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TSH/missed dose
Hello! Last week I missed 2 consecutive levothyroxine doses and then had my TSH taken. I have no clue why it didn't occur to me until today. My TSH was 4.35 - a little high. It's up from 1.6 6 months ago. Could 2 missed doses cause this? I am thinking no because of its long half-life but I don't know and I'm so frustrated with myself because I have been feeling crappy and this would be an easy fix...if this is it. I let my family doc and new (I see him 2/18) endo's office know. Thanks for your help.
There are numerous scientific studies that concluded that TSH is basically useless as a diagnostic, after starting on thyroid medication. The thyroid test that has been shown by scientific studies to correlate best with hypo symptoms is Free T3, while Free T4 and TSH did not correlate at all.
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. 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 after initial tests and evaluation. The letter is then sent to the participating doctor 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
Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, those also need to be tested.
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. 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 after initial tests and evaluation. The letter is then sent to the participating doctor 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
Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, those also need to be tested.
Yes, I have Hashimotos. They only did T4 and TSH and just called to say "it's all good", so I'm thinking the range they use is .5-5 for TSH, which surprisingly you still see a lot of. I thought everyplace had switched to .3-3. I'll see if I can get a copy of the results. Thanks so much for your help!!! I just found this place and it's so great how everyone helps each other!!!
COMMUNITY LEADER
No, your 2 missed doses wouldn't cause your TSH to rise that quickly. Do you have Hashimoto's? If so, your thyroid hormone dosage has to keep pace with the destruction the antibodies are doing to your thyroid.
Do you have any FT3/FT4 results to post? If so, please do so and be sure to include reference ranges as those vary lab to lab and have to come from your own report.
Do you have any FT3/FT4 results to post? If so, please do so and be sure to include reference ranges as those vary lab to lab and have to come from your own report.
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