Experiencing Hypothyroid Symptoms. High TSH. Is High TSH Normal In Mid Cycle?

Posted on Thu, 25 Apr 2013

Question: For many years now I have been experiencing hypothyroid similar symptoms . Seen every type of doctor but has resulted in nothing. Recently when my doctor ordered my routine thyroid panel saw that she tested only my TSH and t3 level. Both were normal however I still wasn't feeling well so I requested a referral to an endocrinologist. The endocrinologist ran a TSH test and a thyroid peroxidase and testosterone test and hinted that tests were fairly normal. t does not appear she ran a t3 or t4 test . My TSH went from 1.93 to 11.9. Is a spike in TSH considered normal when you are mid cycle? Was actually three days beyond my menstrual cycle.

Answered by Dr. Shehzad Topiwala (1 hour later)

A TSH of 11.9 is abnormal. It can occasionally rise upto 20 in non-thyroidal illnesses such as hospitalization but reverts to normal soon thereafter following convalescence.

Were the thyroid hormone levels (ie T3 and T4) below the lower limit of normal? This is important to know as this helps distinguish between overt and sub-clinical hypothyroidism.

Were the thyroid peroxidase antibodies positive? If so, it is quite likely you have permanent hypothyroidism due to chronic thyroiditis ('hashimoto's) and will benefit from lifelong thyroid replacement therapy in the form of a medication called levothyroxine.

TSH values do not fluctuate significantly during different phases of the menstrual cycle.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

T3 done in February was 9.1 while tsh was 1.93. Current tsh 11.9, Thyroid peroxidase just says <10 and testosterone level 5 and testosterone free 1.1.
Doesn't look like the endocrinologist did any other tests except for cortisol slightly elevated and insulin normal. Not showing that endocrinologist did t3 or t4 this time.

Answered by Dr. Shehzad Topiwala (51 minutes later)

It may be worthwhile doing a blood test for Thyroglobulin anitbodies along with TSH, free t4, Total T4, Total T3 and T3 resin uptake , in about a month from now. If the labs are still suggestive of hypothyroidism, especially with positive TG antibodies then you will benefit from treatment. In particular, if you have a thyroid swelling (goiter) and/or strong family history of thyroid disorders then it is extremely likely that you have hypothyroidism

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar