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Suggest Treatment For Hypothyroidism And TSH Level Of 19.4
Question: hello doctor,
My mother is having hypothyroidism from last 15 yrs. She is taking teb of 100mcg on daily basis. The last, we checked her thyroid level was last yr and it was normal. We went for a regular checkup 8 days back and asked for thyroid profile as well. This time TSH level came 19.4 so we crosschecked it, and again it came 20.
We consulted with the physician and he is asking to increase the dose from 100 to 150mch daily. Is it fine? She is regularly taking her medicine then what could be the reason for increasing?? Her digestion is also not proper these days, is it due to hypothyroidism. Any precaution to take.
My mother is having hypothyroidism from last 15 yrs. She is taking teb of 100mcg on daily basis. The last, we checked her thyroid level was last yr and it was normal. We went for a regular checkup 8 days back and asked for thyroid profile as well. This time TSH level came 19.4 so we crosschecked it, and again it came 20.
We consulted with the physician and he is asking to increase the dose from 100 to 150mch daily. Is it fine? She is regularly taking her medicine then what could be the reason for increasing?? Her digestion is also not proper these days, is it due to hypothyroidism. Any precaution to take.
Brief Answer:
Please see detailed answer
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. Thanks for posting the question. I understand your concerns.
The increased TSH (un controlled hypothyroidism)can be due to several reasons:
1. The thyroid disease has progressed - so now requirement of thyroxine is high
2. The medication is not proper - probably the medicine is not kept in a sun protected area, not purchased from a good pharmacy or not taken regularly
3. Thyroid medications are not getting absorbed properly. The medication is not taken in empty stomach. Some medications (like calcium), or tea or food is taken immediately after thyroxine. Severe gastritis or indigestion can also cause a decrease in thyroxine absorption and increase the TSH.
Hypothyroidism can cause indigestion and indigestion can worsen hypothyroidism.
If any of the above reasons are there, do correct it before increasing the medication dose. If gastritis is there, proper treatment can improve the thyroxine absorption and bring down your TSH.
If none of the above factors are there or correction is not working in 6 week time dose of thyroxine can be increased. In a similar case I will increase the dose to 125 mcg (Opinions differ among doctors) and retest after 6 weeks for TSH normalisation.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Please see detailed answer
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. Thanks for posting the question. I understand your concerns.
The increased TSH (un controlled hypothyroidism)can be due to several reasons:
1. The thyroid disease has progressed - so now requirement of thyroxine is high
2. The medication is not proper - probably the medicine is not kept in a sun protected area, not purchased from a good pharmacy or not taken regularly
3. Thyroid medications are not getting absorbed properly. The medication is not taken in empty stomach. Some medications (like calcium), or tea or food is taken immediately after thyroxine. Severe gastritis or indigestion can also cause a decrease in thyroxine absorption and increase the TSH.
Hypothyroidism can cause indigestion and indigestion can worsen hypothyroidism.
If any of the above reasons are there, do correct it before increasing the medication dose. If gastritis is there, proper treatment can improve the thyroxine absorption and bring down your TSH.
If none of the above factors are there or correction is not working in 6 week time dose of thyroxine can be increased. In a similar case I will increase the dose to 125 mcg (Opinions differ among doctors) and retest after 6 weeks for TSH normalisation.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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