TSH 30, No Symptoms, What is proper treatment?

[MsLemur]

Female, 32, not pregnant, thin & fit my entire life. Recently went through a precautionary set of blood tests, after 5 years w/o insurance or regular checkups. My TSH was 30.3, all other results, including blood sugar and cholesterol were great. New doctor diagnosed me with hypothyroidism based on this test, prescribed levothyroxine .05mg daily, & said to come back for a checkup in 3 months.

I have a few symptoms common to hypothyroidism: cold intolerance, constipation, joint pain, low libido. Also a mild form of bipolar disorder (not currently medicated). None of these conditions are acute, I have had all of them for 10 to 15 years at least, and none have gotten worse in the last 5 or so years. Some have improved. I definitely don't have the most common symptoms: weight gain, hair loss, dry skin, or slowed heartbeat.

I insisted on a 2nd TSH test for confirmation, and my doctor grudgingly consented to also do a T4 test, but flatly refused to test for T3 levels or antibodies because it "doesn't change treatment." I asked about treatment plan: he wants my TSH to be "under 10, 6 if possible, lower if I felt like it." I asked about coming in sooner, he was willing but indifferent, didn't see the urgency. I asked about delaying treatment, he thought I would eventually get symptoms, & would prefer that I start within a few weeks.

I'm concerned about his casual attitude & treatment plan. I feel great now, could meds make me worse? Should I just take the meds, see how I feel, and retest in 2 months? HMO means it's hard to see specialists, and I must be my own treatment advocate.

[goolarra]

A related discussion, High TSH, normal FT3 and FT4, symptoms gone was started.

[snake lady]

You DO have hypo symptoms!  Sometimes our bodies cope with this problem for a very long time but time will tell.  Don`t wait until they lay you low.  When a person is hypothyroid their metabolism  systems are not able to cope like they should.  Waiting til they are extreme is not a good idea.  When Dr. Broda Barnes was a young researcher in the 30`s they did a little experiment on rabbits and removed their thyroids  AND THE RABBITS DIED.  Dr. Barnes wrote a very interesting book in 1976  Hypothroidism the Unsuspedted Illness.  It is worth reading. Take Care.

[MsLemur]

OK, I get that my thyroid isn't working properly. But a 10 point jump in a week? I have no symptoms that I haven't had for YEARS, so if any of these symptoms are related to hypothyroidism, then my body hasn't been producing enough thyroid for at least five years. I have had no change in my health at all over the last year, no worsening of any symptoms. So why would my TSH levels jump up from week to week? What is a normal variation in TSH levels between closely spaced tests? If my TSH levels were jumping up 10 points every week, that would presume that my problem with my thyroid is very recent, and it was just blind luck that I happened to be tested and diagnosed.

I just feel like there's nothing out there to instruct people like me, who are fine, healthy, feel great, and yet have these wacky test results that make NO SENSE when compared to my physical experience of my own body. People with the opposite problem, tons of symptoms, but normal thyroid levels, have all kinds of support and are urged to listen to their bodies, not their doctors or their test results. Why can't I do the same? Why can't anyone tell me why I feel fine, what it means for my test result to have gone up so rapidly in a week, how long my thyroid has been having problems, and what will happen to me if I don't treat this?

I'm taking the pills, but I hate it. I hate taking medication that has no perceivable effect on my health, and I hate not understanding the importance of why I have to do this. Without any symptoms, I have no way of knowing whether I am getting 'better' except to look at test results that have no bearing on my actual feeling of health. If my doctor wants to keep me at a dosage that brings my thyroid down to 10, what do I have to say it should be lower? None of this makes any sense, and I find it very frustrating.

[MsLemur]

I just got my test results back from the second round. TSH 44.2, Free T4 Analog .7 which is low?

I thought TSH was supposed to be stable. Why would two TSH tests, a week apart, be so different? Is the fact that I fasted before one and not the other the factor?

Obviously I'm going on the thyroid medication, I just wish I understood why this is happening, and what it means, and why I feel fine, when my blood tests say I should feel awful.

[Mark Lupo, M.D.]

A TSH above 10 confirmed on repeat testing merits treatment even if symptoms are mild -- you do have some mild symptoms.  My target for TSH is around 1.0.  Would test antibodies so you know why you have this and can tell family members.  Would retest in 6 weeks.