Thyroid Disorders Community
rising TSH low to low normal T4
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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rising TSH low to low normal T4

My TSH has gone from 1.71 to 4.0 range on both ( .4-4.5 ) my t4 has gone from .9 to .7 range (.82 - 1.77)
That is from may 10 to Oct 10 of this yeay. Without a change in diet my weight has gone up 19 lbs, my hair is falling out and I can peel the skin off my nose daily it is so dry.
I have been put on and off thyroid medicine over the past 2 years ...last taking in Jan 2012.  Been told you do and dont have a thyroid nodule. I am so frustrated ...I cant eat any less (about 1200 cal a day) ...I exercise regularly
They did do an MRI of my head and there is a partial empty sella ...yet..
Im being blown off like this is "normal" for my age ...what do I do

3 Comments Post a Comment
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Avatar_m_tn
Your doctor is not very well versed on thyroid issues.  First, the range for TSH was recommended to be changed about 10 years ago, down to .3 - 3.0.  Given that , TSH is totally inadequate as the diagnostic for thyroid because it cannot be shown to correlate well with either of the biologically active thyroid hormones, Free T3 or Free T4, much less with symptoms.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.

If you TSH is going up I suspect that you may have the most common cause of hypothyroidism, which is Hashimoto's Thyroiditis.  With Hashi's, the autoimmune system erroneously decides that the thyroid gland is foreign to the body and produces antibodies to attack and destroy the gland.  This occurs over an extended period, during which the production of natural thyroid hormone is gradually diminished and has to be replaced with thyroid meds.  Also, TSH typically rises, as your TSH has done.

Also note that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance after an initial evaluation and tests.  The letter is then sent to the participating PCP of the patient to help guide treatment.  In the letter please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So the first thing I suggest is that you should always make sure that you are tested for Free T3 and Free T4 (not the same as Total T3 and T4), each time you go in for testing.  To confirm Hashi's you should be tested for the thyroid antibodies.  Those tests are TPO ab and TG ab.  Since hypo patients frequently find they are deficient in other important areas as well, you should also request to be tested for Vitamin D, B12 and ferritin.

When test results are available, please get a copy of the lab report and post results and their reference ranges shown on the report and members will be glad to help interpret and advise further.
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4128244_tn?1350077211
Gimel, thank you so so very much for posting that link! I read it just for info, but it turns out that the Dr writing the letter is only 20 minutes from me! Hopefully he is still practicing. I've been searching for a "Good" Dr, and was planning a 3 hour trip to see one! I am so excited about my condition getting treatment, I can't even put it into words! Thank you, thank you, thank you!!!
May God (or whomever you choose) Bless You!
Thank You!
Sue

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Avatar_m_tn
Wow, that is a stroke of luck for you.  You are very welcome for the info that led you there.  Please let us know how things progress.
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