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fluctuating tsh levels
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fluctuating tsh levels

I was diagnosed hypothyroid with a TSH level of 4.135 in October just from a regular wellness screening. I am sure this is due to my body attacking my thyroid post-partum as I had to be hyperthyroid for a few months post-partum (had all the symptoms).  I had and still have no symptoms, but am in my 30s and didn't want to gain a bunch of weight due to a hormonal imbalance, so gave in and started taking the meds.  They started me on 50 mcg and that brought my tsh level to 2.45.  They wanted it lower than 2 so I started on 75 mcg and after 6 weeks my tsh level was 2.75!  During this time, I also weaned my 20 month old son which I would only think would improve my tsh level.  Now they want me up to 100 mcg, but I would have to say the meds aren't working and that seems like a lot of meds for such a close level to begin with.  What do you think?
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Avatar_f_tn
Just curious.  Did they retest your TSH a second time before giving you meds?  I ask because my TSH went high out-of-range, then at second testing it was down in range, so I've yet to get a thyroid condition diagnosis yet.
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649848_tn?1357751184
Have they run any other tests, such as FT3 or FT4? What about antibody tests?  How long have you been on med?  

I don't understand why you think weaning your son would improve your TSH.  TSH is simply a "messenger" hormone from the pituitary gland, telling the thyroid to produce more hormone.  

If your doctor is basing your med dose on TSH alone, he is doing you a great disservice, as TSH is not a good diagnostic.  You need to have FT3 and FT4 done as well, since those are the active thyroid hormones, with FT3 being the most important.  Without knowing what your FT3 and FT4 are, your doctor is merely "shooting in the dark".
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Avatar_f_tn
They did the test 2x to make sure it was correct- both were around 4.125-4.2.  You "give away" thyroid hormones in breast milk and that is why I thought it would improve.  I did the blood tests after my visit and are only calling me with results.  I have asked for the full panel to be sent to me without luck- still trying.  I am not impressed with the care that I have been given.  I feel like they are drug pushers based on a cookie cutter scenario that isn't always the case and they aren't taking the time to look more closely at the whole picture.  That feeling was confirmed with them just wanting to give me more drugs with what I would consider unexpected results......  
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649848_tn?1357751184
You may "give away" thyroid hormones in breast milk; however, they are testing only TSH, which is NOT a thyroid hormone, it's a pituitary hormone and not totally indicative of what your actual thyroid levels are doing.  

By basing your dosage on TSH, your doctor is doing a lot of "guess work" that is not to your advantage.

My suggestion is that you insist on the FT3 and FT4 tests, along with testing for antibodies and if they refuse, do yourself a favor and find another doctor.  This one will only keep you sick.
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Avatar_f_tn
however, if you have more of the thyroid hormones circulating in your blood stream, we would assume that your pituitary would release less TSH (I am actually a physiologist- academic, not medical).  This is why I thought weaning my son would decrease my TSH.  

None of my blood work included anything but TSH, as far as I can tell.  I am going to have to shell out the bucks for an endrocrinologist :(  Wish I had more faith in the medical profession!  There is a lot of thyroid disease and cancer in this area of the country and I feel like I need to be proactive!
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649848_tn?1357751184
I understand your reasoning with the TSH, but unfortunately, it doesn't work that way all the time.  

I'm going to suggest that your thyroid is not working up to par, so your pituitary gland continues to pump out TSH -- without testing for the actual thyroid hormones (FT3 and FT4) you have no way of knowing what your thyroid is actually doing.  There's a chance that your pituitary gland isn't working right -- but again without the thyroid hormone tests, you can't know.........

How do you know that your body is attacking your thyroid?  Have you had antibody testing to see if you have an autoimmune disease?  That's the only way your "body" would attack your thyroid.  

I still say that if you are being dosed only on TSH values, your doctor is doing you a disservice and you will most likely only get worse.........

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Avatar_f_tn
got my full panel- (their normal ranges)  tsh 4.125 (0.5-3), t3 uptake 38.7 (23-35), t4 7.7 (4.5-12), t7 2.98 (1.04-4.2).  These tests were done prior to being on any meds.  I've decided to wean myself off meds.  have been extremely jittery, tense, and on edge since my does was increased to 75 mcg.
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649848_tn?1357751184
I hope you will reconsider about 'weaning' off the med - talk to your doctor.  .  

Your TSH is high, indicating hypo.  T3 uptake is obsolete and tells pretty much nothing.  Is the T4, Total or Free?  If it's total it's also obsolete and also tells nothing.  I'm not sure of the T7; I know it's a thyroid hormone, but have never heard of it being tested separately.  

So, most of the tests that were done tell basically nothing and can't be considered a "full panel".  

You need to get the following tests in order to find out where you are with this:
TSH
Free T3
Free T4
TPOab (thyroid peroxidase antibodies; also called microsomal antibodies)
TGab (thyroglobulin antibodies)
Thyroid Ultra Sound

Those tests will tell you what your thyroid is doing and by testing the antibodies, you will know if you have an autoimmune disease (Hashimoto's Thyroiditis), in which antibodies gradually destroy your thyroid, ultimately leaving you permanently hypo, needing meds for the rest of your life in order to live.

I know a lot of people have a problem with having to take daily thyroid med, but you can compare it taking daily birth control, blood pressure med, daily asthma med or any number of other things you might have to take med for.  

Best of luck to you.
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