High TSH Symptoms, Causes & What it Means
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High TSH Symptoms, Causes & What it Means

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... 

More...

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 to an easy to understand sequence:

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

TSH feedback loop

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. 

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 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 nails quality and texture - brittle hair, dry hair, hair loss, etc.
  • Slowing down of the intestines which manifest 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: 

high TSH and hypothyroidism

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 (1) have shed light on the fact that some of the original tests that helped determine our "standard normal" TSH values may not have 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-year9old to that of a 86-year-old. (5)

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". (6)

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: 

Abnormal TSH kathy

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

TSH levels in various populations

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. (7)

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: 

Hashimotos thyroiditis with high TPO antibodies

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 that 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)(9), while other studies show that the average consumption varies between 120-130 ug per day. (10)

recommended iodine consumption in the US for pregnant women

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

iodine consumption in the US

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. (11)

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 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. (12)

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. (13) 

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 a 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 due to 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 body. 

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. (14)

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 to 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 (15)(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 hormone will help to reduce your TSH due to the feedback loops that exist in your body. 

Remember:

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 it 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. (16)

This idea extends to more than just iodine. 

Other nutrients, such as Zinc and Selenium (17), 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, increase free T3 and free T4 levels in overweight female obese hypothyroid patients. 

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

The use of supplements which contain both Zinc and Selenium have 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? 

Yes!

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 (18) 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. 

Conclusion

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! 

High TSH for pinterest
Westin Childs
 

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

Click Here to Leave a Comment Below 66 comments
Charlene Bare - October 21, 2017

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?

Reply
    Westin Childs - December 12, 2017

    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.

    Reply
      Charlene Bare - December 13, 2017

      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!

      Reply
      PARVINLAL - June 6, 2018

      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

      Reply
Amy - October 24, 2017

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.

Reply
    Westin Childs - December 12, 2017

    Hi Amy,

    Each person is certainly different. I’ve compiled a list of conditions that may trigger Hashimoto’s flare ups which you can read more about here: https://www.restartmed.com/hashimotos-symptoms/

    Reply
Lucas - November 7, 2017

Hello. A suggestion for an article:
Why some people don’t tolerate T3 and need to take T4 only.
Thank you

Reply
    Westin Childs - November 7, 2017

    Hi Lucas,

    Thanks for the suggestion, I will put it in the list!

    Reply
Mary Brown RN - November 13, 2017

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?

Reply
    Westin Childs - December 12, 2017

    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.

    Reply
Sammy - November 28, 2017

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 ?

Reply
    Westin Childs - December 12, 2017

    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.

    Reply
Shay - December 14, 2017

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.
Symptoms:
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.
Questions:
What diet/foods do you recommend?
Do I try to push and go for walks?

Reply
    Westin Childs - December 14, 2017

    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.

    Reply
Kold Cutt - December 25, 2017

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

Reply
Jon - January 19, 2018

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?

Reply
    Westin Childs - January 19, 2018

    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).

    Reply
Natasha - January 25, 2018

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?

Reply
CP - January 29, 2018

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?

Reply
    Westin Childs - January 29, 2018

    Hi CP,

    I think changing your thyroid dose may be a good step in the right direction but there is still quite a bit that you can do. You can find more information on my approach to weight loss here: https://www.restartmed.com/hormone-mastery/

    Reply
Ray Gregory - February 4, 2018

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?

Reply
AL - February 19, 2018

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.

Thanks!

Reply
    Westin Childs - February 19, 2018

    Hi AL,

    A high TSH is sufficient for the diagnosis of hypothyroidism provided it is accompanied by hypothyroid symptoms.

    Reply
AL - February 20, 2018

Hi Dr. Childs,

Thank you for your help, it seems I may need to find another Dr who is more attentive.

Thanks!

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Shela - February 21, 2018

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.

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Patricia Schnell - March 25, 2018

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.

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Liz - March 30, 2018

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,
Liz

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    Westin Childs - March 31, 2018

    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.

    Reply
Lisa - March 30, 2018

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.

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DEBBIE CIOLLI - April 17, 2018

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?

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Darci - April 21, 2018

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!

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Jmax - April 24, 2018

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.
Jmax

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Kimberly Finch - April 26, 2018

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.

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kellieclee77 - April 27, 2018

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?

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Susan Hoffman - May 10, 2018

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,
Susan

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Matthew - May 12, 2018

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
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172850/

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,
Matthew

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Kelsey Johnson - May 16, 2018

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…

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Kimberly Patterson - May 20, 2018

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?

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TRACY TURNER - June 9, 2018

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.

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Shelbi D Cannon - June 28, 2018

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!

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    Westin Childs - July 3, 2018

    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.

    Reply
Daniela - June 30, 2018

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.

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    Westin Childs - July 3, 2018

    Hi Daniela,

    It’s not normal for your TSH to be that high.

    Reply
shefali - July 4, 2018

Hi,
my TSH count is 5.9, can that cause acne or rigid marks on the face.

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Lisa - July 7, 2018

Test results are ….TSH 8.250 0.450-4.500 uIU/mL High.

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    Westin Childs - July 7, 2018

    Hi Lisa,

    Yep, that’s a high TSH!

    Reply
Emell - July 14, 2018

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?

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France - July 15, 2018

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?

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    Westin Childs - July 16, 2018

    Hi France,

    Yes, it may be time to seek out a second opinion.

    Reply
Louise - July 21, 2018

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.

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Cathy - July 21, 2018

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

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    Westin Childs - July 24, 2018

    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.

    Reply
K - July 23, 2018

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?

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    Westin Childs - July 23, 2018

    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!

    Reply
Val - September 2, 2018

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?

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    Westin Childs - September 4, 2018

    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.

    Reply
Val - September 2, 2018

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.

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Angie Walker - September 11, 2018

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?

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    Westin Childs - September 11, 2018

    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.

    Reply
Elizabeth Brown - September 15, 2018

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.

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    Westin Childs - September 15, 2018

    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.

    Reply

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