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Is TSH Level Of 3.9 A Cause For Concern?
Question: So I have Graves disease and been in remission about 8 years (didn't use radioactive iodine, uses medication to control it). Well, now I just had my thyroid levels checked, my TSH is 3.9 and my T4 is 0.79. I am having lots of fatigue, muscle aches, and headaches. I am also anemic (9.6 hgb) and vit D deficient (12.2). I am taking vitamins for iron & vit D. My questions is do you think I should try synthroid for my thyroid levels, or wait to see it I feel better after getting Vit D & iron levels back WNL.
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Your TSH is fairly normal so treatment with synthroid is not warranted at the moment.
Make sure your Hemoglobin and Vitamin D levels come back up into the normal range. You can expect improvement in your symptoms after this. If not, other potential causes will be need to be explored after that.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Iron studies
Vitamin B12
Folate
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Your TSH is fairly normal so treatment with synthroid is not warranted at the moment.
Make sure your Hemoglobin and Vitamin D levels come back up into the normal range. You can expect improvement in your symptoms after this. If not, other potential causes will be need to be explored after that.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Iron studies
Vitamin B12
Folate
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
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
Answered by
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