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Why increase thyroxine with elevated TSH and normal T4 when there is no thyroid gland
I had total thyroidectomy in 2006 for uncontrolable hyperthyroidism (tried meds and radioactive iodine treatment first).
My most recent bloods have come back with an elevated TSH but normal T4 and my dose of thyroxine has been increased.
I understand about the pituitary releasing more TSH to make the thyroid work harder, but in the abcense of a thyroid at all, I am having difficulty understanding why the need to increase thyroxine when T4 is normal?
I am compliant with thyroxine synthesis, taking it within a half hour window of the same time every morning.
Any information to aid my understanding of this would be greatly appreciated, Gail
My most recent bloods have come back with an elevated TSH but normal T4 and my dose of thyroxine has been increased.
I understand about the pituitary releasing more TSH to make the thyroid work harder, but in the abcense of a thyroid at all, I am having difficulty understanding why the need to increase thyroxine when T4 is normal?
I am compliant with thyroxine synthesis, taking it within a half hour window of the same time every morning.
Any information to aid my understanding of this would be greatly appreciated, Gail
This is the patient's forum. Endocrinologists do not participate on this forum. I answered this question on your other thread.
I am 5 weeks pregnant and have had an under active thyroid for 12 years. Pre-pregnancy my TSH was 0.98 and i was on 100mcg thyroxine a day. I had a blood test done last week (@ 4weeks pregnant) and my TSH is now 6.68, my doctor has increased the thyroxine by 50mcg, 25mcg when i first found out i was pregnant a week ago and 25mcg today after blood results, so i am now on a dose of 150mcg daily, does this sound correct?
I agree that I'd like to see your actual FT4 result and reference range (also FT3 if you have it).
TSH can be affected by any number of factors in the thyroid/hypothalamus/pituitary axis. Do you still have hypo symptoms? Symptom relief is the all-important factor and should be the primary driver of meds changes.
TSH can be affected by any number of factors in the thyroid/hypothalamus/pituitary axis. Do you still have hypo symptoms? Symptom relief is the all-important factor and should be the primary driver of meds changes.
Hi,
what is your T4 actual number (and the reference range)?
the range is very broad. It may be that you are low in the range. optimally your would be in the upper 1/2 of the range.
The High TSH is your body's way of saying that it needs more thyroid hormone (regardless of whether there's a thyroid to get that message or not). So the increase in thyroxine is appropriate.
Next time do ask your doctor to test Ft3 and FT4 (instead of T3 and T4, which are outdated and don't represent actual available thyroid hormone, they include protein-bound and unavailable hormone).
what is your T4 actual number (and the reference range)?
the range is very broad. It may be that you are low in the range. optimally your would be in the upper 1/2 of the range.
The High TSH is your body's way of saying that it needs more thyroid hormone (regardless of whether there's a thyroid to get that message or not). So the increase in thyroxine is appropriate.
Next time do ask your doctor to test Ft3 and FT4 (instead of T3 and T4, which are outdated and don't represent actual available thyroid hormone, they include protein-bound and unavailable hormone).
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