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Thyroid Disorders Community
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Avatar universal

tsh levels going up after levothroxine

Hello,
I'll jump right in and just get to my question and skip the long introduction...
My period was off, I went to my OBGYN I ASKED HER TO RUN A THYRIOD TEST ON ME
LEVELS CAME BACK AS SUCH
July 18, 2011
T4 FREE 0.40
TSH ULTRA 48.82
T3 TOT 71

I was put on Levothroxine 50mcg...
I called becasue I was worried and wanted to know what my body is doing... I went back on  8-6-2011
Levels showed the following
T4 FREE 0.51
T3 TOT106
TSH 57
Can someone anyone explain to me what the heck is going on with my body? Other medication I take:
Valium 40mg a day I have very bad panic attacks. I also take 220 flovent just started taking that about 6 months ago for breathing and asthma issues.

I had to pull my doctors teeth out in order for her to even run a T3 on me... and her and I went at it. Why are my numbers going up? My T3 is back to normal YAY for that but what is up with my TSH I am taking the medication like I should be and my levels are going up. And I'm sure someone is going to say your levels are going to go up and down blah blah blah.. I want real answers and direct not the run around. I have heart paplutaions always have.  My anxiety is up and down but i deal the best I can with mediation. I weigh 137.8 i work out everyday. I was a former smoker for 19years I am not 31 I do not eat Red meat, or fish...I eat very healthy or the best I can no is perfect. NO soda or caffeine as of 6 months ago...
I had my gall bladder removed in 2004 stones... I've also had my tubes tied and my adenoids and tonsils removed when I was 12.
I am LOST and I would really like it if someone could help me understand what is going on.
Thank you,
Melinda
9 Responses
1756321 tn?1547098925
Free T4 Index (T7) is an outdated lab test. This is what one doctor said about this test: Brian Jackson, MD: “This is a pretty clear- cut case of something being really obsolete. The free T4 index is an estimate that requires a calculation. It became obsolete as soon as good free T4 assays became available.”

It is possible T4 (levothyroxine) is not converting effectively to active T3.

Factors that inhibit the body's conversion of T4 to T3 include: low levels of iodine, selenium, zinc, copper, vitamin B12, vitamin B6, vitamin A, and vitamin E; high levels of fluoride; high or low levels of serum ferritin (iron); a diet that is too low in calories; beta blockers; birth control pills; high levels of estrogen; lithium; lead; mercury; stress; cigarette smoking; pesticides, aging; diabetes; surgery; adrenal insufficiency; high or low cortisol levels, human growth hormone deficiency.

These substances should never be taken at the same time, or within an hour of taking thyroxine (T4) tablets: iron salts, antacids, calcium carbonate (including milk), sucralfate, cholestyramine, and soy-based formulas. Leave at least 4 hours between taking calcium or iron supplements, or soy products. Levothyroxine (Synthroid) can affect, or be affected by insulin (used by diabetics) and warfarin (a blood-thinning drug). Cholesterol-lowering drugs can decrease the effect of Synthroid (the Levothyroxine binds to the cholesterol drug and so is not absorbed by the body).

Also, not addressing the underlying autoimmune condition - Hashimoto's Thyroiditis will also leave lingering symptoms.  "Hypothyroidism can be induced by various diseases. An autoimmune cause accounts for approximately 90% of adult hypothyroidism, mostly due to Hashimoto's disease." Testing for thyroid antibodies TPO and TgAb is highly recommended.

"New research has shown that Hashimoto's patients with high thyroid antibodies report more symptoms than patients with low thyroid antibodies, even if their thyroid function test is normal. In other words, thyroid replacement is not enough to ameliorate symptoms of autoimmune thyroid disease."

Besides correcting underlying issues, you can trial a combination of T4 and T3 medication (T3 is called tertroxin or cytomel) or natural desiccated thyroid extract, like Armour or Naturoid, which contains T4, T3, T2, T1, and calcitonin.  200mg selenium daily lowers TPO antibodies. A gluten free diet as well as maintaining vitamin D levels of at least 125nmol/L (50ng/ml) will also help lower antibodies.

More information...

http://www.suite101.com/content/why-isnt-my-thyroxine-working-a100521#ixzz1UXVvgWVm
http://www.aacc.org/publications/cln/2007/dec/pages/cover1_1207.aspx
http://www.ncbi.nlm.nih.gov/pubmed/3066320
http://www.********************.com.au/metabolic-hormones/thyroid-article
http://www.worldtrichologysociety.org/membersarticles/vitamindillnessprevent.html
http://www.aerobices.com/458.html
Avatar universal
Well, I hope you don't interpret this as the "runaround".  TSH is very volatile.  It varies a lot even intraday and on a circadian rhythm, so even the time of day the blood is drawn can affect it.  TSH also varies as a percent, so the higher it is to start, the more it swings up and down during the day.

Since being on meds, your FT4 and TT3 have both improved...this is what they should do, so your meds are helping.  Unfortunately, TT3 is considered a bit of an obsolete test.  FT3 gives a lot more useful information.  Ask foe FREE T3 next time.

It takes 4-6 weeks after starting meds or after a dose change or the meds to reach full potential in your blood.  Levels will keep building for that long.

Are you taking your levo first thing in the morning, on an empty stomach, then waiting 1/2 to 1 hour before eating or drinking anything?  Do you take your other meds and any supplements at least 4 hours away from your thyroid meds?
Avatar universal
Hi. I just talked to the on call doctor whom I asked to have a Free T3 done and she is also doing a T7? And yes I have always taken the Lev first thing in the morning with nothing to eat. I set my alarm for an hour an half before I actually have to get out of bed :) Thank you for getting back to me. It means a lot. Do you have issues also? I am going for more lab work at 2:30 today ;)

231441 tn?1333896366
Hi,

your levels have improved slightly, but are they still low in the range, I think?  Please confrim the reference ranges.  Often optimal level is somewhere mid to upper half of the range.

It may be that your thryoid is in the process of failing and because the med you are taking is not yet enough your body still perceives not enough meds.

It can take some time to adjust thyroid levels.

Let us know how your next tests are.  
Avatar universal
Thank You Red_Star, Although it will take a couple of days of me re-reading this over and over again until it clicks in my as to what your saying, I wanted to say thank YOU so much. My Doctor at this point has had it with me, but I keep pushing I am looking forward to going out to Boston Medical in a month. And I have high hopes that the doctor out there isn't like the one I am seeing now! :/ Thank you again for all your help in explaining this to me and trying to help me out. I will ask to have TPO and TgAb run although I have no idea what either of those test measure????? I will call first thing in the morning and ask to have them run and go in and have more blood taken, I will not stop until we find what is truly underlining and what my body is trying to tell me is wrong.
Avatar universal
Why do I feel better after two weeks, but my blood work isn't showing the same. God I feel so lost. Also note my doctor told me to take 50 mcg in the morning and the other 25 in the middle of the day two or three hours after lunch... why would she do that?
Avatar universal
TPOab and TGab are the two antibodies that are elevated (either or both can be elevated). if you have Hashimoto's thyroiditis.  Hashi's is an autoimmune disease, meaning that your immune system sees your thyroid as foreign protein (much like a bacteria or virus) and attacks it.  Hashi's is the most frequent cause of hypo in the developed world.

Your blood work IS showing that you are improving.  Both FT3 and FT4 are higher than they were before you started meds..  It's only TSH that is not improving.  FT3 and FT4 levels are responsible for how you feel.  TSH is not.  TSH is nothing but a messenger from your pituitary to your thyroid to tell it to produce more hormone.  TSH levels cause NO symptoms.  FT3 and FT4 levels are much more important to how you feel than TSH.  

Getting FT3 and FT4 to proper levels is a process.  It doesn't happen overnight.  Each dosage change has to be given 4-6 weeks to completely stabilize in your system.  You have to be much more patient.  It's very likely that you will need a meds adjustment after this dose has stabilized.  You might need another after that.

I don't know why your doctor told you to take your meds that way.  If you're on T4-only meds, like Synthroid, there's no reason to take them that way.  If you're on any meds with T3 in them, like Cytomel or dessicated, however, splitting the dose is recommended.

What we always say is patience, patience, patience, and when that fails...more patience.  There's no way to try to rush the process.  Trying to rush it usually just lengthens it.
Avatar universal
Couldn't be anymore right about giving my body more time. I need to hear that from time to time in order to keep me in " check" my mind is running wild. Things are starting to look better, my anxiety isn't as high which is very ODD for me and I feel so much more alive once I get up and moving. I am very tired in the am but once I get my body moving I feel okay. This is less then 4 weeks on this medication. I'm keeping my fingers crossed. Thank you all for your support and input.
Avatar universal
Hello, I notice that you seem to know a lot about the thyroid and medication. Well I would be most grateful if you please tell me if it's okay if I stopped Levothyroxine 50 after taking it for 3 months? And replacing it with something natural? My Nurse Practitioner is not all that good, she has prescribed me wrong medicine before, and I'm experiencing some scary side effects. Please reply to me as soon as possible. Thank you so much. God bless.
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