High TSH

[MAnna9]

Hi,

20 days back I have got the TSH test results (with fasting) and the result shown as 80.85 uIU/ml and doctor asked me to take levothyroxine 100 MCG tablet.

I feel like I am very sick and tired. My hands are paining and muscle is very weak. Is it because of the high dosage?

Yesterday I have gone for Thyroid test again (without fasting) and got the test results as 1.37 uIU/ml.

I could not understand the too much variation in the test result within 20 days.

can someone help me in understanding the test results? Is it common or anything wrong with the test results?

Thanks in advance.

Regards,
MA

[goolarra]

Your initial FT4 result indicates you were very hypo.  It's below range, and an optimal level for FT4 is close to midrange.  

Your doctor should be testing FT3 and FT4 every time you have blood work.  Treating based on TSH alone will most likely have you on a rollercoaster of meds adjustments.  

100 mcg is a high starting dose for someone who is very hypo.  Your body is no longer used to having thyroid hormones available, and it has to rebalance.  If you read the insert on any of the T4 meds, like levothyroxine, you will see that the recommended starting dose drops considerably if you have been hypo for more than a few months.  I'd guess with your very low FT4 that would be the case.  Since you are young, and assuming you have no history of heart arrhythmia, I'd suggest you ask your doctor to start you at about 50 mcg.  After about four weeks, you can retest, see how you feel and increase as needed.

I'm sure you must have had quite a list of hypo symptoms.    

[MAnna9]

Hi,

Thanks for your reply.

My age is 35 (Male).

Initial test results of Free T4 (FT4) was 0.58 ng/dL (Std range 0.80 - 1.80 ng/dL).

Today I have received only TSH test results as below.

1.37 uIU/ml (Std range 0.30 - 5.00 uIU/ml)

Regards,
MA

[goolarra]

While lab error is always a possibility, your experience is not all that unusual.  On starting meds, TSH will often tumble.  That possibly is because we take our meds once a day rather than having our thyroids supplying them continuously throughout the day.  Our pituitaries may have a hard time interpreting that.

That being said, 100 mcg is a pretty high starting dose.  It's often a good idea to start at about half of that, retest in 4-5 weeks and increase if necessary.  After being deprived of thyroid hormones for a period of time, it's a jolt to our bodies to have them available again.  It takes time for your whole endocrine system to rebalance.  The longer it's been off, the longer it takes to recover.  If you're uncomfortable, ask your doctor about starting at a lower dose.

How old are you, and did your doctor test FREE T3 and FREE T4 as well as TSH?  If so, please post those with reference ranges from your own lab report.