Are the TSH test ever wrong? How long does it take to regulate after surgery?

Question

Thanks to everyone for the comments. Just to be clear and in response to the one post I did not say or intend to imply nor do I believe that “depressed people are crazy” unfortunately my desperate frustrated post followed many years of suffering due to being misdiagnosed by highly qualified GP's and specialists.

In Nov 07 an Endo started me on synthroid and I started feeling better right away and was feeling good on 50 mcg synthroid with a TSH of 1.17 in Jan 08. My symptoms were relieved finally and I wish I could say that was the happy ending to my story.

After FNA twice on a large nodule I had recommended surgical removal of the right in April. The pathology came back benign and it seemed like the right thing to do at the time but if I could have known where I would be today I would not have gone through with it. The surgery itself went well and the scar has healed nicely but I am more miserable than I have ever been in my life. My clinical hypo symptoms are worse than ever and my TSH is way off. It was fine before surgery on 50 mcg, but 6 wks post surgery I was feeling awful and it was 8.63, then after about 6 wks on 75 mcg and still feeling hypo the TSH came back .27! I thought it had to be an error. But .27 is too low so I was put on an alternating dose of 50/75 and after about 5 wks, my TSH just came back 13.95! The Endo called Tuesday with the 13.95 result and said she is puzzled because the test is so reliable but she recalled my complaints to her for weeks have been clinically hypo and she wondered if maybe the .27 result was an error. Now I am to try 75 mcg daily for 4 weeks and retest. So far I have done exactly as told and followed the medication instructions to the letter but since the surgery I can hardly function. This is so discouraging and it is destroying my life. Has anyone else gone through this? Dr. Lupo, are these tests ever wrong?

This discussion is related to hypothyroid symptoms years "normal" test now a goiter?!.

AR-10 · Answer

I agree.

You had a partial thyroidectomy. The remaing thyroid was traumatized during surgery, and it may be sputtering, functioning irratically.

It's possible the TSH of 0.27 was an error. You may be in a phase where your thyroid is trying to return to normal function but is unable to.

I can't explain it. The only thing you can do is keep testing your levels until you become stable at the proper level.

sotired48 · Answer

Thanks your explanation about the lag makes sense.  But the .27 does not.  

8.63 on 50 mcg
.27 on 75 mcg 
13.95 on alternating does of 50/75 every other day

the swings relative to the dosages seem improbable to me

AR-10 · Answer

Dr. Lupo does not participate on this forum.

You can find his forum on the right, where it says "related expert forums".

The answer to your question is yes. Blood tests can be in error. It is not common, but it can certainly happen.

That is one reason it is good to have a Free T4 run with your TSH test. You can compare the results and if one test is messed up, it will look odd when you compare the two tests.

You can also test hyper and feel hypo. Symptoms lag behind hormone level changes, and it's possible to be hyper a week or two before you feel it, especially if it is only mildly hyper as your 0.27.