Do I need synthroid?

[Courtney33]

I recently had thyroid bloodwork done due to weight loss.  I am 7 months post-partum and am breastfeeding.  I am working at a pretty stressful job part-time (veterinarian) and probably not eating as much as I should.  My TSH was actually high (10, unsure of the units) and fT4 was 0.97.  My doctor could not feel a goiter.  My doctor wants to start Synthroid, but I am worried that I will actually lose more weight if I do.  Instead, should we be doing more investigation as to why the TSH is elevated?  I was thinking a CBC, full blood panel, etc.  Thanks for any information.  

[Courtney33]

I actually discussed all of this with my MD as well as the other vet at my clinic :).  We decided it would be prudent to hold off on the Synthroid and recheck my thyroid levels in one month.  We would then be out far enough that any alteration in levels I was potentially getting from my kenalog injections would have resolved.  I did ask about a thyroid panel with tests for thyroid autoantibodies, but she didn't seem inclined to do that...although I will not go on synthroid without getting the full picture of my thyroid levels including autoantibodies.  Bottom line is that I am feeling good right now, no obvious hypothyroid symptoms, so we'll wait a month and go from there.  The only reason this all got started was because I had lost quite a bit of weight and wanted to make sure I wasn't hyperthyroid along with stressful work/breastfeeding/probably not eating enough.

[stella5349]

This may sound odd to you - but have you talked with your colleages about this and your thyroid levels?

I have a friend that is married to a vet and he sure informed her of what was going on with her thyroid.

I would test for autoimmune thyroid at your next lab. A TSH of 10 should indicate a need for thyroid support - it may be temporary due to the injection.

[Courtney33]

I feel fine, a bit tired, but I have a seven month old :).  On the days I work, I am pretty wiped out by the time I get home, but my off days I feel normal.  I've always been a person who is sensitive to the cold, but I am quite thin.  If anything, I am a bit of a hyper person, always cleaning, doing laundry, etc.  That is all pretty normal for me.  I am inclined to recheck levels again in a few weeks along with a full panel of bloodwork, and see if the abnormalities are repeatable.  Also, I'm wondering if my thyroid levels could be abnormal d/t 3 injections of IM triamcinolone I received q2 weeks in Nov/Dec d/t nerve damage from giving birth.  In my realm of practice, triamcinolone can affect the body for 3 months, which for me would be until early to mid March.  With postnatal thyroiditis, will you have authoantibodies to T3/T4?  Is this like an immune-mediated thyroiditis?  Thanks for any info!  Courtney

[Super_sally888]

TSH of 10 is too high and it is a good idea to start synthyroid.  Ideal TSH is between 1 and 2

As TM514 said some people lose weight even with hypo.

Given that this is postpartum, it may resolve over time.  So your doctor will need to monitro you regularly with the treatment (actually he should monitor your regularly anyway when on thyroid meds).... in case it needs adjustment.

[tm514]

Guess it would help if I answered your first question regarding needing synthroid.

How do you feel other than the weight loss?  Are  you having any of the other symptoms of Hypothyroidism?  Joint Pain, hair loss, tiredness, always cold?  If so, then you might benefit from synthroid.  It is possible your weight loss is a sign of hypo - there are individuals who are hypo who don't gain weight, just like there are hyperactive folks who gain weight when that is not the norm.

[tm514]

Your TSH is high because your pituitary gland is not detecting enough thyroid hormones in your bloodstream.  TSH is secreted by the pituitary gland to regulate production of thyroid hormones by the thyroid.  I'd say further blood tests for thyroid levels and thyroid antibodies might be warranted, but I'd doubt a CBC or full blood panel would tell you anything more about your thyroid levels.