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Suggest Treatment For High TSH Level When On Thyronorm
Question: Hi, I'm a 55 year old woman.
Earlier I was taking Thyronorm 100 mg but today my TSH results showed as >15. My doctor advised to take Thyronorm 200. I need a second opinion whether to stick with Thyronorm 100 or increase to Thyronorm 200. I also suffer from back pain. I'm a vegeterian, so please suggest me the vegetables that I should not eat to keep thyroid level in control.
Earlier I was taking Thyronorm 100 mg but today my TSH results showed as >15. My doctor advised to take Thyronorm 200. I need a second opinion whether to stick with Thyronorm 100 or increase to Thyronorm 200. I also suffer from back pain. I'm a vegeterian, so please suggest me the vegetables that I should not eat to keep thyroid level in control.
Brief Answer:
You need to increase the dose of thyronorm
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Are you taking thyronorm regularly in morning empty stomach? If still your TSH is high you need to increase the dose of thyronorm. We usually increase the dose by 25 mcg. So you have to take thyronorm 125 mcg and repeat TSH after 6 weeks.
There are no dietary modifications needed for Hashimoto's hypothyroidism ( if your anti thyroid antibodies are high). In iodine deficiency hypothyroidism, you can increase the iodine by increasing the iodised salt consumption and decreasing the intake of vegetables like cabbage, cauliflower etc.
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
You need to increase the dose of thyronorm
Detailed Answer:
Hi,
Welcome to HCM. I have gone through the question and understand your concerns.
Are you taking thyronorm regularly in morning empty stomach? If still your TSH is high you need to increase the dose of thyronorm. We usually increase the dose by 25 mcg. So you have to take thyronorm 125 mcg and repeat TSH after 6 weeks.
There are no dietary modifications needed for Hashimoto's hypothyroidism ( if your anti thyroid antibodies are high). In iodine deficiency hypothyroidism, you can increase the iodine by increasing the iodised salt consumption and decreasing the intake of vegetables like cabbage, cauliflower etc.
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. Chakravarthy Mazumdar
Thanks a lot for the reply. Please find my report of Thyroid testing attached with my profile. Before getting your reply I had taken 200 mg as asked by the doctor and at night I started having breathing problems and couldn't go to sleep, after an hour or so I was at ease. Just wanted to confirm if I should still increase my dose from 100 to 125. I would also like to know if this medication has to be taken for life long or I can stop once the levels are normal. The last time I stopped was an year ago when my levels were normal. After a couple of months when I tested it had gone up so had to start it again. Is there no way I can get rid of this medication after a certain time?
Please let me know how care should I take of myself to become less dependent on medication. I do exercise daily and go out for walk in the morning, don't drink any cold drinks or ice creams or fast food, just the normal vegetable diet.
Please let me know how care should I take of myself to become less dependent on medication. I do exercise daily and go out for walk in the morning, don't drink any cold drinks or ice creams or fast food, just the normal vegetable diet.
Brief Answer:
See detailed answer
Detailed Answer:
Hi,
Welcome back.
I think there was some problem with uploading your lab reports.
The symptoms (breathing problems, decreased sleep) could be due to increased dose of thyroxine. Still if your TSH is high, you need to increase the dose if you were already on regular 100 mcg treatment.
The situations I increase the thyroxine medications aggressively (like from 100 to 200mcg) are in growing children or in pregnancy. In your condition it is better to increase it slowly - like to 125 mcg - and retest after 6 weeks. Please check T4 along with TSH.
You probably is having permanent hypothyroidism. Additional investigations needed to confirm this are
1. Anti TPO antibodies - if high : more likely permanent hypothyroidism, no lifestyle or dietary modifications needed. If low can try high iodine diet ( more iodised salt, less of cabbage, cauliflower etc)
2. Ultrasound - abnormal thyroid - more likely permanent hypothyroidism.
So if you have permanent hypothyroidism, you need to be on life long medications and no life style modification is needed.
Regards
Dr Ajish TP
See detailed answer
Detailed Answer:
Hi,
Welcome back.
I think there was some problem with uploading your lab reports.
The symptoms (breathing problems, decreased sleep) could be due to increased dose of thyroxine. Still if your TSH is high, you need to increase the dose if you were already on regular 100 mcg treatment.
The situations I increase the thyroxine medications aggressively (like from 100 to 200mcg) are in growing children or in pregnancy. In your condition it is better to increase it slowly - like to 125 mcg - and retest after 6 weeks. Please check T4 along with TSH.
You probably is having permanent hypothyroidism. Additional investigations needed to confirm this are
1. Anti TPO antibodies - if high : more likely permanent hypothyroidism, no lifestyle or dietary modifications needed. If low can try high iodine diet ( more iodised salt, less of cabbage, cauliflower etc)
2. Ultrasound - abnormal thyroid - more likely permanent hypothyroidism.
So if you have permanent hypothyroidism, you need to be on life long medications and no life style modification is needed.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The details of the lab report are as follows,
T3 - Value = 200, Reference Range = 60-200
T4 - Value = 9.9, Reference Range = 4.5 - 12.0
TSH - Value = 16.24, Reference Range = 0.30 - 5.5
Regarding the test you suggested, please clarify a bit as to where do I need to get these tests done. Can they be done in the ThyroCare lab or in some hospital.
What should be told to the labs instructor for these tests, any specific name for the Anti TPO antibodies test?
Is it a generic Ultrasound test or I need to specify Ultrasound for Thyroid.
Thanks a lot for being patient and clearing my doubts.
T3 - Value = 200, Reference Range = 60-200
T4 - Value = 9.9, Reference Range = 4.5 - 12.0
TSH - Value = 16.24, Reference Range = 0.30 - 5.5
Regarding the test you suggested, please clarify a bit as to where do I need to get these tests done. Can they be done in the ThyroCare lab or in some hospital.
What should be told to the labs instructor for these tests, any specific name for the Anti TPO antibodies test?
Is it a generic Ultrasound test or I need to specify Ultrasound for Thyroid.
Thanks a lot for being patient and clearing my doubts.
Brief Answer:
Thyrocare is a good lab
Detailed Answer:
Hi,
Welcome back.
Gone through the reports. Your T3, T4 are normal and TSH is high. The dose need to be increased as I suggested - definitely not to 200, but to 125 mcg. Follow up after 6 weeks with free T4, TSH.
Thyrocare or DDRC are good labs in XXXXXXX You can as them to do Anti TPO antibody (anti microsomal antibody). A routine ultrasound from a good sonolologist is needed - No need of any special scans.
Regards
Dr AJISH TP
Thyrocare is a good lab
Detailed Answer:
Hi,
Welcome back.
Gone through the reports. Your T3, T4 are normal and TSH is high. The dose need to be increased as I suggested - definitely not to 200, but to 125 mcg. Follow up after 6 weeks with free T4, TSH.
Thyrocare or DDRC are good labs in XXXXXXX You can as them to do Anti TPO antibody (anti microsomal antibody). A routine ultrasound from a good sonolologist is needed - No need of any special scans.
Regards
Dr AJISH TP
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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