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TSH stuck at .01

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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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By bunnylover4 | Dec 17, 2012

1 Comment

Answered by Mark Lupo, M.D.

TSH stuck at .01

I have Graves Disease. I have been on 15 mg of Tapazole for about 6 weeks now. The good news is the Free T4 and Free T3 are going down (29 and 8.5 respectively! But, the TSH is still .01. Is this to be expected? At what point should the TSH wake up and start rising? Thanks so much!

Mark Lupo, M.D.

Dec 20, 2012

Yes, it will take several months the TSH to increase. This is not unexpected. The important thing is to not rely only on the TSH in the beginning as this will be low for often 6 months or more. Following the T4 and T3 in the beginning is the best way to titrate methimazole dose to avoid overtreatment with methimazole and medication-induced severe hypothyroidism which unfortunately is not uncommon if only the TSH is low fat.

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