Raise in TSH after stopping Thyronorm 25 mcg

I am 32 yrs old male from India. I got my T3,T4 and TSH test done in Mar'09, the values were

Total T3 -> 0.59 ng/mL       (Reference Range 0.79 - 1.49)
Total T4 -> 4.19 ug/dl         (Reference Range 4.5 - 12)
TSH      -> 5.92 uIU/mL      (Reference Range Adults -> 0.4 - 4.67)

I am already taking Seloken XL 50 mg and TG-TOR EZ for slightly elevated hypertension and Cholesterol. Seeing these values of T3,T4 and TSH doctor advised me to take 1 tablet thyronorm 25 mcg daily in the morning. I took this tablet for about a month and got my test done again in June'09 and the values were

Total T3 -> 1.89 ng/mL       (Reference Range 0.79 - 1.49)
Total T4 -> 8.30 ug/dl         (Reference Range 4.5 - 12)
TSH      -> 0.01 uIU/mL      (Reference Range Adults -> 0.4 - 4.67)

As the TSH value had become very low, doctor advised me to stop thyronorm 25 mcg immediately. After about 3 months, recently I again got the test done and saw that TSH value is increased. Also the Bilirubin value is increased in Liver Profile Test.

Total T3 -> 0.65 ng/mL       (Reference Range 0.79 - 1.49)
Total T4 -> 3.09 ug/dl         (Reference Range 4.5 - 12)
TSH      -> 47.06 uIU/mL    (Reference Range Adults -> 0.4 - 4.67)

Total Bilirubin     -> 2.1 mg/dl (Reference Range 0.2 - 1.2)
Direct Bilirubin   -> 0.5 mg/dl (Reference Range  0 - 0.3)
Indirect Bilirubin -> 1.60 mg/dl (Reference Range 0 - 0.6)

I am confused about these values. In general, I don't have any symptoms of Hypothyroid. Please advise.

[6hashi]

Hello ,
First the Total Ts does not give a lot of information, next time ask for the Free T4 and Free T3 instead .

It was a good Idea to start taking thyroid med for your TSH indicated hypo ,however , you get slightly Hyper and so your doctor should have decreased your dose rather than recommend stop taking the med !

all the best ,

[Super_sally888]

Hi,

i would guess that you are gradually getting more hypothyroid. Your doctor should have been adjusting based on the t3 and t4, not just tsh.

your middle results actually looked ok, though tsh was apparently low.  your doctor probably should not have stopped the meds just looking at the t3 and t4 results which were still normal range,.

your latest results show more severe hypothyroid showing you definitely need the med and probably your doc will ned to build you up to a higher than 25 mcg dose.

Yes, do get free t3 and free t4 next time, which give much better indication of thyroid status than t3 and t4.

When do yu see your doctor next?  Let us know how you go.

[vij77]

Thanks for the advise, I will keep you posted on the Free T3 and T4 results.