Thyroid Cancer/Nodules & Hyperthyroidism Expert Forum
Difficulty withstanding targeted TSH
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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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Difficulty withstanding targeted TSH

I am a 41 y.o. female diagnosed with and treated for thyroid cancer in 2008 (1 nodule @ 1 cm, no lymph node involvement), and I have since had trouble tolerating the TSH levels I am told I need to prevent recurrence.  I feel ok with a TSH of 0.3, and felt absolutely fabulous before my last lab test which showed 0.7.  I understand the protocol is 0.1, so increased my dose consistent with my doctor's orders.

Two and a half weeks after increasing my synthroid dose by 8%/week, I have ringing in my ears, metallic taste in my mouth, zero restfull sleep, and every single mucous membrane in my body feels like it's shriveled like a raisin.  My gums are completely dehydrated, and I have cut in my mouth that won't heal due to inadequate saliva (so says my dentist).  

Will these symptoms go away? Is there any way to mitigate the dry mouth symptoms, in particular? Am I endangering my life by targeting a TSH level that doesn't make me miserable?  Is there actual data to support risk/benefit trade-off with respect to TSH levels?

Thank you so much for your insight.

Denise
Tags: TSH, side effects of synthroid, synthroid dehydration
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You ask a very good question.  In fact the degree of TSH suppression is dependent on the risk of recurrence of thyroid cancer.  You had what sounds like a stage I cancer 4 years ago with no clinical evidence of persistent or recurrent disease.  Therefore the TSH goal is typically 0.3-1.0 or even as high as 2.0 according to some recent articles.  There is a good paper in the journal Thyroid from 2010 by Dr. Cooper to address this question.
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Thank you, Dr. Lupo! The article will be so helpful when I discuss this with my doctor.
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