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How Often Should TSH Be Checked When Diagnosed With Hypothyroid?

Posted on Sat, 12 Sep 2015

Question: I am a 57 year old female. My TSH level has been creeping up for years, but this year, my TSH was out of the lab's normal range (my level was 6.31; the lab's cut-off normal level is 5.6). My doctor does not think that I need to be treated at this point and want to repeat the test in 6 months. Meanwhile, my weight continues to inch up despite frequent exercise. I am rarely hungry but try to eat a healthy, primarily Mediterranean diet. I don't notice any loss of energy. Instead, I am often tired but unable to sleep. If I am hypothyroid, I would like to be treated. Does it make sense to wait six months to repeat the TSH test?

Answered by Dr. Michelle Gibson James (1 hour later)

Brief Answer:
consider checking T3 and T4 (the thyroid hormones themselves)

Detailed Answer:
HI, thanks for using healthcare magic

You can consider measuring the thyroid hormones ( t4 and t3) directly to see if their levels are abnormal.

TSH is the hormone released from an area in the brain called the pituitary.

It sends a message to the thyroid gland in the neck, causing it to release the thyroid hormones T3 and T4.

If the levels of T3 or T4 are low then the pituitary releases more TSH to try and stimulate the thyroid gland to make and release more of the hormone.
This is why in hypothyroidism there are high levels of TSH and low levels of thyroid hormone

If you are truly hypothyroid, your thyroid hormone levels would be low so this is the reason that I suggest you might consider having them done.

I hope this helps, feel free to ask any other questions

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

Follow up: Dr. Michelle Gibson James (34 minutes later)

So should I ask that my doctor test the T3 and T3 levels now? I believe the plan was to re-test the THS level on 6 months. Are there other conditions that would lead to an elevated TSH level? I have an annual CT scan of the abdomen and pelvis for cancer screening, and in 2012, 13, and 14, total body PET scans to makes sure there was no colon metastasis. I do not have thyroid cancer (no nodules), but could all of the radiation from the scans have thrown off the thyroid? My biggest concern is feeling tired but not being able to sleep and not feeling hungry, despite a lot of exercise. This doesn't seem right. I am also depressed and irritable, but I chalked that up to stress and menopause.

Answered by Dr. Michelle Gibson James (5 hours later)

Brief Answer:
yes can do thyroid hormone levels now if possible

Detailed Answer:
HI

Yes, you can check the thyroid hormone levels now to see their values. Also consider checking your complete blood count to rule out anemia as cause of your fatigue

The tests mentioned (ct, pet scans) should not have that significant effect on the thyroid to change hormone levels.

Please feel free to ask any other questions

Note: For further follow up on related General & Family Physician Click here.

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