High TSH Symptoms, Causes & What it Means

High TSH Symptoms, Causes & What it Means

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Have you been told, or are you suspicious, that you have a high TSH?

If so there are many things you want to consider before pursuing treatment.

While your TSH is important for assessing thyroid function it’s certainly not the only test, or the best way, to identify thyroid disease. 

We are going to take an updated, scientific dive into TSH including what a high TSH means, what kind of symptoms are associated with this condition, and the top 5 causes… 

What does your TSH Really Mean?

Many physicians consider TSH to be the most accurate marker of thyroid status in your body. 

With that in mind, it makes sense to talk about what it actually does in your body. 

TSH stands for thyroid-stimulating hormone and it is a hormone secreted by your pituitary gland. 

Thyroid physiology is quite complex (1) but we can break it down into an easy-to-understand sequence:

Your hypothalamus (part of your brain) pumps out a hormone called TRH (thyrotropin-releasing hormone). 

TRH then acts on your pituitary gland (another portion of your brain) to stimulate the release of TSH (thyroid-stimulating hormone). 

TSH then enters your bloodstream and lands on receptors directly on your thyroid gland which then causes the release of thyroid hormones – T3 and T4

T3 and T4 then enter the bloodstream and target specific cells in the body (almost every cell has a thyroid receptor) to alter genetic transcription, increase energy production, and so forth. 

This complex system is regulated at several steps and one step that we use to assess the stability of this entire system is the serum concentration of TSH

This isn’t the best marker of thyroid function by itself (2), but it can give you a quick idea of what is happening in the body. 

So what does a high TSH actually mean?

An elevation in TSH is an indicator that the system is not working properly, and in this case, it means that thyroid function in the serum (T3 and T4) is low. 

Low levels of T3 and T4 circulate back up to the pituitary gland which tells the body that not enough thyroid hormone is being produced. 

Your pituitary gland compensates by increasing TSH levels in the serum because it is trying to tell your thyroid gland to produce more thyroid hormone. 

Hopefully, this is making sense. 

It can be confusing because a high TSH level actually means that there is not ENOUGH thyroid hormone in the blood and this condition is known as hypothyroidism. 

Hypothyroidism = low thyroid function = sluggish thyroid = low T3 and T4 levels of thyroid hormone in the blood = high TSH (all of these terms are ways to describe the same condition).

The exact opposite is true when the TSH is low. 

A low TSH is an indicator that your body has enough T3 and T4 in the body and so your pituitary responds by reducing the production of TSH from the pituitary gland. 

Hyperthyroidism = excessive thyroid production = high T3 and/or T4 levels of thyroid hormone in the blood = low TSH.

This isn’t the complete picture because certain medications can actually reduce TSH but still leave T3 and T4 levels low in the body, but it gives you a general idea of what is actually happening in the body and what your TSH actually stands for. 


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So How do Doctors Use TSH?

TSH is primarily used as a marker of thyroid hormone status in the entire body. 

Checking your TSH can be used as a quick measure to determine if your thyroid is functioning properly or not. 

A high TSH (defined below) tells your Doctor that your thyroid is not working properly which means that you may need the use of thyroid hormone medications to increase and normalize thyroid function. 

After starting thyroid medication (if necessary) the TSH can be used to “track” your progress

As you take thyroid medication your TSH should be reduced back to the “normal” range. 

As this occurs you are said to once again become “euthyroid”. 

This is how everything is supposed to work, but is it really that easy?

This is where Doctors and patients tend to disagree (3).

Even though you can “normalize” the TSH with thyroid medications, many of the symptoms of hypothyroidism may actually still persist. 

This, along with many studies, may indicate that TSH may not be the best marker for thyroid function in the body (4).

We will discuss more of that below, but for now, let’s discuss what kind of symptoms you may experience if your TSH is elevated. 

High TSH Symptoms

As your TSH increases it is a sign that circulating levels of thyroid hormones are dropping. 

Therefore, the symptoms associated with high TSH levels present as the symptoms of hypothyroidism. 

Symptoms do not stem from the TSH itself but from the lack of circulating T3 and T4 and their influence on your cells.

In addition, symptom severity is dependent, at least somewhat, on the degree of elevation of TSH. 

Higher levels of TSH, those greater than  

The degree of elevation of your TSH will also help determine the severity of your symptoms. 

People who have a TSH of 5.0 will likely experience symptoms that aren’t quite as severe as someone who has a TSH of 7.0 or higher. 

You can find a list of the symptoms that one might experience with a high TSH below: 

  • Weight gain or difficulty losing weight (the degree of weight gain and inability to lose weight depends on the severity of thyroid lab studies)
  • Fatigue or decreased energy
  • Insomnia or inability to sleep
  • Changes to the menstrual cycle or changes to sex hormones (reduced testosterone in both men and women and changes to progesterone/estradiol in women)
  • Drop in body temperature – cold hands/feet
  • Slower than normal metabolism
  • Changes to skin that include dry or cracking of the skin
  • Changes to hair, skin, and nail quality and texture – brittle hair, dry hair, hair loss, etc.
  • Slowing down of the intestines which manifests as constipation or acid reflux
  • Mental changes to include depression, anxiety, poor concentration or poor memory
  • Swelling of the face or extremities (puffy eyes)

Why are these symptoms important?

Symptoms reduction, along with TSH, can also be used as a marker to determine if your therapy or treatment is working. 

If you take medication to lower your TSH and your TSH lowers but your symptoms remain, then there may be another issue you are missing. 

You can find a more complete list of thyroid symptoms that women may experience in this post and a complete list of thyroid symptoms that men experience in this post

Definition of a “High” TSH (Reference Ranges)

So what defines a “high” TSH?

By definition, the standard reference range for TSH is anywhere between 0.30 to 5.0 uIU/mL. 

If your TSH is higher than 5.0 then the lab will flag you as “high” and you may experience the symptoms listed above. 

You can see a clear example of this below: 

The reference range in this example is 0.3 to 5.00 uIU/ml and the result is 7.024. 

Having said all of this, there’s actually a good case to make that you can still have a “high” TSH but still be inside of the reference range. 

So how do we get there?

Well, newer studies (5) have shed light on the fact that some of the original tests that helped determine our “standard normal” TSH values may not have been full of “healthy” people. 

When you are being compared to some standard you want to make sure that the standard you are being compared to is actually healthy!

It doesn’t make sense to compare your TSH as a 25-year-old to that of an 86-year-old (6).

Using this logic some newer studies have suggested that a more “normal” TSH reference range is somewhere between 1.0 and 2.5 uIU/ml and anything higher than 2.5 is considered “high” (7).

With this logic you can have a “high” TSH anywhere between 2.5 and 5.5, even though it technically falls within the “normal” range: 

In addition, other studies have suggested we use the African American population as the standard for TSH testing because they have one of the lowest rates of autoimmune disease compared to other populations and their TSH is somewhere around 1.0. 

It’s important to realize that many physicians are not aware of these studies or these concepts so they may use the “standard” laboratory reference range instead of these newer guidelines

5 Causes of High TSH

Having a high TSH is never normal. 

An elevated TSH (as defined by the reference ranges listed above) is an indication that your body is working overtime to try and increase the amount of thyroid hormone that it can produce. 

In most cases, your TSH is simply a warning sign that indicates your body is under stress and increased pressure. 

While knowing that your TSH is elevated is important, your TSH itself does not tell you WHY it is increased. 

That’s why it’s important to understand the potential causes because each of these causes has a different treatment. 

#1. Hashimoto’s Thyroiditis

Probably the most common cause of slightly elevated and high TSH levels is an autoimmune disease known as Hashimoto’s Thyroiditis. 

It is estimated that anywhere between 50% and 90% of all cases of hypothyroidism may be caused by this condition in the United States. 

Hashimoto’s thyroiditis is a condition where your body begins to attack its own thyroid gland, through an autoimmune process, which results in long-term and potentially permanent damage to your thyroid gland over time (8).

As your thyroid gland becomes damaged the amount of thyroid hormone it produces will be reduced over time. 

As this happens your pituitary compensates by increasing TSH levels slowly over time. 

In a sense, it’s like trying to squeeze water out of a rock. 

How can your thyroid gland produce thyroid hormone if it is permanently damaged?

It can’t. 

The good news is that diagnosing Hashimoto’s thyroiditis is not very difficult and can be assessed by checking for thyroid antibodies in the serum

The presence of clinical thyroid damage (symptoms) combined with elevated antibodies is sufficient to diagnose the disease. 

Your Doctor should know to check for the following antibodies:

If they are contributing to your TSH then your labs may look something like the example listed below: 

Identifying that you have Hashimoto’s is important because it means you may be able to influence the course of the disease and reduce the autoimmune damage if you take steps as soon as possible. 

Note, though, that in some cases by the time the diagnosis is made it may be too late – there may already be permanent damage to your thyroid gland, especially if the autoimmune process has been going on for decades. 

You can learn more about treating, identifying, and managing Hashimoto’s in this post

#2. Iodine Deficiency

While overt iodine deficiency is no longer a huge issue in the United States, many people may still have what I refer to as “sub-optimal” iodine levels. 

The main method by which we get iodine is through our diets, but unfortunately, many factors may be influencing how much we actually get. 

For starters, many people simply aren’t consuming enough iodine because they don’t consume sea vegetables regularly. 

This is worsened by the fact that the iodine concentration in the soil is dropping as well, so foods that would normally contain iodine may vary in their concentration. 

In addition, other factors such as the lack of utilization (from goitrogens) in certain foods may limit the activity of iodine that you do consume. 

Taking this one step further…

Studies have shown that the average person should be consuming 150 ug of iodine per day (up to 250-290 if you are lactating or pregnant) (10), while other studies show that the average consumption varies between 120-130 ug per day (11).

You can compare this to the 1970s when the average consumption of iodine was up to 294 ug/day. 

Putting all this together you can make a case that many people simply may not be getting sufficient iodine even though we live in an iodine “replete” environment. 

How does this impact TSH?

Iodine is required for the production of thyroid hormone in your body (12).

Therefore, low iodine will result in low circulating thyroid hormone in the serum. 

This will trigger a feedback loop which will result in an increase in TSH from your pituitary. 

Low iodine = high TSH. 

The good news is that replacing iodine through dietary means will rapidly result in an improvement in your thyroid function

You can learn more about using iodine safely and correctly in this detailed guide

#3. Obesity & Metabolic Damage

Most people assume that hypothyroidism (low thyroid function) causes obesity, but what they don’t realize is that obesity can actually decrease thyroid function as well. 

The cause vs effect has not been settled but we will most likely find that while hypothyroidism can cause obesity, obesity can also reduce thyroid function and increase TSH. 

Why does this matter?

For starters, it means that if obesity is the cause of low thyroid function (and therefore an elevated TSH) it means that if you lose weight you will improve your thyroid status. 

And this is what studies have shown. 

As you lose weight TSH tends to drop and FT3 and FT4 levels tend to normalize (13).

Another important implication of the obesity-thyroid connection is that due to the widespread increase in obesity we may need to alter TSH reference ranges (14).

Our current understanding of obesity and thyroid function is that obesity is the RESULT of hypothyroidism. 

But if obesity causes hypothyroidism then that means we need to create a “normal” TSH based on the reference ranges of people that have normal body weight and who do NOT have Hashimoto’s thyroiditis. 

This may impact our definition of the “ideal” or “normal” TSH. 

Moral of the story?

Obesity, weight gain, and metabolic damage may all potentially increase your TSH and lead to hypothyroidism. 

#4. Stress & Increased Cortisol

Another important cause of high TSH is stress and increased cortisol. 

Cortisol is considered our stress hormone which is released to help our body “tolerate” excessively stressful situations. 

Stressful situations range from lack of sleep to social pressure from jobs and back to the food we put in our bodies. 

The idea here is that all of these factors influence this stress hormone and may result in chronic elevations in serum cortisol. 

High cortisol is positively correlated with TSH levels in the serum (15).

This means that as cortisol increases so too does TSH. 

What isn’t clear is whether or not this relationship is physiologic or pathologic. 

In my experience, I tend to lean more toward the pathologic side as patients with both high TSH and high cortisol exhibit higher rates of depression, anxiety, and poor cognitive function. 

These symptoms lead me to believe that stress, excessive stress which is chronic in nature, most likely results in an increased TSH which reduces thyroid function in the body. 

The treatment for this condition is to focus on limiting the impact that stress has on your physiology by taking targeted supplements and practicing specific therapies. 

You can learn more about addressing cortisol to improve thyroid function here

#5. Thyroidectomy (Partial or Complete) & RAI

Next up is really any condition that results in damage or removal of your thyroid gland. 

It makes sense that if you damage your thyroid gland or completely remove it that you won’t be producing as much thyroid hormone as you were before. 

Most people who undergo complete thyroidectomy (meaning complete removal of their thyroid gland) are given thyroid medication right away. 

The same is not necessarily true for those who have only had a portion or partial thyroidectomy (partial removal of their thyroid gland). 

Patients who undergo RAI or radioactive iodine ablation therapy may also still have some thyroid gland function, but this function may not be sufficient to provide adequate thyroid hormone to the entire body

In both cases, these patients may still have somewhat “normal” thyroid lab studies but tend to present with MANY of the symptoms of hypothyroidism. 

The bottom line?

Damage to your thyroid gland or removal of your thyroid gland (16) (even part of it) may result in an increase in TSH levels. 

The treatment for patients in cases such as these is the replacement of thyroid hormone with thyroid hormone medication. 

Treatment Options

If you have a high or high-normal TSH then your next step should be to focus on ways to bring it down. 

This can be accomplished by focusing on several areas: 

#1. Using thyroid hormone replacement medication

Using thyroid hormones will help to reduce your TSH due to the feedback loops that exist in your body. 


As you put thyroid hormone into your body, your brain will “sense” this thyroid hormone and respond by normalizing your TSH. 

This will result in a reduction in your TSH, provided that the dose of thyroid medication that you are taking is sufficient for your needs. 

This is exactly how many Doctors use the TSH to help guide their treatment. 

The idea is to bring down your TSH to a “normal” level based on your lab results and to stop the titration of medication once you get there. 

This sounds fairly easy, but it doesn’t quite work this way in all patients. 

Some people will feel great as they take thyroid medication such as Levothyroxine to help lower their TSH. 

In other people, it may not be quite that simple. 

Up to 15% of people may suffer from genetic changes in their body which limit their ability to utilize or “convert” thyroid medication appropriately

If you have this genetic defect (which is a problem with a deiodinase enzyme) then you may not respond very well to standard thyroid medication. 

This problem can be overcome through the use of different types of thyroid medications. 

Even though thyroid medication may be helpful to lower TSH it may not be required in each person. 

#2. Addressing the primary cause of your high TSH

Another area of focus should be on the CAUSE of your high TSH. 

As I discussed with you previously, not all causes of high TSH are permanent. 

In fact, some causes, such as iodine deficiency, can completely be reversed if you treat them appropriately. 

In the case of iodine deficiency, this problem can be easily treated with iodine supplementation. 

In the case of stress, you may be able to improve your TSH by completely removing the stress in your body or by attempting to lower your cortisol. 

Other conditions, such as Hashimoto’s thyroiditis, may be more difficult to treat because they indicate a deeper problem. 

Hashimoto’s is a result of autoimmune dysfunction and is not readily reversible (at least not in the majority of cases). 

#3. The use of targeted supplementation

We’ve already established that nutrient deficiencies, such as iodine deficiency, may play a role in altering thyroid function (17).

This idea extends to more than just iodine. 

Other nutrients, such as Zinc and Selenium (18), also play an important role in regulating thyroid function in your body. 

One study showed that using the combination of zinc and selenium helped to reduce TSH and increase free T3 and free T4 levels in overweight female obese hypothyroid patients. 

What’s really interesting is that these patients didn’t experience any increase in serum zinc or selenium levels. 

The use of supplements that contain both Zinc and Selenium has been shown to improve thyroid function in those who have deficiencies. 

The good news is that this is a potentially reversible cause of high TSH, the bad news is that it will probably only work if you are deficient

But, as a potential therapy with very little downside, it’s always worth evaluating for these simple deficiencies. 

Using a supplement such as this one may be beneficial and has worked well for other hypothyroid patients. 

Is it Possible to Have a High TSH and Normal T3 & T4? 


In some cases, the serum T3 and T4 levels can be relatively preserved despite elevation in TSH levels. 

Some people assume this is a reactive response but you must realize that serum concentrations of thyroid hormone do not necessarily reflect tissue levels of thyroid hormone. 

What’s important is not the serum concentration but the amount of thyroid hormone that enters the cells and activates genetic transcription. 

TSH reflects the tissue concentration of the pituitary gland, but it does not reflect the concentration of say your liver. 

We can use SHBG as an indirect marker for assessing the concentration of thyroid function in the liver (19) and this can actually be used as a somewhat sensitive marker for tissue levels elsewhere in the body. 

You can learn more about using the SHBG for this purpose in this guide

Just realize for now that in order to get a “complete” picture of thyroid function in the body, you should evaluate TSH in the presence of other thyroid lab studies such as free T3, total T3, free T4, sex hormone-binding globulin, and of course thyroid antibodies


A high TSH level may indicate that you have sub-optimal levels of circulating thyroid hormone in your body. 

This condition is known as hypothyroidism and presents with MANY diverse symptoms. 

If you find that you have a high TSH then your next step should be to look into the potential causes of the disease and treat that issue, if possible. 

Treating can then be focused on several areas:

#1. Thyroid medication. 

#2. The underlying cause.

#3. The use of Supplements.  

This approach will ensure that you cover all of your bases and will provide you with the most relief. 

You will also want to consider if thyroid medication is right for you or if taking a more conservative approach may be the best fit. 

Once you start thyroid medication you may be taking it for life so you may not want to jump into it. 

Lastly, when evaluating your TSH make sure that you are looking at your value with the “optimal” level in mind and not just the standard reference range. 

Looking at your TSH in this way will help you get back to your 100%

Now I want to hear from you:

Is your TSH high? 

If so, have you been able to find appropriate treatment?

If not, why not?

Leave your comments below! 

#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1544601/

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480274/

#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169863/

#4. https://www.ncbi.nlm.nih.gov/pubmed/16416346

#5. https://www.ncbi.nlm.nih.gov/pubmed/16148345

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877984/

#7. https://www.ncbi.nlm.nih.gov/pubmed/16148345

#8. https://www.ncbi.nlm.nih.gov/pubmed/7794089

#9. https://www.ncbi.nlm.nih.gov/pubmed/20135568

#10. https://www.ncbi.nlm.nih.gov/pubmed/19178515

#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266621/

#12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063534/

#13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911848/

#14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911848/

#15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520819/

#16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737508/

#17. https://www.ncbi.nlm.nih.gov/pubmed/8262474

#18. https://www.ncbi.nlm.nih.gov/pubmed/25758370

#19. https://www.ncbi.nlm.nih.gov/pubmed/16416346

what a high TSH means for your thyroid

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

119 thoughts on “High TSH Symptoms, Causes & What it Means”

  1. No medication or concerns with thyroid prior to surgery except for 2.6 nodule found. I had 1/2 my thyroid removed Jan 2017, diagnosed with Stage 2 minimally invasive Hurthle Cell Carcinoma. Spread in April, placed on 75 mg of Synthroid 10 weeks after surgery. Started Gerson Therapy, 100% organic plant based diet, 13 juices a day, vitamins/enzymes, 4 coffee enemas, acupuncture, vitamin C IV, ozone, etc.
    2 out of 3 spots gone in 4 weeks, last spot reduced from 5mm down to 3mm on remaining side, will check again next month.
    TSH 3.5 keeps getting higher every month I check
    T4 1.3 normal
    T3 2.9 normal
    My doctor wants to increase Synthroid to 88 mg to suppress my thyroid that is waking up and wants to start working. She says it could give fuel to the cancer if we don’t suppress it. I want to get off meds all together, but I don’t know what to do?

    • Hi Charlene,

      If you underwent thyroid surgery for thyroid cancer then the standard of care is to suppress the TSH to prevent the chance of recurrence or growth of the cancer.

      • Thank you for replying. Last ultrasound was clear in November. Oncologist now says wait a year, then we can reduce and get off meds. I appreciate your knowledge and the information you provide!

      • Hello Dr. Westin Child,
        I am Parvinlal, My TSH is > 150, T3 is 0.6ng/dL and T4 is 1.4 pg/ mL, Right know my doctor has suggested me 150 mg levothyroxine, please can you suggest me what are the precaution I have to take. Thank You

  2. I have Hashimoto’s that was “uncovered” after the birth of my son. I became very ill with many symptoms and each I told my ob/gyn he would just brush me off, telling me it was a hormone thing/normal for new moms etc…He said to be patient it would rebalance itself. About 5 months post-partum I started South Beach diet and boom! I became so sick and tumors started growing in my neck. Went to primary doc and she tested me – TSH 67! Antibodies in the thousands. After many tests diagnosed Hashimoto’s. Revamped my lifestyle for the better. A year and half of thyroid meds and then my thyroid returned to normal (no more meds). After careful reflection, I’ve come to believe my trigger was pregnancy hormone shifts, then a labor induced with more hormones. Also I believe very low carb diets trigger my Hashimoto also. 3 times I tried LC, 3 times became very ill. No more of that.

  3. Hi Dr Childs,
    My 95 yr old mother has been on levothyroxine for many years after her RAI ablation. Her TSH has been increasing and the last level came back “7”. She is symptomatic of hypothyroidism, extremely fatigued & cold. Her levothyroxine dose is 125mcg, which I was told for her age is the maximum dose before potential adverse side effects may occur. I’m very realistic of her age but want to optimize the quality of life that she has left. She also has Parkinson’s Disease and is well controlled. She presently is in a nursing home. I feel although the care is palliative it doesn’t mean it can’t also be optimal. Any suggestions?

    • Hi Mary,

      Realistically the negative side effects of overdosing your mother with thyroid hormone won’t manifest because they take quite a bit of time. Having said that the general attitude of most physicians will be not to “rock the boat” in someone her age. It’s unclear to me how much benefit (if any) she would get at her age by increasing her dose and if that benefit would outweigh any potential negative side effects, but it’s something worth looking into depending on her goals and quality of life.

  4. I have been suffering from Hypothyroidism for over 6 years. Severe lethargy, major weight gain , out of breath when walking on even a slight gradient and hair loss. My GP does not prescribe T3 and it is not the norm in the UK. Results of test in
    FEBRUARY 2017 Sep-26-2017
    tsh – 14.04   free Thyroxine at 23.2 pmol/l
    t4 total – 91.9 TSH is 0.05 mIU/l
    free t4 – 12.26   total T3 at 1.6 nmol/l.
    free t3 – 4.16 vitamin D at 29 nmol/l
    free t3 – 4.16
    Since Feb I have been was advised to increase from 125mcg of levothyroxine to 150mcg and after Sept, asked to reduce to 75mcg. This is my current dose but have not noticed any difference . Can you advise as it is very depressing ?

    • Hi Sammy,

      Unfortunately the way to find the optimal dose for patients requires time, iteration and some trial and error so it’s difficult to come up with in the comment section of the blog with limited information.

  5. Hello!

    This was a very interesting read!!
    I was first diagnosed 13 years ago after delivery of my third child. I was very into natural remedies. Vegan. I took liquid iodine, but I didn’t continue or follow up. Denial that I could have an illness. No treatment. Fast forward today. TSH 35.
    Thyroid antibodies have not been checked.
    Day 3 of 50mcg, levothyroxine.
    Super Tired, any simple task is a no go.
    Random rapid heartbeat
    Random blood pressure spikes
    Hair loss
    Cold hands and feet, but warm neck/face
    No weight loss.
    TSH over the past 3 years will go from 16 to 5 in 3 months
    All Over the place.
    I didn’t treat my hypothyroidism because I avoid meds when possible. I didn’t know that it would bring to this point where I have trouble functioning throughout the day. Brain Fog/memory.
    Most sources online state the cause of thyroid dysfunction is UNKNOWN.
    So happy to read about possible causes!
    I think a long term amount of stress is the main trigger.
    What diet/foods do you recommend?
    Do I try to push and go for walks?

    • Hi Shay,

      When it comes to treatment each treatment plan should be individualized to the patient and it largely depends on history and lab tests. The kind of questions you are posing here are better answered by someone who is very familiar with your personal history and knowledgable about thyroid function.

  6. My TSH results are 99.609uIU/mL which is way higher than 7.0 which is an example I seen above. So I’m kinda worried because My body feels like its about to fall apart and now that I’ve read up on this information I’m now understanding where all of this pain and loss of energy is coming from… Man I didn’t know this was that serious.The only difference is I cant gain any weight I’m almost 30 years old and I weigh 107lbs..smh

  7. Just found out my TSH level is 5.4 and the last few months I have rapidly dropped weight, from 170 to 145lbs. Could this be why I’m losing weight?

    • Hi Jon,

      A high TSH is generally associated with hypothyroidism which is generally associated with weight gain.

      Your TSH may increase as a result of caloric restriction if that was the cause of your weight loss (meaning if it was intentional).

  8. Hi! I get tested this month on 11th. My T3 is 0.85, T4 is 9 and TSH is 9.57. I was on 50mcg because reports came back normal about 6 weeks ago. Even a slight decrease in dosage changes my test values greatly. And my symptoms are only getting worse. My nails have become even more brittle. What should I do? Is there any alternate treatment/therapy I should be taking?

  9. I have had zero luck in losing weight – even tried eating just 1000 calories per day without any luck. (That’s background)

    Have dealt with Hypothyroidism for more than 10 years.

    Doctor took me off synthroid – when on Armour for the last 6 months
    MY TSH
    6/7/17 = 1.755
    8/2/17 = 0.218
    11/17/17 = 0.082
    1/26/18 = 82.917 (that is not a typo and the doctor confirmed that level)

    T4 =
    6/7/17 = 1.21
    8/2/17 = 1.09
    11/17/17 = 1.23
    1/26/18 = 0.32

    T3 =
    6/7/17 = 2.45
    8/2/17 = 3.04
    11/17/17 = 2.83
    1/26/18 = 2.45

    I have all the classic symptoms – I guess I’m so used to not feeling good – but am envious of the women my age that have more energy, etc.

    Doctor is going to double my dose of Armour from .25 grain to .5 grain

    What else should I do?

  10. Good morning Doc,
    Having symptoms of thyroid issues.
    1100 a.m.
    First TSH test: 2.62
    Retested a week later.
    3 p.m
    TSH was 3.23
    FT4 was 1.19
    T3 Free was 3.24.
    Could I be Hypo.. or Subclinical.? Should my TSH levels increase during the day?

  11. Hi Dr. Childs,

    I went into my PCP with all of the symptoms of hypothyroidism along with a strong family history. She did blood tests and my TSH is elevated, but it seems that everything else, t3, t4, antibodies, are all normal. It doesn’t seem that I have Hashimotos, does this mean I am not hypothyroid? I’m just concerned because my symptoms are only getting worse and my tsh keeps rising.


  12. Hi, After having RAI and no dr appt for 3 months, tests now show that I have a TSH of 134.5. Am I right to be scared? Also, I lost significant weight over the years by eating right and exercising and now I’m gaining weight. Is there nothing I can do about it. I’m really feeling awful. Sorry.

  13. Hello Dr.
    I have had weight/obese issues for some years now and extremely dry skin. It was only recently that I had my granddaughter diagnosed with Hashimoto’s and decided to test myself.
    As I got my answers my TSH is 1000. UIU/ml
    And was told that I have no activity in free t3 my T 4 is an excellent range, but here is the kicker for me. My primary dr.gave me losartan and now I been added a beta blocker on top of that for a heart murmur. What should I consider doing when all my symptoms relate to thyroid issues?
    Hate taking a beta blocker and thyroid medicine at the same time.

  14. Good evening,
    My TSH level has been sitting at approximately a 9, this week it has gone up to 59. I have been taking Levothyroxine for over 18 years with an increase in dosages throughout the years. I have been increased from 100 msg to 150 msg as of this week. I have gone to a different Dr. today and subsequently asked for a repeat lab test. I am a 51-year-old female, chronic stress due to my husband’s heart attack in 2016, also I now follow a low fat, low sodium diet with my husband. Would an increase in cortisol be the reason for this increase or something more?
    Thank you,

    • Hi Liz,

      I can’t imagine a scenario in which cortisol would cause a TSH that high. Stress may have contributed to a thyroid issue but is most likely not the sole contributor.

    • I am 52yrs old and saw a dramatic increase in cortisol acitivty a few years before menopause starting when I was 48. The symptoms were elevated pulse and blood pressure and 4 point saliva testing revealed elevated cortisol levels throughout the day. along with the need to lower my thyroid medication dose (T3 + T4) to avoid hyperthyroid like symptoms. Further testing later before and during menopause demonstrated rising aldosterone levels (goning from lower end of range to very top) along with adrenaline hormoens at top of range with one being moderatly out of range.

      The rise in gonadtropin hormones (whcih normally rise during perimenopause & menopause) often results in increased autonomimc nervous sympathetic activity which in turns results in increased adrenal activity. Many women on thyroid medication having to lower their thyroid dose during this time which might be a response to decreased metabolic needs as well as as side effect of increased adrenal acitivity. The amount any stability of FSH and LH varies tremendously among women -some only seeing a modest rise while others like myself end up with dramatic rises in FSH and LH. At the same time there is a loss of ovarian hormones associated with negative feedback loop that normally occures with egg production. Those hormones have a profound regulatory effect on FSH and LH. Their other influences are still not fully understood but from an adrenal point of view I would imaging they have a calming influence on the adrenals.

      In your case -given your age – It might be worth doing a series of full sex hormone panels over the year conccurantly with cortisol and adrenaline panels to see if there is any correlation betweeen rising gonadtropin hormones decreasing or unbalanced sex hormones, and rising adrenal hormones. Menopause alone is often associated with arise in adrenal activity among many women – and withgiving recent events might be yet another cause of your symptoms. You might be having problems converting T4 to T3 because of the elevated adrenal activity -and often gonadtropic hormones (FSH & LH) can be overlooked causes of elevated cortisol and other adrenal hormones…it certainly had a profound effect on mine not ieffecting my thyroid medication dose but also type of thyroid medication that I can now tolerate. Good luck.

  15. Hi. I had thyroid cancer and had a thyroidectomy. I’ve also had gastric bypass, and 3 spine surgeries, a hysterectomy, gallbladder removal as well. My TSH is now at 79.59 this week. No matter how much Synthroid I’m on and I’ve been on as much as 900 mcg of it at a time it’s all over the place. Not sure if it’s because I’ve had so many surgeries or what but my blood work tends to jump around. What can I do other than take the meds? My eyesight is now suffering I’ve gained 40 lbs in a couple of months and my hair is brittle my skin is flaky and I’m nonstop exhausted and I am now forgetting things more than usual.

  16. Hello, I just went through 18 months of a severe weight loss & after many tests not one being anything except the Normal Tsh & T4 which would All come back “Normal Range”, so they looked & did tests that had Nothing to do with why I’d have lost 22 lbs out of 134 lbs total on a 5’3 medium to small frame female. I also lost more than half of my hair, thankfully had a lot, but Not anymore. Got tired literally of being I felt jerked around with tests that did not have a thing to do with weight loss & actually just Truthfully, it’s a very large Medical Group & they passed me around to all their dr’s. I’m pretty medical savy, not a youngin here, So I changed Dr’s & she’s been seeing me now since November last year. I’ve tried to explain what all transpired over the previous 18 months, & that my weight that was last month only 112 with Clothes on, was still dropping. I asked this time for another set of Thyroid function tests, even asking for a Reverse T3 &4. This time my TSH came back at almost 11. Now I know, I was diagnosed 25 years ago with Hashimotos, at that time all those years ago, I had a dr but not an endo that told me I should just have the thyroid cut out & be done with it. I did not, because that’s not what the endo dr suggested. But, I haven’t been to an endo in probably 15 years, maybe longer. With now the TSH at almost 11, my New Dr. says I’m Hypothyroid, How can I Be when I did just gain 2 1/2 months this past 30 days, But..It’s also because I was determined to GAIN so I ate literally 18 hours a day for a solid month, pretty much everything I could. I’d been a vegetarian for decades but last year with such a dramatic unintended weight loss along with so much hair loss, I started eating chicken only. My protein is up thankfully, but again, How in the World could I be hypo now? Doesn’t make sense other than to know I do have Hashimotos so maybe I was Hyper before & the “test” didn’t show it?? I only had my thyroid testing previous 18 months maybe twice. They did Nuclear stress, an Mri of shoulder & neck, that I’m sure had nothing to do with weight loss, but I also had something strange happen on left side where I lost hearing & had to once in my entire lifetime, a Tube put in that ear to restore my Hearing. You think they’d have checked for a Stroke since I had weight loss & pain on left side. But No, they did not, & that’s the reason I Finally changed Dr’s. Now though, I’m being told I’m Hypo. Seriously. Confused, although I did tell the Dr I started a month ago taking my Levo 100mcg After Eating, because I’d Assumed I was Hyper thyroid & I new that would decrease the Effectiveness, but unfortunately now she wants me to take 1st thing in the AM without eating first & then re-check my labs in 8 weeks. I feel like I Need to see an endo now. Suggestions? I am in 60’s & small frame. Today I did weigh with Clothes, 115. Progress or up & down yoyo..Again?

  17. Extremely sick last year. (And had been on antidepressants for much longer and really think this has all been going on for quite some time of just not feeling well and fully functioning) It amazes me that every doctor can still say you are within range when you are completely crashing. Tons of symptoms–to the point of body tremors like a Parkinson Patient, racing heart, profuse sweating, loss of vision, brain fog, severe lethargy, depression, anxiety etc. Finally went to an Endo–he diagnosed me with Graves Disease, also a thyroid nodule. TSH crazy–many blood tests showing lower than 0.001 Completely off the charts! Had full thyroidectomy Nov. 30, 2017–no cancer–and no more Graves, there is nothing left to attack. Started on Levo–112 and after 3 months was reduced to 100. Blood work this week with same numbers–TSH lower than .01. Continually gaining weight and many symptoms of feeling tired, lethargy etc. Now what? The thyroid is gone! What is the next step in regulating the hormones? Should I focus more now on a bigger picture–adrenals, pituitary? Any thoughts would be great!

  18. Dr. Childs, I have a TSH level of 5.57 with T4 1.27 and T3 of112.3
    My doctor doesn’t seem to attach any significance to the hi TSH. I don’t think if have any symptoms of hypothyroidism. Should I be concerned at this point? I’m 83 and very healthy other than a 50%-60% occlusion in the left carotid artery.

    Thank you for any info you can give me.

  19. Hi, I was diagnosed with Hashimoto’s 21 years ago. Had my thyroid removed due to suspicious biopsy? Was on 250 micrograms for many years and then the last 10 years I can’t get my thyroid regulated, I go up and down, hyper, hypo, hyper hypo, the doctors can’t get it leveled out. Just went and got a test yesterday and my levels are 12.26 and I’m sick of synthetic thyroid medication because it’s.no helping and I want to take something natural. I just don’t know how much are what brand to take.

  20. Hi, Dr. Childs,

    So, I got off my thyroid meds in January because I feel like 2 years ago I was prematurely diagnosed with Hypothyroid. The meds didn’t help and we tried a lot of different brands and doses. The only Thyroid that worked was WP, which is very difficult to get.

    I just had my blood work done this week, and my TSH was high. It was 5.070. My T4 was normal.

    Also, I am 25 pounds overweight since I started having Thyroid issues in 2016. The meds never helped with my weight gain, not even the WP.

    Do you think I can get my TSH down through diet and exercise? I really don’t want to take meds. I have done Paleo, whole30 and much more – I guess I just need to know if I should go back on the meds, or if you think it is possible to do it without the meds?

  21. Thank you for the information, Dr. Childs,
    1 year ago I had a 3cm mass removed from the base of my neck, which was suspicious for cancer and turned out to be exophytic thyroid tissue. My surgeon left my thyroid intact, but I now have a TSH of 24, T3 .79 and T4 .70.
    I took levothyroxine 12.5 mg for 2 weeks (MD prescribed 25mg) but had my 1st pneumonia at the time and told him I was discontinuing, felt pretty awful.
    I am not overweight, eat a mostly vegetable and healthy plant fat diet, almost no gluten, refined sugar or dairy for the past year and exercise regularly. In spite of this, my cholesterol, blood sugar, and blood pressure are all on the rise. Overall, feel fine.
    Long question, short- will my amazing metabolism ever return or do I need to medicate for the rest of my life, which I am averse to doing? I am 64 years old and other than arthritis from age 29 have been remarkably healthy.
    Your guidance is appreciated,

  22. Hi Dr. Childs,

    Thank you so much for the detailed information on this site and your willingness to give your thoughts.

    I am a 43yo male who was unaware that I had been living with a thryroglossal duct cyst until about 3 months ago when it became inflamed. The cyst had become inflamed several times in the past starting around 30yo, but none of the doctors who evaluated me identified it as such and the inflammation would resolve on its own. Although I saw an endocrinologist who advised I had a goiter, no one ever diagnosed me with a thyroid imbalance or syndrome.

    Finally in Feb 2018, a surgeon identified it as a cyst and recommended surgical removal. The surgeon reported he removed the main part of the thryroglossal duct cyst, but that a ‘tail’ was identified that traveled down my neck and was just “clamped off” instead of turning the surgery into a more invasive exploration.

    Soon after the surgery, my immune functioning seemed to take a nose dive. I contracted a flu/cough which lasted for about 2 months (my GP tested for bronchitis and pneumonia and both were ruled out) and while the cough has mostly resolved, significant lethargy persists now about 3 mos post surgery. I just had a lab workup that revealed a high TSH level of 6.71 and also an elevated Eosinophils at 18% (standard 0 – 7 %). My free T4 is normal at 1.0.

    I read an article about an occurrence of delayed diagnosis of hypothyroidism following excision of a thyroglossal duct cyst

    I also read your article on this site about delayed diagnosis of of Hashimotos.

    Wondering if you have any thoughts on whether the removal of the thyroglossal cyst could have triggered a flare up or if perhaps the cyst might have actually been performing some thyroid function and now my body is unbalanced. My other thought is perhaps a viral infection from the flu/cough could still be living within me and caused a flare-up

    Thank you in advance for any thoughts or insights you may have.

    Best to you,

  23. I’m a 25 year old fit woman (5’6, 130 lbs, 20-21% body fat). Since I graduated high school, I have felt tired, anxious, depressed, and lacked motivation in life. My thyroid levels are normal. I’m very health conscious, I eat very healthy, weight lift, do relaxing workouts as well, and get at least 8 hours of sleep. I got pregnant for the first time in January and miscarried in March. I’m convinced it’s my thyroid but my doctor says I’m fine. 5 years ago my TSH was 1.2. last week it was 2.7, my free t4 was 1.3 and my tpo was 15. What do you think? Could my lifestyle be enough to prevent a diagnosis and treatment but not enough to sustain a pregnancy? I’m afraid to try for kids now…

  24. My TSH went from 5.5 two months ago started 25 mg every morning since I was starting radiation on the right side of my neck and partial throat, now on immune therapy and my TSH levels jumped up to 99.66. Doc increased my dose to 50 since he said he can’t right away or could cause other health issues. So my doc stopped treatments for two weeks cause he said the treatments can cause that and will retest in 2 weeks and again in 4 weeks to see if I need another increase is dosage. Another concern is permanent damage done to the thyroid due to radiation. If there is permanent damage would I just be on medication forever or would they remove part of it and keep me on medication?

  25. In October 2017, my labs were TSH 12.23, Antibodies 321, A1C 5.7, T4 Free 0.7. I was put on WP Thyroid 65 mg and LDN because I was told I had Hashimoto’s. I went gluten and dairy free, eating a WFPB diet.

    January 2018, my labs were TSH 4.54, Antibodies 132, T4 Free 0.3, T3 Free 2.6, switched to a compounded T3 medication and LDN.

    March 2018, my labs were TSH 12.10, Antibodies 77, T4 Free 0.9, T3 Free 2.5 Switched to Nature-Throid 32.5 mg and removed from LDN because it spiked my cortisol. Worked very hard to keep my blood sugar balanced and level at all times and to bring down my cortisol.

    June 2018, recent labs are TSH 5.25, Antibodies 42, T3 Free 2.7, T4 Free 0.9, cortisol normal. I feel we cannot dial in the right medication to get my thyroid functioning better. We have improved some things but still can’t get the thyroid right. Do you any suggestions you can offer to help me? I would so appreciate it! Thank you.

  26. Hi Dr. Childs,

    I am a long time hypothryoid patient with Hashimoto’s. I’ve been on NT for a few years now; I just went and got my labs done and my TSH came back at 66! My FT3 is normal and within the functional range, and the FT4 is a little low. My TPO is high as well….and the RT3 registers in the ‘low’ range of the lab. I love that I came across this article right when I saw my results. I am so confused on why my TSH would be this high?? I’m wondering if the FT3/FT4 serum levels are just from the medication in my system and am now wondering if my thyroid is working at all…or even getting in the cells. I’ll look into the SHBG testing soon. Thank you for the great article; let me know if you have any indirect recommendations for testing or insight on the high TSH. Thanks!

    • Hi Shelbi,

      If the test doesn’t make sense given your history then you should re-test it before making a clinical decision based on the result.

  27. Hi! I’m 24. I had thyroid cancer and had my whole thyroid removed February 1st this year. I’ve been taking 125mg of levothyroxine. First few months were hard trying to adjust. Mood swings, a lot of hair loss, weight loss. I got another check up first week of June to see my TSH, T3 and T4 levels and everything came out fine all within range. Also i’d like to add that for 15 days before my blood test my doctor told me to stop taking my birth control. Anyway, now my doctor said he wanted to try to suppress my TSH level a little more, below 1, so he said to alternate between 150mg on the weekends and 125 weekdays to see what dosage would be good. I also resumed taking my birth control like normal. I take my thyroid pill in the morning and birth control at 6pm so it doesn’t interfere. After a month I took another blood test and my TSH is at 14, and my T3 and T4 levels are a little lower than previous results. Is this normal? Im kind of freaking out. I’m seeing my doctor about this soon.

  28. 59 yo, 1/2 thyroid left, other half removed over 10 years ago due to nodule, taking 90 MG Thyroid NP, been on thyroid hormone for years, 9 weeks ago TSH was 5.26, stopped taking a supplement that was recently reported to suppress thyroid production, now my TSH is 10.12. No other prescriptions than progesterone (bioidentical). Extreme fatigue and depression. Not overweight. Eat relatively healthy. Blood sugar fasting is 99 or 100. Taking fist fulls of supplements for heavily researched reasons. Taking doctor (MD) prescribed adrenal supplements (His formula) and they help me get through day, but I’m having a hard time with all this. Any suggestions you would care to share?

  29. For 2 years now I’ve experienced fluctuations in T4 and TSH levels; hypo, hyper at one time, and back hypo again. Currently TSH is 12. Three months ago it was 6.9. I’m exhausted physically and mentally. My current doctor insists on only looking at T4 and TSH levels, with adjustments to levothyroxine. Is it time to find another endocrinologist?

  30. In April 2018 had my thyroid levels checked for Rx refill.
    T3 = 62
    Free T4 = .73
    TSH = 17.85

    Doctor changed me from 50mcg of levothyroxine to 75mcg.
    I also take 12.5 Cytomel each day (most days).

    90 days later I go back for a recheck and my TSH is .136. So now he wants to take me back to 50mcg. I feel MUCH better at this level. Is it dangerous or unhealthy to stay on this dose? I feel so much better! I haven’t changed doses yet.

  31. HI Doctor,
    I will appreciate your reply because I’m really nervous not sure what to do.
    So before I start my current diet (keto) I was on the border TSH = 4.6
    After I started my keto diet and in 3 months I managed to lose 8kgs things were going great until I started losing lots of hair so I intentionally increased the amount of food as I was scared. That said I put on weight again and started feeling bad over all.
    Today I had my TSH level checked and it was 7
    Now the doctor said it’s not advised to take medication if it’s under 10.
    But when I told him it’s extremely difficult for me to lose weight and that my hair was falling too much and I feel tired he prescribed 25mg only.
    Now if I go ahead and start taking it, will I be taking it for the rest of my life? Or shall I try once again to go to the gym and excercise as you mentioned, weight loss helps improving the thyroid?
    Is it possible to take it only for 3 months then stop?
    Lastly, do I have to stop coffee and cruciferous?
    Thank you so much

    • Hi Cathy,

      You don’t necessarily have to take thyroid medication for the rest of your life if you start taking it, but most people do end up in that situation.

  32. Hello, my TSH is 4.95 absolutely my free T4 is 0.9. My doc wants to put me on meds and refuses to test me for Hashimoto’s. Isn’t that something I deserve to know?

    • Hi K,

      Yes, it would be helpful to have that information. If your current physician is unwilling to work with you then it may be time to seek out a second opinion!

  33. First of all, thank you for your thorough explanation of the causes of increased TSH.
    My lab results the other day were: TSH=9.46 and Free T4=0.72. I have felt symptoms for several years: cold extremities, tired, depressed, etc. I had my 4th child a year ago and figured that explained my tiredness, brain fog, and lack of motivation to do things that I once enjoyed. Because of my feelings of depression, I started an antidepressant about 4 months ago, but now I am wondering if Hypothyroidism is to blame. I have had a very stressful 6 months (house fire, hotel stay, hunt for and purchase of home in 1 month) and I also started working new hours: overnight weekends. I have lost 15 pounds in 3 months of this new shift, but I might not be eating enough, I eat a snack while at work and I sleep when I get home so I really only eat dinner 4 days a week. Is it possible that my TSH has increased due to these other factors or would it still be beneficial to seek a further exploration of my thyroid function?

    • Hi Val,

      It would be a good idea to evaluate other thyroid markers as well. You don’t necessarily have to start treatment right away but you should at least keep an eye on your thyroid over the next few months to see if anything is changing/getting worse/getting better.

  34. Update:
    I decided to recheck my labs today (2 days after the previous results) and run a cortisol level after reading this article.
    TSH=6.71 (dropped from 9.46), Free T4=0.74 (same), and Cortisol=2.79 which is actually lower than the normal range.

  35. My TSH has been around 130-150 for over a year. Last year I was hospitalized and given 2 units of blood, my hemoglobin was so low they didn’t know how I was standing upright. I had had my period for 3 months and it was BAD. My doctor had told me the couple days before to give it a few more weeks. So after that, they found out about my thyroid. This was causing my bleeding. It’s been a year and a hysterectomy and I still am suffering from feet so swollen I can’t wear shoes, my eyelashes have fallen out, my arm is almost feeling like I am having a heart attack every day, and yet my doctor has not done a thing. I am on the same medication Levo 75 mgs. for over a year. Nothing has changed could I have Hashimoto’s? Am I being over paranoid and should I just keep taking it? I don’t feel like she is doing anything about it. Should I be worried about it being so high?

    • Hi Angie,

      It sounds like you may benefit from more advanced testing and probably a second opinion. You’ll want to get your thyroid tested and also tested for thyroid antibodies.

  36. Hi, I was diagnosed with papillary thyroid cancer 6 years ago, my blood tests have always come back fairly normal until 6 weeks ago when my t3/t4 came up low and my TSH was 2.6, the blood test from last week came back today and my t3/t4 has stabilized but my TSH has jumped up to 6. My doctors are baffled and I’m a little scared.

    • Hi Elizabeth,

      There’s nothing to be baffled about! Thyroid demand changes in the body and so does absorption based on other factors. Your thyroid (if you had one functioning) would change up the amount of thyroid produced each day based on the demand. If you don’t have a thyroid to do this then you will have to make changes to your medication. It happens all the time.

  37. I have had a very high TSH and normal T3 & T4 for over a year. Had thyroid issues for 40 years. Had goiter removed with iodine. Could the high TSH make me restless at night? I am so restless, especially in my chest area.

    • Hi Susan,

      A high TSH indicates that you may not be appropriately treated so yes it may lead to some of the symptoms you are experiencing.

  38. Very informative! I have high TSH, 3.8 to be exact and the lab uses the range to 3.5. Other indicators (FT4 or T3 ) are normal but FT4 is on the lower side of the range. Does this mean I definitely have thyroid issues because I don’t really feel any of the symptoms? Or maybe they are too mild to be noticed.. Should I ask the doctor for more tests to find out why I have high TSH and do I definitely need treatment now?

    • Hi Hera,

      Abnormalities in the TSH without coinciding symptoms should just be rechecked in a few months. Most of the time they are anomalous lab findings and don’t necessarily indicate thyroid disease.

  39. Hi. I was diagnosed with Hashimoto’s after having my son 8 years ago. I was taking 50mcg Levothyroxin and it slowly increased. Once my dosage was over 100mcg I had an allergic reaction 5 days after starting the dosage. I didn’t realize that was the cause until 3 months later when my dr at the time increased my dosage again and I had the same reaction. I would break out in hives for a few days after having taken the medicine for 5 days. I decided to see an endocrinologist. My endocrinologist decided it best to have me take a steroid and allergy medicine for a week after having my dosage increased. (I did also try Synthroid and the same thing happened.) I still felt horrible on the medicine even after the reaction went away because my body did not like it. I stopped going to that endocrinologist and told my new dr what happened. He put me on Tirosint. I did not have any reactions to that and have been taking it now for about 4 years. My problem is that my TSH fluctuates so much. I’ve went as high as having to take 200mcg and just dropped from 150mcg to 137mcg. In the beginning of this journey my TSH was >150 and this last time was .2 . When I go hyperthyroid I feel like I have bugs crawling all over me, headaches everyday, anxiety , very irritable and then when hypo I gain weight, tired, can’t concentrate, horrible memory… the list goes on. I am so tired of this roller coaster ride. Any advice? How do I know if my thyroid even works at all anymore? One last thing, I am perimenopausal which I’d imagine doesn’t help the situation. Thanks for any advice:

  40. Hi Dr Child’s,

    I just recently took a blood test and my TSH 4.95 and my T4 Free was 1.1, I’ve found it hard to lose weight and have gained about 30lbs in the last 5 years with irregular menstual cycles, thinning hair, dry skin, mood swings and some anxiety. My doctor hasn’t contacted me about these tests and the results were emailed to me about 3 weeks ago. What would you do? I read conflicting articles in TSH


    • Hi Marie,

      Personally, I don’t think there’s anything conflicting about it but I have the advantage of hours of research and practical application. I would recommend that you take a look at new research and determine if you want to proceed with treatment: https://www.ncbi.nlm.nih.gov/pubmed/19941233

      All of the information presented on my site is in line with this treatment and a new paradigm of treatment for thyroid patients.

  41. Dr. Childs,

    I have a question regarding treatment for partial thyroidectomy. I had a parathyroid tumor removed in Oct 2018 and the partial thyroidectomy at the same time. My surgeon prescribed 50 mcg Levothyroxine when my TSH was elevated. TSH results -26.13 (11/18),13.110(1/19),and 7.360 (2/19). My current doctor also did a Free T4 with the last TSH – 1.41 ng/dL. She told me to stay on the same medication because my circulating thyroid hormone level was normal. I am having constant palpitations and am constantly cold, to state it mildly I feel terrible. Are there other blood tests that should be done? Is it okay to have an elevated TSH?
    Thanks for any clarification you can provide, Gay

      • Dr. Childs,
        Thanks for the quick response. From your website I have gathered that I need to also do a free T3 and reverse T3 test. I am taking Coreg and this can inhibit conversion of T4 to T3. If this is the case it would mean that a just a T4 medication would not work for me and that might be why my TSH is still elevated?
        No wonder doctors are confused by thyroid issues!!!

        • Hi Gay,

          Not necessarily. Beta blockers inhibit T4 to T3 conversion, but the total inhibition may not be noticeable or relevant in all patients.

          • Thanks! I want to thank you for your wonderful website. I am currently receiving your emails and have learned a lot. I will be going to my doctor in a few weeks and will also add FT3 and reverse T3 in addition to T4 and TSH. I also determined that the mfg of Levothyroxine was changed from Mylan to Lannett when I developed palpitations. I am also hoping the change back to Mylan will help. Thanks again, Gay

  42. I’m 49, Diagnosed with Graves disease after a long year of extreme symptoms and doctors being clueless. Had thyroidectomy Dec. 2017–went about 14 months with my TSH never moving above .01 taking Levothyroxine, and continually dropping the dosage. Finally got it to move–unfortunately between 6 week appointments it went from .01 to 13.5. I am so done with feeling bad for 2 years now–I’m also using compounded hormones-estrogen, testosterone and progestin. (My testosterone was a 3! Estrogen was crazy low too!) Feeling completely awful has been the norm-very fatigued, depressed and lots of anxiety. What to do now? Should I look at a possible tumor on the pituitary? It has been hinted about in appointments. I don’t understand why after a full thyroidectomy it would not budge from hyperthyroidism for 14 months, then swing that far to 13+ hypothyroid . I’m so tired of doctors appointments and lab work! This is literally infuriating. I want to feel good–how do I find a “normal range?” I’m honestly not sold on the idea that a thyroidectomy would solve my problems. It has solved NOTHING. Any advice?

    • Hi Darci,

      If you aren’t treated appropriately after your thyroidectomy then you will suffer from hypothyroidism. You can find out how well you are being medicated by testing your ranges against those found here: https://www.restartmed.com/normal-thyroid-levels/

      Unless you find a doctor who practices similar to the way found here, it’s going to be very difficult for you to actually feel better.

  43. In 2015, I was told I had a high TSH (4.8) and my Doctor wanted me to start medication. I did not. I was not retested until this year and my TSH has doubled (9.8), my T4 was also very low normal. I began supplementing with a thyroid support and an adrenal support supplement. After 3 weeks I feel better, less fog and more energy, also my mood has improved. I plan to retest after a 60-day supplement plan to see if they have had an impact on my numbers. My current supplements total 600mg/day of L tyrosine and also have iodine, selenium, zinc, B vitamins and some other herbal ingredients like ashwagandha and pepper extracts.

    • Hi Anna,

      Thanks for sharing! Keep us updated on your progress and your new lab tests when you get them. It sounds like you are on the right track.

  44. I had a thyroidectomy several years ago due to hyperthyroidism. I have been on 100 mcgs Synthroid for some time now and I have been feeling terrible for a few months so my MD had several tests ordered and completed today. My TSH is 14.20…extremely high. T4 is normal 1.05 so now I’m perplexed. I’m extremely tired and my gut hurts…now what? Thanks.

  45. 28 male, have optic glioma which was pressing on the pituatary gland in childhood, had chemotherapy and hormone therapy.

    Recently found to be iron deficient and TSH 7.8, my doctor is going to do further pathology testing to try to identify the cause, however, I am a nurse and though I hope everything will be ok, I know what can go wrong.

    What should I watch out for? I have been having issues with sleep due to depression and as a nurse, I work nights frequently.

  46. Dr. Childs, Thank you so much for all the information you are sharing. Many doctors don’t have in-depth knowledge about thyroid disease. I have thyroid disease for 10 years, it started with Hashimoto’s. Eventually, my antibodies came down to 30. My recent tests showed my TSH and FT4 levels are low, whereas my FT3 is with in the range. I’m on 25 mcg Cytomel ( which I started 6 months back) and 90 mg Armour thyroid. Should I be concerned about those lower levels of TSH and FT4? Why do I have low TSH?

  47. I did my yearly blood work up and was called by the clinic to say that the last two years my TSH has been 4 but this year it came back at 18.
    I’ve been researching just what this all means. I am often tired.

  48. Dr. Childs, I am not sure if my comment posted as I did not see it. I have struggled with Thyroid problems for the past 38 years now. My most recent thyroid tests how these results: TSH: 12.24; T4: 1.0; T3 is 2.4. Thank you very much for your videos about High TSH they were very helpful to me. From what I have learned from your video is that my thyroid is low and that my doctor will be increasing my medication. Thanks again for your great videos. I will check out your other videos about thyroid function. Much thanks again!

  49. My TSH level is 1.98 (4-29-21), but was 1.85 (8-8-19), 1.03 (6-23-16) and 0.68 (6-23-15). Is it possible I have hypothyroidism or Hashimoto’s? I will be seeing an Endocrinologist in the near future. I’ve had ALL the symptoms for YEARS.

    • Hi Kristina,

      Yes, it’s still possible but you will need to check your antibody levels to know for sure.

  50. I am a 57 yo female thats been on synthroid for 22 years (dosage now 137mcg) and my Sept 2021 visit to the doctor said my TSH was 19.300(high), T4 was 8.5, T3 uptake was 36 and Free Thyroxine index was 3.1 I told the doctor I took about 3 drops of iodine in my coffee everyday, I take a selenium capsule daily, 1 L-tyrozine cap daily, I use sea salt on my food, I also take Shilajit with is concentrated minerals small amount a day and other supplements. I am about 35 pounds over weight. Sedentary. Why did my TSH go up so high? My doc told me to lay off the Iodine and sea salt and retest. Do you agree?

  51. I’m 70 and was diagnosed with hashimotos about 15 years ago from a thyroid test. However, I’ve never experienced any low thyroid symptoms. A recent blood test showed my TSH went up from 7.0 to 9.0, and since I feel fine with no low thyroid symptoms, my endocrinologist is keeping me on 30 mg of NP Thyroid. A higher dose gives me hyperthyroid symptoms. My weight, blood pressure, oxygen level and T3 are all normal. I’ve always been energetic and work out often.
    Just thought I’d give you this example that a person can feel just fine with no low thyroid symptoms–even with a TSH level of 9.0. Thank you for your interesting video.

    • Hi Jeanne,

      Thank you for sharing! I’ve seen a handful of people with high TSH levels feel quite well. It’s rare but it definitely does occur!

  52. Interesting ….been on thyroid meds over 20 years seems like last 2 years they change dosage every three months 1.37/1.50 use to be on synthroid now on levonthryoxine recently found a mass on adrenal gland no big deal but thyroid for last 6 months was low 1.00 , .19, .22 then three days ago tsh was 19.90 so they re tested and today it is 15.60 and t4 is flat 1.0 Nobody really alarmed by this and schedule endro doc group in couple of weeks I am a bit alarmed by this have put on maybe 35 pounds in 6 months and sleep a lot 12-14 hours a day.

  53. Stopped my thyroid meds in sept because I was trying to get away from relying on pharmaceutical drugs. Ended up in the ER yesterday (Dec) with abnormal EKGs indicating heart attack, freezing cold, extreme weakness, dizziness, droopy eyes, facial swelling, and sleepiness. My TSH is 95.40. Moral of the story- do NOT just stop your meds and think everything is ok. It took 3 months then out of the blue my heart and liver were being damaged and I felt like death (and just as freezing cold!). Just started to take a 1/2 dose of my original 175 mcg meds to get my body weaned back onto the meds. Hopefully I didnt cause permanent damage. Is there a non-pharmacutical was to put thyroid hormone into the body if your thyroid no longer functions?

    • Hi Melody,

      Thank you for sharing and sorry to hear about your experience! I’ve explained why you never want to stop your thyroid medication cold turkey here: https://www.restartmed.com/side-effects-of-stopping-thyroid-medication/

      In regards to your question, there is currently no way to get T4 and T3 into your body outside of a pharmaceutical medication. All thyroid medications are bio-identical, though, so it really shouldn’t be a huge concern if you have to take the medication.

  54. So I took my husband to the ER early Monday am. Heart racing, upper and lower extremities numb/ tingling. Afib with RVR, he converted after a blue of cardizem. TSH 15, t3 and t4 in normal range. They consider his thyroid sub clinical hypothyroidism and put him on levothyroxine low dose. What are the odds we need an endocrinologist? Why would he suddenly have this happen? He is a very healthy 61 year old. He only has one prescription for idiopathic hypertension, well controlled with 10 mg lisinopril. He has congenital left bundle branch block but otherwise has always very healthy, rarely has colds or other seasonal illness.

    • Hi Lydia,

      The most likely cause is Hashimoto’s thyroiditis, probably related to lifestyle/stress/genetics/things of that nature. He may benefit from seeing an endocrinologist and, at the very least, he should be re-tested to see if those lab tests are consistent or just an anomaly.

  55. Hi Dr Childs,
    I had a thyroidectomy @ 5 years ago but have been on levothyroxine for 35 years. Most recently the dosage had been increased to .175mcg. Yesterday I was tested again and the TSH is 79.9. I haven’t yet heard from the doctors office yet, but what do you suggest should be done now? Thank you so much for your time.

    • Update: I did hear from the doctor who has increased the dose of levothyroxine to 224 mcg daily while keeping the liothyronine at 10mg although that was also low. A week on the new dose and although I know it’s early, not noticing any difference yet.

  56. HI. I am on 25mg Euthyrox down from 125g over past 4 – 5 years. I am determined to get of the meds altogether. The last test was T3 3.6, T4 16.4, TSH 5.8. Basically normal but for slightly high TSH which COULD be accounted for by some increased stress experienced in the days before the test.
    I have been on homeopathic treatment Aur-Iod (Gold / Iodine) and am now going to start iodine drops.
    Is it safe to abandon the Euythrox? Physically I feel find. What effects I do have seem to match more closely with side effects to the drug than to a thyroid malfunction effects.
    I am 64, caucasian, live in Asia, use no other meds – use TCM when needed (CHinese Traditional Medicines)eat healthy foods and avoid all processed food.

  57. Hi, found this very informative! Last check I had 6.3 tsh. Doc increased my synthroid. II had another test yesterday. Waiting for doc to call this evening. I have all symptoms you describe from obesity to exhaustion. Not any better since raising med. I expect its not any better. Waiting to hear. Thank you, Maggie

  58. O.Williams
    August 18,2022
    After being hospitalized 2 days in November 2020, with AFIB my blood test for TSH was 8.56.From Years before my ranges were from 1.71 up to2.77.
    My most recent 7/27/22 was 1.18mc/U/mL . From a second home test my test read TSH 1.4ulU/mL, ft.4 -1.4ng/dL ft3 3.1pg/mL, TPO 25lu/mL. Should I stay on 50Levothyroxine mcg tablet? I have since been advised I have parathyroid ism by my kidney doctor who subscribed 6 doeses of D2 50,000 every two weeks. My primary isn’t very enthused re talking about the Hypo issue . I have your thyroid multi vitamins but can’t take them yet as my Dr. Says no with my blood thinner Paradaxa.

  59. I had head/neck cancer at the base of mu tongue. I went through 35 sessions of radiation and 7 session of chemo. Last treatment was Feb. 10, 2022. In June I was cancer free. The TSH results were in range through June (TSH 2.48) However, during 3 months follow up my TSH went 7.9. I don’t have any symptoms but now I’m a little concern. I had my follow up with my Radiologist last week but the lab results didn’t come through until this week. What do you think will be the next step? I’m hoping to hear from my doctor as well, but just want to see what you think.

  60. I have normal range T4 and T3, my TSH was 7.0, mid 50s, and my primary care has increased my Synthroid from 150 mcg to 175 mcg to attempt to lower. Except my TSH is now at 30.0 and my weight has increased by 50lbs. My CRP has also increased significantly. I am not iodine deficient. I do have to gradually increase the Synthroid, or I have adverse reactions. I am not celiac, however I have an extreme reaction to corn gluten (like a celiac would) and sensitivity to many medications, allergies to sulfa, prednisone, and plaquenil (hives, fever). I am on a “clean” diet. I am at a loss of what to do and my primary care now wants to increase from 175 mcg to 200 mcgs, but I fear another 50lb increase and I am already in thyroid fatigue having no feelings of restfulness after 9 hours of sleep and needing an afternoon nap.


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