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Is TSH Value Of 0.03 MIU/L A Cause For Concern?
Question: I've had periodic episodes of hypertension, tachycardia, a pounding pulse, and a feeling of doom. Two weeks ago this became persistent, with a previously absent constant thirst, and an unexplained 5 pound weight loss. My TSH today was 0.03. Clearly I have hyperthyroidism--yet I was diagnosed 20 years ago with Hashimoto's thyroiditish and my TSH usually ranges from 3-13 on 175 mcg of Synthroid.
Can hyperthyroid symptoms be episodic? Why would this occur so long after my autoimmune diagnosis (antithyroid antibody value 1138)?
Can hyperthyroid symptoms be episodic? Why would this occur so long after my autoimmune diagnosis (antithyroid antibody value 1138)?
Brief Answer:
With TSH at 0.03, you are clearly hyperthyroid on medication.
Detailed Answer:
Hello,
Thank you very much for posting your query.
I have studied your history and considered your questions, I can understand your confusion and concern.
Your TSH value is very low, this means the thyroid hormone supplement you have been taking for over 20 years is becoming more than sufficient, you might have had Hashimoto's 20 years ago, and the remaining unharmed thyroid seems to have recovered and has started producing some amount of thyroid hormone, hence the requirement for supplemental thyroid hormone will be naturally less.
However, you have been continuing to take the same amount of thyroid hormone, so your body has excess thyroid hormone.
The sudden onset of the symptoms and persistence indicates an hyperactive thyroid nodule, suggesting the weight loss and persistence of symptoms.
I can confirm your suspicion that all the symptoms being experienced by you are due to an excess of thyroid hormone.
The cardiovascular symptoms are quite common with hyperthyroidism and you need to lower the dose of supplemental thyroid hormone.
To answer your specific question.
Yes, hyperthyroid symptoms can very well be episodic (Indicating a nodule that becomes active for some time and then regresses).
This would occur so long after your diagnosis because the body has a potential to regenerate, so some part of thyroid would be growing back, thus causing the symptoms.
The antibody level is high, indicating a continuing autoimmune thyroiditis, however, your current situation will be best managed by a close monitoring of free T3, T4 levels, and clinical symptoms along with regular cardiac monitoring in the form of ECG.
Please consult with your endocrinologist at the earliest and get yourself evaluated completely again.
Get the above mentioned investigations done along with an ultrasound scanning of the neck to look for active thyroid nodules.
Treatment will involve a reduction in thyroid hormone supplementation and close monitoring.
I hope this answers your query adequately, I would be happy to help you further if you have any doubts.
Wishing you speedy recovery.
Warm regards.
With TSH at 0.03, you are clearly hyperthyroid on medication.
Detailed Answer:
Hello,
Thank you very much for posting your query.
I have studied your history and considered your questions, I can understand your confusion and concern.
Your TSH value is very low, this means the thyroid hormone supplement you have been taking for over 20 years is becoming more than sufficient, you might have had Hashimoto's 20 years ago, and the remaining unharmed thyroid seems to have recovered and has started producing some amount of thyroid hormone, hence the requirement for supplemental thyroid hormone will be naturally less.
However, you have been continuing to take the same amount of thyroid hormone, so your body has excess thyroid hormone.
The sudden onset of the symptoms and persistence indicates an hyperactive thyroid nodule, suggesting the weight loss and persistence of symptoms.
I can confirm your suspicion that all the symptoms being experienced by you are due to an excess of thyroid hormone.
The cardiovascular symptoms are quite common with hyperthyroidism and you need to lower the dose of supplemental thyroid hormone.
To answer your specific question.
Yes, hyperthyroid symptoms can very well be episodic (Indicating a nodule that becomes active for some time and then regresses).
This would occur so long after your diagnosis because the body has a potential to regenerate, so some part of thyroid would be growing back, thus causing the symptoms.
The antibody level is high, indicating a continuing autoimmune thyroiditis, however, your current situation will be best managed by a close monitoring of free T3, T4 levels, and clinical symptoms along with regular cardiac monitoring in the form of ECG.
Please consult with your endocrinologist at the earliest and get yourself evaluated completely again.
Get the above mentioned investigations done along with an ultrasound scanning of the neck to look for active thyroid nodules.
Treatment will involve a reduction in thyroid hormone supplementation and close monitoring.
I hope this answers your query adequately, I would be happy to help you further if you have any doubts.
Wishing you speedy recovery.
Warm regards.
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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