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High TSH

I recently had blood tests performed for screening for a study testing the diet drug Remonabant (sp?).I was disqualified due to my High TSH results. My blood test came back with a reading of 13.8 for my TSH and 1.3 for my free T4. I do take 100 mcg of Levothroid, but I can't see that it does anything for me. I have  been back to my doctor twice since I started taking the Levothroid about 18 months ago and he said nothing needed to be adjusted. I belong to a health plan that offers only Kaiser (California resident) and it seems to be the pits as far as health insurance. I am grossly overweight, I feel horrible. I last lost weight by walking two hours a day everyday and staying on the Atkins induction diet for about two years. (seriously).  However, I hurt my knees and had to stop walking for about a year. Then I gained back the weight. I have fasted for two weeks straight (drinking water and broth and V8 juice) and I lost absolutely no weight...not even water weight. I have eaten under 900 calories regularly since I gain rapidly on a higher intake. I walk everyday- about an hour, I do step aerobics daily. I cannot budge the weight. My hair is very thin, I take 4 tablets of Vitamin A daily and that has stopped my hair loss. I have no nails to speak of, they just flake off. My skin is dry and rough. Any ideas, anyone?
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Avatar universal
This is a very old thread, and many of the people who commented may not be on the forum any longer.  You'd get more attention to your individual concerns if you went to the top of the page and hit the "Post a Question" button and started your own thread.

You can re-post waht you've already told us and answer the following questions as well:

Is your doctor testing anything but TSH?  Does he test FREE T3 and FREE T4?  

What was your dose of Levoxyl before you switched?  Was it the brand name Levoxyl or generic levothyroxine?  I've never heard lf "lavothroid" before.  Could you please check the name again?

Thanks.
Helpful - 0
Avatar universal
Do you have any stomach issues. If you have Gerd. Or any Stomach Acid problems It is harder to asorb the thyroid Medications I have Esophical problems and Acid Reflex, Thats my problem My THS was 29 this time. I take my Thyroid Medicine at 5;00PM at night. 5 hours after I eat. With nothing to eat before I take it, Because I took it for one year in the morning before I ate' And my THS was still high 18 I have a hard time tolerating the Thyroid Medicines It causes me to have  chest pains. which is a side effect of the medications. I just went from Levoxyl to lavothyroid. Which is a name brand from forest labs. So now it is all waked out. But I couldn't tolerate levoxyls higher dose. I don't know if I will be able to handle a higher dose of Lavothyroid either.  I havent tried Synthroid yet.
Carol.
Helpful - 0
Avatar universal
You'll probably get a lot more feedback if you go to the top of the page and click on the green "Post a Question" button.  That way, you'll start your own thread, which usually gets better response than tagging onto an old one like this.

Thyroid blood tests do not require fasting.  However, TSH is very volatile and can even be affected by the time of day the blood was drawn.  Were the draws at different times of day when you were fasting versus when you weren't???  That could account for the difference.

If you want a much more accurate profile of your thyroid function, ask your doctor to test free T3 and free T4 (NOT total T3 and total T4).  These are the actual thyroid hormones and indicate what your thyroid is actually doing.
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Avatar universal
I was diagnosed with a problem with my thyroid 3 years ago now
In the 1st fasting test it was 5.0 so dr's did a normal blood test 6 weeks later which was normal
The next year another fasting test reviled it was up again at 6.0 so again drs did a normal test 6 weeks later reviling it was back down
This year i had another fasting test and it was at 7.0 then again 6 weeks later its back down
I am a borderline diabetic (not on any meds)
I have asthma/bladder & bowel problems/high blood pressure (controlled by meds) tinnitus in right ear/arthritis in right shoulder/elbow/wrist/arthritis in left wrist/coxit & hips and now very bad in my left knee,
I suffer vertigo attacks just by turning my head and suffer anytime even when walking outside or glancing down to keyboard to type,
Im getting very forgetful & my hair is receding backwards from my forehead
My dr refuses to put me on anything for my thyroid all he does it rechecks with a normal not a fasting bloods 6 weeks later
Why would a fasting bloods show it up but a normal bloods does not?
Helpful - 0
Avatar universal
Thank you for replying to my question I didn't think to start my own post and never even been on a site like this before.  

As for the questions I was diagnosed one month ago.  I'm on Synthroid 75 MCG.  I have not had any other test done.  
I was at the doctor for vertigo and had no idea what was coming.  

Since being told I have this I have been trying to educate myself before going back to the doctor which will be next week.  I want to know what are the smart questions to ask.  I have not even seen any lab reports.

I feel like a child who has been dependent on her parents and now is on here own.
Any help will be greatly appreciated.

Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Since this is a very old thread, it might be better if you start your own post.  Have you had any tests done besides TSH, like Free T3 and Free T4?  Antibody tests, etc?

When posting lab results, please make sure you also post the reference ranges used by the lab as they vary from lab to lab, so must come from your own report.

How long ago were you diagnosed with hypothyroidism?  What med/dosage are you on?  

Sorry to ask so many questions, but without certain information, it's really difficult to answer your questions.

The time frame for the whole process of feeling better varies from person to person and depends on your particular issues.
Helpful - 0
Avatar universal
I'm new to this having only found out a month ago I have a TSH level of 22.  I only found out because I came down with Vertigo and the doctor ran blood tests to see what was causing it.  While there I mentioned over the past three or four years I have put on about 50 pounds even though I have been an avid gym person I have a fairly healthy diet.  I have felt exhausted even when I first wake up.  I thought it was all due to getting older as I'm in my forties now.  I feel betrayed by my body angry about all the work I've done to stay fit only to have my body fighting me at every turn.  At least now I know I'm not crazy and it's not because I'm old.  It has really wreaked havoc with my mind and my sense of self.  In all this my question is how long before the meds start to really take effect?  I do feel as if I have more energy in the morning. I have not lost any weight I still ache feel forgetful dry skin but my hair is great my sex drive seems just ok. How long before I have more energy throughout the entire day and will my weight really get to where I used to be if I keep exercising?
Helpful - 0
393685 tn?1425812522
I wish I had a concrete answer for you but really / medically - you need to test after changes to your meds to really see where things had moved to.

I think you need to remain in the consistant dose your doctor designed for your start up and steps your in.. regularly test at the times this doctor schedules them and check those labs to see if you see improvement or not with symptoms changing things up and down./
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Avatar universal
hey thanks to both of you for your help so far, i phoned to speak to my consultant today and his secretary is getting him to call but that could be forever. So i phoned my doctor and he was useless and said go down to 25mcg!!!!!!! what!!!!!! so i have just put myself on 75mcg until the consultant gets in touch, i think 50mcg was to a low drop as feeling soooooooo tired.... do u think this will be okay for now? i don't want my levels to drop quickly, does the ft4 just stabalise then and not keep going up? i don't really understand it in as much detail as you!
Helpful - 0
393685 tn?1425812522
anxiety is not just a hyper symptom. Its in relation to the FT3 balance - either too high or too low and linked to both hypo and hyper symptoms.

If your doctor is not testing your FT3 and has no idea where you really are at then its not an educated dosage change and you could be headed into worse symptoms if you are not monitored correctly.

Both hypo and hyper are linked to anxiety and heart palps all due to the FT3 testing...

If you are approaching your doctor with the right resources on getting the FT3 test - with the FT4 and TSH - then s/he has no real say on refusing your request to get it done.

Another thing here could be a conversion issue based off the T4. It sounds like you have been up and down in dosages for some time and still.... your situation has not improved as you would like it. Holding back conversion and even storing T3 hormone can happen at any time of thyroid treatment if the other glands and organs are lacking somewhere. To test for that the ratios of FT3 and FT4 must be looked at with past tests and see if anything is consistant between those too along with maybe requesting an RT3 blood lab and see where you are at there.

Some liver testing too could help look at a lack of conversion.

Helpful - 0
Avatar universal
So, you've been on 100 mcg for eight weeks.  After six of those weeks, FT4 should have leveled off to stable levels.  However, often what happens is that FT4 levels, then FT3 continues to rise for sometime afterward as conversion ramps back up.  So, my guess (and it's just that - a guess - without seeing FT3) is that's what's happening to you.

A decrease is probably in order (at least to see if your anxiety is relieved).  However, a drop to 50 mcg from 100 mcg is WAY too much.  That kind of change will have you flipping right back over to hypO most likely.  Do you think your doctor might consider dropping your dose just a little...maybe to 88 mcg per day, or even alternating 100/88?  Meds changes have to be made very slowly, or you will swing back and forth, which is no fun.  
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Avatar universal
hey thanks so much for replying, they won't test my ft3. My meds were re adjusted 8 weeks ago to 100mcg its in the last two weeks i have started to feel really anxious. My doctor has told me to put it down to 50mcg and wait to see what my consultant says when he gets back is that right to do so? i don't really trust my doctor he is not that great at thyroid stuff! i have had no other hyper symptoms.
Helpful - 0
Avatar universal
Your FT4 is high, and TSH a tad low, but not alarming.  Whether or not you are hyper depends on your symptoms.  Anxiety is a hyper symptom.  Do you have any other hyper symptoms?  Diarrhea, rapid heart rate, high BP, insomnia, etc?  

Do you know your FT3?

How long ago was your most recent meds adjustment?  Did you feel well on it for a while?
Helpful - 0
Avatar universal
hey
long time!! a question for you please, my consultant is on holiday and i think i have now gone hyper my T4 is 23 top of the range is 22 and my tsh is 0.2. range is 0.5 to something, does that mean i am now hyper? i don't know what to do about my meds, i have started getting anxiety attacks aswell :(
Helpful - 0
Avatar universal
Yes, the thyroxine can be a shock to your system.  You're body has to get used to having those hormones available again.

I do feel well now.  I haven't had any hypo symptoms in close to two years.  I briefly had some hyper symptoms a little over a year ago when I was overmedicated.  You will feel better, too.  This just takes such patience...it's really an art form getting your meds right.  You have to increase fast enough to keep symptoms at bay, but not so fast that your body doesn't have time to adjust to each higher level of hormones.  Just keep at it slow and steady...you'll get there.  You felt good for a while on 25 mcg, then you backslid a little...you'll probably find that that happens after every increase on your way to the proper dose, BUT the good days will increase and start outnumbering the bad days each time.  Do you keep a journal of meds and symptoms?  Sometimes the changes are subtle unless you can go back and read what was happening a while back.  Good luck with your increase.  
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Avatar universal
thanks for replying, you are very helpful! when i first went on levo my chest went very tight, i had insomnia and palpations but that only lasted about 4 or 5 days but i was very hypo so don't know if the thyroxine was a bit of a shock to the system?! i will phone the doctors tomorrow then to see someone as can't stand feeling like this for another 3 days! do u feel normal now? i am worried i will never feel like myself again!
Helpful - 0
Avatar universal
Well, your labs still need some work, and you still have some symptoms.  I wouldn't have a problem increasing as long as you're tolerating your 25 mcg well.  You might consider taking 37.5 mcg for a couple of weeks to see how you do with that, then increasing to 50 if 37.5 goes well.  In order to do the 37.5, you'll either have to have 25s to break in half and take 1 1/2-25s or get some 75s and take a half.  I think the doctor who called you has the right idea.
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Avatar universal
ok, sorry to bother you AGAIN!  i think i spoke to soon about feeling better, suddenly started feeling really tired and nausea but my bloods ar e so much better. My T4 is 13 range is 9.4-22 and my TSH is 11 which is still high but better than 45! range is 0.5-5 my doctor is on holiday but the one that called me wanted to put me up to 50mcg but i was not sure about this and said would rather wait for my regular doctor to come back?
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Avatar universal
So, patience, Grasshopper, paid off!  I hope you're not too young to understand the Grasshopper reference.  So glad to hear you're feeling better...still, take it slow...you might want to hit 37.5 mcg for a little while before jumping right to 50.  Depends on labs.
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Avatar universal
Hey
feeling so much better on levothyroxine!!! will be having a blood test soon but have so much more energy!!! its great but i am sure they will prob still need to put me up to 50mcg
Helpful - 0
Avatar universal
That's not an easy question to answer.  If your thyroid function continues to degenerate and your dose is too low, then your FT4 might continue to drop.  If your thyroid function isn't changing much, then the addition of 25 mcg will increase your FT4.  

However, bear in mind that it takes thyroxine 4-6 weeks to build up in your system to stable levels.  Don't expect to feel a lot better for a few weeks.  It's not a day-to-day thing, but keeping levels constant over time.  Also, you might need an increase (or two) before your symptoms completely go away. You have to give it four weeks.  If you still don't feel well then, it's time to ask your doctor for more bloodwork and re-evaluation of meds.  Treating this disease is slow, slow, slow.  We always say:  patience, patience, and when that fails, more patience...
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Avatar universal
sorry one more question! if my levo dose is to low with my T4 levels continue to drop? i still don't feel well...
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Avatar universal
Just about everyone does...this is all a very trial-and-error process.  We all react so differently to different levels of hormones in our blood that you have to start out low and build slowly.  

99 times out of a hundred, it's their thyroid problem not being properly controlled that's the problem. There are some issues with allergies to fillers in the meds, etc., but by-and-large, the meds (which are really not meds, but replacement for the hormones your thyroid would make if it could) are well-tolerated.

The easiest way to know if you need T3 is to test for it everytime, right from the beginning.  It may not be all that useful at first since they will try to regulate you on T4-only meds.  If you have FT3/4 levels going back, you can see how FT3 changed relative to FT4.  Does FT4 keep going up with increases in meds?  Does FT3 go up along with it like it should?  If id doesn't go up like it should, and you still have hypo symptoms, then conversion issues are to be suspected.  That's probably a while down the road for you.  And it may never be an issue...

You can also usually tell by symptoms.  If FT4 is at a good level, and symptoms remain, you probably have a conversion problem.  But, right now, you just have to worry about getting your FT4 up.
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Avatar universal
does everyone end up with their doses being increased? what these people experience then is due to their thyroid problem not by the medication itself? how do u know if you T3 meds when my doc won't test for it?
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