hyperthyroid and Synthroid

[Deb5180]

How long does it take for your TSH to return to normal.  Was diagnosed with hyperthyroid and taken off all Synthroid (100 mcg) a day.  Five weeks ago TSH 0.01 and FT4 2.1  now TSH still 0.01 and FT4 now 1.7.  I would really like to know why TSH hasn't moved in five week?  How long will it take to return to somewhat normal levels.  I am now in Afib.  Ugh!!!!  Thanks for your help, sure could use some answers.

[gimel]

So, between Feb. and July nothing was changed regarding your meds.  Yet, your Free T4 went up over the range to 2.1 and TSH dropped to .01 when tested 7/13.  And Afib started 6/25.  This is what made me think that an ultrasound of your thyroid gland is in order, to check for nodules..  Were you symptom free early this year, before the Afib?

You said no to Hashi's, yet your TSH was 3.11 in Feb, which doesn't usually fit with central hypothyroidism.  So what was the reason you were originally started on thyroid meds?  Was it due to symptoms, or lab test results?

Just for info, here is some info about ferritin, which seems to be a precursor to serum iron levels.  So, I also recommend testing for that.  

Low ferritin can cause the following symptoms.

    Minor aches
    Fatigue
    Weakness
    Heart palpitations
    Increased pulse
    Loss of energy
    Loss of libido
    Confusion
    Irritability
    Shortness of breath

Sorry for all the questions, but your case is unusual, worthy of learning more about it.  

[Deb5180]

yes to afib.  Last test for TSH was Feb. 14 it was 3.11.  Never had a FT4. Never had problem til found in July this year. No symptoms at all. Just don't understand why TSH will not move. No to ferritin or full iron test panel.  Will ask doc when he gets back next week. Have appt with both heart and GP. Just can't get an answer to TSH ?  Thanks

[gimel]

Are you still having Afib?  Have you been tested for ferritin, or a full iron test panel?  Before the 7/13 test what were your Free T4 and Free T3 results, and when tested?  I am trying to understand when your levels increased.

[Deb5180]

Afib since June 25, found hyperthyroid on July 13 thru routine yearly blood work.  Cardioversion on July 23 didn't work. Heart doc doesn't want to do anything till thyroid under control.  First test on July 13 TSH 0.01 FT4 2.1
July 23 TSH 0.01 FT4 1.9, Aug. 13 TSH 0.01 FT4 1.7.  Will test again in two weeks.  My doc is watching close so I don't go hypo, he is a great doctor and I know he will watch very close.  He's on vacation and I can't get an answer to why TSH wouldn't move in 5 weeks time when FT4 is getting better?  Thank you for all the info you have given me.  I really appreciate it.  TSH ? is driving me crazy!!!! LOL

[gimel]

When did you start having Afib?  Are you still having Afib?  What were your test results the last time tested before the last two tests?  When were those done?  

As the Free T4 continues to decline, the TSH will follow.  Realize that since you have stopped thyroid meds altogether, it will take a while to build back up when you restart on meds.  So, I think it would be a good idea to try and get tested every week until levels are optimal.  That way you will minimize the possibility of going too low on Free T4 and Free T3 and having hypo symptoms again.  

It is unfortunate that neither doctor understands that thyroid medication adequate to relieve hypo symptoms frequently suppresses the TSH level.  I can provide links to scientific studies that support that.  So the suppressed TSH itself is not a cause for concern.  The biggest question is why your Free T4 would go to 2.1 with no identified cause.  That is why I asked about Hashi's and an ultrasound test of the thyroid gland to test for nodules.  

[Deb5180]

Hypo for 15 years started at 50 synthroid then 100 synthroid 5 years ago. No to Hash's.  They just found out I was Hyper 5 weeks ago thru routine yearly check.  Just wondering when TSH would start to go back to normal levels.  Heart doc will not do cardioversion til levels of TSH and FT4 are normal.  FT4 is getting there but TSH hasn't moved in 5 weeks.

[gimel]

Of course it isn't TSH (or lack of it) that causes hyper symptoms.  Those are caused by excessive levels of Free T4 and Free T3.  Five weeks ago your Free T4 was really high.  Since the half life of T4 is about a week I would have expected your Free T4 to have dropped more than it has.  Which leads to questions regarding the beginning of your hypothyroidism.  Was it due to Hashimoto's Thyroiditis?  What symptoms did you have at the time/  What was your starting dose of Synthroid?  How long were you on the 100 mcg dose?  Any other symptoms besides the Afib?  Ever had an ultrasound of your thyroid gland?  

Keep in mind that the doctor can prescribe med to take care of the Afib short term, while further diagnosis proceeds.