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Hello Doctor, I Had Slight Elevated TSH Levels (~6 UIU/mL)
Question: Hello Doctor,
I had slight elevated TSH levels (~6 uIU/mL) and low Vitamin B12 and D levels for the last six years. I didn't pay much attention to it since T3 and T4 levels were always normal until beginning of December 2018 when my TSH became 0 and T3 and T4 became abnormally high. I had extreme fatigue and weakness.
I consulted an endocrinologist for the first time. He suggested Isotope scan of Thyroid along with free T4 and TSH.
That confirmed Thyroiditis.
After about two months, i again became hypothyroid with high TSH. This time, however, T3 and T4 were low as well.
Doctor put me on Thyroxine 75 mcg.
I have been taking it since Feb 2019.
I have been regularly testing TSH and free T4. I did the test today and following are the test results.
TSH = 4.41 uIU/mL
free T4 = 1.67 ng/dl
I would like to know if i should continue with Thyronorm (Thyroxine) 75mcg or do i need to change the dosage.
Also, i had tested Thyroid Anti-bodies on someone's suggestion, and i have very high anti-TPO and normal anti-TG but my endocrinologist doesn't consider that.
He says anti-bodies are not related to thyroid condition, and I just need to take Thyroxine to keep TSH and T4 in right ranges.
On reading some research papers related to Thyroid disorders like Hashimoto's online, i got to know that auto-immune disorder is the underlying cause. If we don't treat that, this will be a lifelong disorder.
Kindly guide me with a solution that treats the underlying root cause and not just manage TSH and T4 levels.
Also, i have been having muscle loss and hair loss for the last six months or so (since i had the episode of Thyroditis). Is it related and what could i do to contain that?
I had slight elevated TSH levels (~6 uIU/mL) and low Vitamin B12 and D levels for the last six years. I didn't pay much attention to it since T3 and T4 levels were always normal until beginning of December 2018 when my TSH became 0 and T3 and T4 became abnormally high. I had extreme fatigue and weakness.
I consulted an endocrinologist for the first time. He suggested Isotope scan of Thyroid along with free T4 and TSH.
That confirmed Thyroiditis.
After about two months, i again became hypothyroid with high TSH. This time, however, T3 and T4 were low as well.
Doctor put me on Thyroxine 75 mcg.
I have been taking it since Feb 2019.
I have been regularly testing TSH and free T4. I did the test today and following are the test results.
TSH = 4.41 uIU/mL
free T4 = 1.67 ng/dl
I would like to know if i should continue with Thyronorm (Thyroxine) 75mcg or do i need to change the dosage.
Also, i had tested Thyroid Anti-bodies on someone's suggestion, and i have very high anti-TPO and normal anti-TG but my endocrinologist doesn't consider that.
He says anti-bodies are not related to thyroid condition, and I just need to take Thyroxine to keep TSH and T4 in right ranges.
On reading some research papers related to Thyroid disorders like Hashimoto's online, i got to know that auto-immune disorder is the underlying cause. If we don't treat that, this will be a lifelong disorder.
Kindly guide me with a solution that treats the underlying root cause and not just manage TSH and T4 levels.
Also, i have been having muscle loss and hair loss for the last six months or so (since i had the episode of Thyroditis). Is it related and what could i do to contain that?
Brief Answer:
continue same plan with some supplements.
Detailed Answer:
dear XXXXXXX hi! welcome to Ask A Doctor service.
very usual story, auoimmune thyroiditis is your diagnosis. this condition is marked with high antibody titres and fluctuates from hyper to hypo. this is what happened to you. now as of treatment, again your doctor is correct. we don't chase antibodies. though they tell you the diagnosis and the cause of thyroid damage. we treat thyroid failure. so now on treatment your thyroid status is normal, in that case, you need to continue the same treatment. and keep monitoring thyroid profile quarterly. antibodies are not followed.
as you feel myalgia and other symptoms, i would suggest you to add some multivitamins and calcium, and some vitamin D on regular basis.
regards!
continue same plan with some supplements.
Detailed Answer:
dear XXXXXXX hi! welcome to Ask A Doctor service.
very usual story, auoimmune thyroiditis is your diagnosis. this condition is marked with high antibody titres and fluctuates from hyper to hypo. this is what happened to you. now as of treatment, again your doctor is correct. we don't chase antibodies. though they tell you the diagnosis and the cause of thyroid damage. we treat thyroid failure. so now on treatment your thyroid status is normal, in that case, you need to continue the same treatment. and keep monitoring thyroid profile quarterly. antibodies are not followed.
as you feel myalgia and other symptoms, i would suggest you to add some multivitamins and calcium, and some vitamin D on regular basis.
regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for responding, Dr. XXXXXXX
Could you help me with the below queries i have?
#1 Should i continue with Thyronorm 75 mcg or change the dosage?
Even with thyronorm, I have lethargy and occasional mood swings, and feel quite tired by night.
On days when i do some physical exercise in the morning, i feel much better during the day.
My test results (please find attached thyroid test and annual health checkup report)
TSH = 4.41 uIU/mL
free T4 = 1.67 ng/dl
Vit B12 = 492 pg/ml
25 hydroxy vit D total = 21 ng/ml
#2 Could you specify the multivitamins or any other supplement?
I currently take Cholecalciferol 60k IU every two weeks with milk.
My calcium levels are normal as per recent tests.
#3 Is there anything i could do to treat the underlying auto-immune disorder?
Could you help me with the below queries i have?
#1 Should i continue with Thyronorm 75 mcg or change the dosage?
Even with thyronorm, I have lethargy and occasional mood swings, and feel quite tired by night.
On days when i do some physical exercise in the morning, i feel much better during the day.
My test results (please find attached thyroid test and annual health checkup report)
TSH = 4.41 uIU/mL
free T4 = 1.67 ng/dl
Vit B12 = 492 pg/ml
25 hydroxy vit D total = 21 ng/ml
#2 Could you specify the multivitamins or any other supplement?
I currently take Cholecalciferol 60k IU every two weeks with milk.
My calcium levels are normal as per recent tests.
#3 Is there anything i could do to treat the underlying auto-immune disorder?
Brief Answer:
Thyronorm is going in right dose.
Detailed Answer:
Dear XXXXXXX thyronorm 75 mcg is correct. I would have suggested 88 mcg as TSH is > 4 but your FT4 is normal. So continue same. We don’t and can’t treat antibodies medically. Surgically if thyroid is removed antibodies do come down. But surgery is not recommended just for this purpose.
Now vitamin d supplements are good that u r taking. Cap becotrol from Pfizer - You may add at night daily. Keep physical activity a routine.
Regards!
Thyronorm is going in right dose.
Detailed Answer:
Dear XXXXXXX thyronorm 75 mcg is correct. I would have suggested 88 mcg as TSH is > 4 but your FT4 is normal. So continue same. We don’t and can’t treat antibodies medically. Surgically if thyroid is removed antibodies do come down. But surgery is not recommended just for this purpose.
Now vitamin d supplements are good that u r taking. Cap becotrol from Pfizer - You may add at night daily. Keep physical activity a routine.
Regards!
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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