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Suggest Medication Dosage For Hypo Thyrooidism

Posted on Thu, 18 Dec 2014

Question: Two quick questions.due PTC I'm on synthryoid 150 mcg and my TSH is 0.02. Am I hyper or hypothyroid. I'm tired and hair is thinning but am hot most of the time and don't sleep much. Also on my recent blood work I noticed their was no test for thymoglobin on previous blood work from endochronologist it had gone up and I think that's why my synthroid was increased. Should I ask to have that checked? My t3 is one point within normal low and my t4 is in the normal high Also what causes enlarged thyroid with benign nodules

Answered by Dr. Ajish TP (44 minutes later)

Brief Answer:
Hypothyroidism - now on overdose of Synthyroid

Detailed Answer:
Hi XXXX,

Have you undergone thyroid surgery? How long you are having PTC?

The answers to your questions

1. Synthyroid is used for treatment of hypothyroidism. In PTC the treatment is to give higher dose of Synthyroid to keep your TSH low (over treatment to make you hyperthyroid ). This is to prevent recurrence of PTC as low TSH will prevent thyroid growth.

The follow up of PTC is with serum thyroglobulin, thyroglobulin antibody and ultrasound neck every 6-12 months depending on your disease stage and iodine scan when needed. You can discuss this with your doctor.

2. The cause of benign modules are not exactly known. It could be genetic, environmental or due to some autoimmune disease in body.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajish TP (14 minutes later)

Almost two yrs since thyroid removed. No iodine treatment the endo said I was boarder line as to should iodine treatment be done. So should I ask for the thymoglobin level be checked or would that not be a concern because my TSH is so low? What would be considered too low TSH

Answered by Dr. Ajish TP (38 minutes later)

Brief Answer:
Low grade PTC. Follow up with Endo

Detailed Answer:
Hi XXXX,

Probably you are having low grade PTC. If radio iodine treatment is not done, ultrasound alone may be needed for follow up. Thyroglobulin estimation is more useful after radio iodine treatment.

The low TSH depends on the duration and stage of disease. After few years your Endocrinologist will decrease the dose of Synthyroid to keep your TSH around 0.3. After 5 yrs your dose will be further reduced if there is no sign of PTC like swelling in neck. Your symptoms of increased heat will come down with that.

Wishing you good health

Regards
Dr Ajish TP
Consultant Endocrinologist

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Above answer was peer-reviewed by : Dr. Shanthi.E