VERY high TSH - Interested in range information

[sdp1988]

I am having trouble finding out range information on the net regarding TSH levels.  I have taken synthoid for several years and occasionally have to adjust the dosage.  I know what a level TSH is but at one point had a level of 32.5 - which was treated by adjusting the dosage.  However, due to recent HORRIBLE symptons, knew I needed to have it checked again (3 months earlier than my scheduled check).  It was at 85.8 which scares me to death after doing what little research I have.  I have been looking for ranges and what effects they may have on me at certain ranges (other than the obvious ones I have been feeling).  Last, how high can a TSH be and how close am I to it?

[sryna]

Thank you so much... means a lot...  I am so grateful to be a part of this community... sincere thanks to you :)

[gimel]

I really do not know enough to comment on those other test results, but it is doubtful that they affect her hypothyroidism.  She should make sure to be tested for Vitamin D, B12 and ferritin and then supplement as needed to optimize.  And push the doctor as needed to get her treated clinically, to relieve hypo symptoms, rather than just by TSH or other test results.  I don't think you need to be depressed.  If you mom gets these things done I think she will feel much, much better.  

[sryna]

Oh, thank you very much... I really appreciate your fast reply... and no, there was no Vit. D, ferritin or B12 tests done... but he has recommended Tpo ab test and USG of thyroid gland... Her ESR is also high 40, PCV is low 34.8,  MCHC is high 33.6, lymphocytes count is high too 46 She also has small fibrous growth in uretus.. do all these further intensify her hypothyroidism??? She was also referred to gynocologist... well I'm really depressed right now???

[gimel]

So, from her symptoms and the lab test results it appears she is hypothyroid.  The doctor prescribed a low, starting  dose of T4 med.  Thyronorm is a brand name for Levothyroxine, or synthetic T4 med.  

Since she was also prescribed Cholirol, I assume she was deficient in Vitamin D.  What was her test result for Vitamin D?   If not tested for B12 and also ferritin, those need to be done also.  Hypo patients are frequently deficient in both and need to supplement to optimize.  B12 should be in the high end of its range, and ferritin should be at least 100.

A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  Many of us have found it best to have FT4 at least mid-range, and FT3 in the upper third of its range, or as needed to relieve symptoms.


Also, be aware that your mom nay not notice any effect from the 50 mcg of T3 med.  The reason is that when taking the med, TSH will go down in response, resulting in less stimulation of the thyroid gland and less output of natural thyroid hormone.  Since serum thyroid levels are the sum of both natural thyroid hormone and thyroid med, only when TSH becomes suppressed enough to no longer stimulate natural thyroid hormone production will serum thyroid levels reflect further increases in thyroid medication.  

[sryna]

Hey.. I wouldnot be any help cause my mom is having the similar problem so can u plz help me too??? Recently my mom had a whole body package test where she was diagnosed with hypothyroidism I guess...FT3 is in normal range I.e. 3.98, low FT4 9.64 and very high 3rd generation ultra sensitive TSH I.e.25.10... she did have fatigue, sleepy all the time, body pains symptoms since a long time but never had done any medical checkup though until recently... She is five feet two inches tall and weighs 70.5kg.... So the doctor has prescribed T4 50 mcg and cholirol 60k for 8weeks OD and has advised to have a FT3, FT4, .TSH, anti TPO Ab test and also USG thyroid gland after 6 weeks.. I reckon, he is suspecting hasimoto as well.. I, myself is a fresh pharmacist so I am really confused with the prescription... T4 50mcg was prescribed so will it be okay if I get my mom thyronorm 50mcg tablets??? T4 is equivalent to thyronorm right??? Do u get it what I am tryna say?? Sorry if I confused you!!!

[sryna]

Hey.. I wouldnot be any help cause my mom is having the similar problem so can u plz help me too??? Recently my mom had a whole body package test where she was diagnosed with hypothyroidism I guess...FT3 is in normal range I.e. 3.98, low FT4 9.64 and very high 3rd generation ultra sensitive TSH I.e.25.10... she did have fatigue, sleepy all the time, body pains symptoms since a long time but never had done any medical checkup though until recently... She is five feet two inches tall and weighs 70.5kg.... So the doctor has prescribed T4 50 mcg and cholirol 60k for 8weeks OD and has advised to have a FT3, FT4, .TSH, anti TPO Ab test and also USG thyroid gland.. I reckon, he is suspecting hasimoto as well.. I, myself is a fresh pharmacist so I am really confused with the prescription... T4 50mcg was prescribed so will it be okay if I get my mom thyronorm 50mcg tablets??? T4 is equivalent to thyronorm right??? Do u get it what I am tryna say?? Sorry if I confused you!!!

[sryna]

Hey.. I wouldn't be any help cause my mom's having the similar problem so can u plz help me too??? Recently my mom had a whole body package test where she was diagnosed with hypothyroidism I guess...FT3 is in normal range I.e. 3.98, low FT4 9.64 and very high 3rd generation ultra sensitive TSH I.e.25.10... she did have fatigue, sleepy all the time, body pains symptoms since a long time but never had done any medical checkup though until recently... She 5'2 and weighs 70.5kg.... So the doctor has prescribed T4 50 mcg and cholirol 60k for 8weeks OD and has advised to have a FT3, FT4, .TSH, anti TPO Ab test and also USG thyroid gland.. I reckon, he's suspecting hasimoto as well.. I, myself is a fresh pharmacist so I'm really confused with the prescription... T4 50mcg was prescribed so will it be okay if I get my mom thyronorm 50mcg tablets??? T4 is equivalent to thyronorm right??? Do u get it what I'm tryna say?? Sorry if I confused you!!!

[seacat1]

I read you post and I am going though the same thing. I had a bypass/ open heart 1 1/2 years ago and I am hypo. I am taking 100 syn. and my heart was racing so bad it scared the hell out of me thinking I was having another heart attack. I cut mu 100 mg in half myself and my heart started to slow down. Now my heart Dr. just called me and said my thyroid level is way high and stop cut my does in half. So here I am. What did they do for you..??

[Fairytailarts]

Ok thank you I will have a long list for my doc for next time.  I am currently only seeing a family physician but am thinking seriously about going to a specialist thyroid preferably if not an endocrinologist. I will have to see how much I can get my family doctor to do.  Many are just very stubborn which doesn't help in our wellness.   All so much to think about in the 2 days I have known phewww!

I had been taking Evening primrose oil and a complex for hair skin and nails that had biotin antioxidants A C and a few others so maybe that could have helped me retain my iron levels....who knows. I can't even tell if my thyroid died slowly or all at once.  I am a need to know it kind of person and some things are impossible or next to impossible to know with this.
Thank you Gimel for all of your time and assistance.  

[gimel]

Okay, your B12 is pretty good.  Your ferritin is higher than I would have expected, since you are apparently hypothyroid.  So, I suggest that the next time you go in for tests, you should also request to be tested for a complete iron panel, including serum iron, TICB and % transferrin saturation.  Those tests will indicate if there is something causing your higher than expected ferritin level.  

[Fairytailarts]

lol Ok I get it.....my Ferritin was 98 and my B-12 was 721 Folate 11.8 glucose 86 any other numbers that you think are important to share?

[gimel]

Please post the B12 and ferritin results so we can see how "perfect" they are.  

[Fairytailarts]

Ok thank you I will read the article to further educate myself.  My B12 and Ferritin were perfect this visit. He did not test for the T3 but he did for the free T4 which was low .34

[gimel]

It would be a good idea to test for TPO ab and TG ab just to confirm that it is Hashi's.  You should also request to be tested for Free T3, along with Free t4 each time you go in for tests.  Since hypo patients frequently are too low in the ranges for Vitamin D, B12 and ferritin, I suggest testing for those as well.  A deficiency in either of the three can cause symptoms as well as affecting the metabolism of thyroid hormone.  Since T4 meds are basically fully effective in serum levels in about 4-5 weeks, I suggest that you try to get back in for followup tests before 8 weeks.  

For info, 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

So when you see the doctor next you might want to discuss this with him and find out if he is going to be willing to treat clinically, rather than strictly by test results.  If not, then you will ultimately need to find a good thyroid doctor that will do so.  

[Fairytailarts]

Yes it was the first time I had been tested. I am 33 with no real previous health issues.  As far as I know there is only one Aunt on my father's side that has hypothyroidism not to the effect of mine though. My doc said yesterday that my TSH was one of the highest he had ever seen and my thyroid just wasn't working.  I asked him why I didn't feel worse and he said he thought my body had just compensated.  So who knows I guess how long I have actually had issues that I just passed off as I am getting older and I have two little girls 8 and 5 I am chasing around :)

I really have no idea how long some of the symptoms have been occurring.  As some things can just come with age.  Menses change started about 1 year ago...change with my hair started 4 years ago. Temper change maybe about 6 months ago. The severe symptoms happened about a month and 1/2 ago. I started taking Calcium gluclosamine which I quit because I got hit with extreme fatigue that was not resolved with a nap muscle weakness, cramps, tingling in my feet while I slept, vertigo.  I also gained 15 pounds in about 1 month and that is just not like me.  I quit smoking 8 months ago so I have put on a few pounds just because of that.

He started me one 50 mcg of the levothroid once daily. He wanted to start me off strong because of my very high TSH but low enough I don't develop hyperthyroid and I need to check back in 8 weeks.  He has not tested for TPO ab or TG ab.  All other blood work of mine came back perfect...besides my TSH and t4 free

Thank you all for any additional help in my transition to getting used to not having a working thyroid:)

[gimel]

Yes, it does.  You can confirm Hashimoto's Thyroiditis by testing for both Thyroid Peroxidase and Thyroglobulin antibodies.  Those tests are often listed as TPO ab and TG ab.  Have you been started on thyroid med?  If so, what type and how much daily?  What symptoms are you having?  

Is this the first time your doctor tested for possible thyroid issues?  

There is lots to discuss, so hang with us.  

[Fairytailarts]

I just had my testing done...my TSH is 276.4 and my T4 free is .34.  Does this seem to be in line with Hashimoto?  Just trying to figure out as much info as possible.  I have never been on medication for this before so I am new to the hypothyroidism etc.  

[Barb135]

That's very high... are you sure you've read the report correctly?  Have you had other tests, such as Free T3, Free T4 and thyroid antibodies done?  

Are you having hypo symptoms? You should talk to your doctor immediately, as you could go into a very serious condition called Hashitoxicosis, which is life threatening.

[suhani28062004]

TSH IS MORE THEN 1000 ,WHAT MAY BE THE CAUSES

[gimel]

Meant to add that in order to rule in or out, the possibility of Hashi's, two tests are needed.  Those are for Thyroid Peroxidase antibodies and Thyroglobulin antibodies, usually listed as TPO ab and TG ab.  

[gimel]

First thing you should know is that TSH is a pituitary hormone, not a thyroid hormone.  TSH is only an indicator, at best.  Far better indicators are symptoms you may have and your levels of the biologically active thyroid hormones, Free T3 and Free T4.  That said, your TSH is high enough that typically it would be indicating the possibility of the primary cause for hypothyroidism, which is Hashimoto's Thyroiditis.  

With Hashi's your immune system erroneously identifies the thyroid gland as "foreign" to your body and produces antibodies to attack and eventually destroy the gland.  Along the way, thyroid hormone production is diminished and so the TSH level rises, trying to signal the thyroid gland to produce more hormone.  Unless the diminishing levels of natural thyroid hormone are replaced adequately with thyroid med, hypothyroid symptoms occur.  

This can become a problem only if your doctor does not adequately test and treat your hypothyroidism.  The tests you need are Free T3 and Free T4 (not the same as Total T3 and Total T4).  You should make sure they test you for Free T3 and Free T4 each time you go in for tests.  Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin (iron), you should request those as well.  If the doctor resists doing all these tests, you should insist on them and don't take no for an answer.  When you have additional test results, please post, along with reference ranges shown on the lab report and we will be glad to help interpret and advise further.

Last, for now, what symptoms, if any are you having?  

[anshi20]

Hi,
I am 24 yr old. My TSH value is 29.23-Ref value should be 0.34 to 4.82 . I am really worried, Is this a severe problem?. My doc called me for further discussion.

[dwalter24]

When I found out I had hypothyroidism,  my tsh was 1000... yes, that's 3 zeros. And a few years ago I wasn't able to take my synthroid for 3 months and it was 1200. My dr flipped.

[gimel]

I know you didn't ask any questions, but I could not help responding that how you feel should be all important, not test results, and especially not TSH.  Have you been tested for Free T3 and Free T4.  If not, you should make sure they test both every time you go for new tests.  Free T3 is the most important because scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

You have been taking large doses of T4 med.  Sometimes hypo patients find that their body does not adequately convert the T4 to T3, resulting in low levels of Free T3 and hypo symptoms.  This will show up in the Free T3/Free T4 test results.  When conversion is inadequate the addition of T3 med is required to raise the Free T3 as necessary to relieve symptoms.

Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, if you haven't been tested for those you should do so.

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