if you have any suggestions as I have an appointment with my ENT on Tues. and I would run it by him. Also, I have had an enlarged lymph node in my posterior cervical region that we have been "watching" since my surgery. It is not painful and since July it had not gotten any smaller, maybe a little larger. I just would like a second opinion on the "just watch approach."
Since my TT in July for papillary carcinoma I have went from feeling perfectly fine to absoulutely horrible. I understand that it does take a while to get your levels of synthroid just right, however, it seems that maybe something is being overlooked. My last TSH level was 14.8 and my synthroid was increased from 225 to 250. The main issue I am having is with muscle and joint pain. From all that I have read, this seems to be a fairly high dose. I would like to know if you have any suggestions as I have an appointment with my ENT on Tues. and I would run it by him. Also, I have had an enlarged lymph node in my posterior cervical region that we have been "watching" since my surgery. It is not painful and since July it had not gotten any smaller, maybe a little larger. I just would like a second opinion on the "just watch approach."
Doctor's Answer
by Mark Lupo, M.D., Nov 02, 2009 06:35AM
, Nov 02, 2009 06:35AM
High doses of synthroid are not uncommon, but it may reflect a relative decrease in absorption of the medication - make sure you are taking it on an empty stomach at least 30 minutes before food or other meds. Until the TSH is optimized (usually 0.1-0.5 initially after cancer surgery), it will be difficult to sort out symptoms.
The large lymph node may well be a normal "reactive" lymph node -- it depends on ultrasound characteristics and thyroglobulin levels whether observation is appropriate. An FNA biopsy is an easy procedure that would help address if this is a problem node.
The large lymph node may well be a normal "reactive" lymph node -- it depends on ultrasound characteristics and thyroglobulin levels whether observation is appropriate. An FNA biopsy is an easy procedure that would help address if this is a problem node.
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