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Suggest Treatment For Increased TSH Levels When On Thyronorm And Vitramin D3
Question: Dear Dr XXXXXXX Moht,
This is XXXX. A month ago i took suggestion form you regarding Hypothyroidism as you suggested i'm using Thyronorm 62.5 mcg and Vitamin D3 60k per week. But surprisingly my TSH level got increased rapidly to 20 microIU/ml. Kindly look into our previous discussion and suggest me that what i have to do now.
Regards,
XXXX
This is XXXX. A month ago i took suggestion form you regarding Hypothyroidism as you suggested i'm using Thyronorm 62.5 mcg and Vitamin D3 60k per week. But surprisingly my TSH level got increased rapidly to 20 microIU/ml. Kindly look into our previous discussion and suggest me that what i have to do now.
Regards,
XXXX
Brief Answer:
A little unusual.
Detailed Answer:
Dear Mr. XXXXXXX
hi! I remember the case. it is a little unusual. with dose of 50 mcg. TSH was high, with 75 mcg. it was low. so the obvious choice was 62.5. now if TSH is going high with 62.5, then either you are missing the dose, or you have gained weight, the tab may be exposed, or may be your thyroid function is worsening, there may be lab error as well. To find we need a revised report from another good lab. if TSH is still high, check your bottle, if the drug is exposed or expired we need to replace the bottle. if you are sure you have not missed the dose, you take your tablet early morning empty stomach, observe another 30 min gap between tab and food or beverage, ie no error on our part, then the dose needs to be increased. we will make it 75 mcg and repeat test after 6 weeks. then let me know.
regards !
A little unusual.
Detailed Answer:
Dear Mr. XXXXXXX
hi! I remember the case. it is a little unusual. with dose of 50 mcg. TSH was high, with 75 mcg. it was low. so the obvious choice was 62.5. now if TSH is going high with 62.5, then either you are missing the dose, or you have gained weight, the tab may be exposed, or may be your thyroid function is worsening, there may be lab error as well. To find we need a revised report from another good lab. if TSH is still high, check your bottle, if the drug is exposed or expired we need to replace the bottle. if you are sure you have not missed the dose, you take your tablet early morning empty stomach, observe another 30 min gap between tab and food or beverage, ie no error on our part, then the dose needs to be increased. we will make it 75 mcg and repeat test after 6 weeks. then let me know.
regards !
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Doctor,
All these doubts were clarified that i took the first test in Apollo clinic.
Here is the Apollo test results:
CALCIUM: 9.3
Vitamin D: 68.54
T3: 1.270
T4: 8.15
TSH: 20.490
I was surprised by seeing my TSH and this morning i took the test again in XXXXXXX Path Labs only for TSH and the result was 19.47.
After your answer i checked the bottle was not expired and not exposed to sunlight and my weight difference was also in grams and i have not missed the tablet for even one day. From last one year i'm taking this tablet on early morning with empty stomach and after one hour i used to take breakfast.
As per your suggestion i reduced the Thyronorm to 62.5 from 75 mcg and started using D3 60k from last 6 weeks is this D3 tablet leads to increase in my TSH?
I was really worrying about this situation. I was thinking that i might have some tumor to my thyroid gland and if we go for scanning or CT scan and all... Please suggest me doctor.
Instead of increasing and reducing dosages can we go for that kind of scans for my Thyroid glands? Please advise.
Regards,
XXXX
All these doubts were clarified that i took the first test in Apollo clinic.
Here is the Apollo test results:
CALCIUM: 9.3
Vitamin D: 68.54
T3: 1.270
T4: 8.15
TSH: 20.490
I was surprised by seeing my TSH and this morning i took the test again in XXXXXXX Path Labs only for TSH and the result was 19.47.
After your answer i checked the bottle was not expired and not exposed to sunlight and my weight difference was also in grams and i have not missed the tablet for even one day. From last one year i'm taking this tablet on early morning with empty stomach and after one hour i used to take breakfast.
As per your suggestion i reduced the Thyronorm to 62.5 from 75 mcg and started using D3 60k from last 6 weeks is this D3 tablet leads to increase in my TSH?
I was really worrying about this situation. I was thinking that i might have some tumor to my thyroid gland and if we go for scanning or CT scan and all... Please suggest me doctor.
Instead of increasing and reducing dosages can we go for that kind of scans for my Thyroid glands? Please advise.
Regards,
XXXX
Brief Answer:
Only solution is to increase the dose.
Detailed Answer:
dear sir, hi! first , please relax.
second no thyroid tumor or other wise and no scans required.
third, d3 has no relation with dosing as long as you are taking them separately.
now please understand that thyroid is a tweetchy gland. initially may be your requirement was low as the gland was partially functional and may be the gland is now becoming less functiona so your requirement is going high.
Again i will emphasize do not panic, do not worry, this is usual! thyroid fluctuations are usual initially till the dose is finalized.
please start 75 mcg and recheck after 6 weeks and let me know. Regards!
Only solution is to increase the dose.
Detailed Answer:
dear sir, hi! first , please relax.
second no thyroid tumor or other wise and no scans required.
third, d3 has no relation with dosing as long as you are taking them separately.
now please understand that thyroid is a tweetchy gland. initially may be your requirement was low as the gland was partially functional and may be the gland is now becoming less functiona so your requirement is going high.
Again i will emphasize do not panic, do not worry, this is usual! thyroid fluctuations are usual initially till the dose is finalized.
please start 75 mcg and recheck after 6 weeks and let me know. Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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