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What Causes Elevated TSH Levels Inspite Of Being On Homeopathic Treatment For Hypothyroidism?
Question: I am 20 years old female and have been hypothyroid since last 4 years. have been taking thyronorm 50 mg all the time . since last two years this treatment has been backed by homeopathic treatment which according to the homeopathic doctor will prevent any increases in thyronorm dosages.Since last 4/5 months my tsh levels have increased again and the latest test shows T3:42, T4:8.5 and TSH as 8.90. as you can see the T3 levels are very low even though T4 looks normal. Do i need to increase the dosage of thyronorm now from 50 mg to lets say 75 mg and keep the homeopathic treatment as it is? I also observed that my body tempertaures remain low at 97.6 and my blood pressure also remains low . My menstruation cycles are irregular and sometimes very painful.
Brief Answer:
Hello
Detailed Answer:
Good day,
Noted your cocern.
This looks like the natural progression of hypothyroidism. The most common type of hypothyroidism in a woman is auto immune hypothyroidism. In this case, usually, the thyrid cells will progressively get damaged inn most cases and based on that , one may reuire higher doses. Ultimately, their thyroid profile will stabilize on a particular dose and most commonly it is around 100 mcg Thyronorm. Again it depends on your age.
Personally, i do not feel homeopathic medicines are useful. In your case , i noted that present thyroid function shows that the TSH is high and i would advice that you can straight away increase the dose to 75 mcg of Thyronorm ( since you are young. If you were old and had heart diseases etc, we would go slow).
Again, one other important clue for auto immune hypothyroidism would be to do Anti TPO antibody test. Once you increase the dose, please do repeat thyroid function tests after 6 weeks. I recommend Free T4 ( Ft4) instead if T4 when you do the test next time.
In summary, your symptoms are suggestive of hypothyroidism and you may safely increase the dose to 75 mcg Thyronorm. ( before food). Store Thyronorm in a cool and dry place away from sunlight and heat. Once you increase the dose, repeat Free T4 and TSH ( empty stomach) and Anti TPO after 6 weeks. Please let us know the reports then. Thyronorm is a very safe medicine.
Wish you good health
Regards
Binu
Hello
Detailed Answer:
Good day,
Noted your cocern.
This looks like the natural progression of hypothyroidism. The most common type of hypothyroidism in a woman is auto immune hypothyroidism. In this case, usually, the thyrid cells will progressively get damaged inn most cases and based on that , one may reuire higher doses. Ultimately, their thyroid profile will stabilize on a particular dose and most commonly it is around 100 mcg Thyronorm. Again it depends on your age.
Personally, i do not feel homeopathic medicines are useful. In your case , i noted that present thyroid function shows that the TSH is high and i would advice that you can straight away increase the dose to 75 mcg of Thyronorm ( since you are young. If you were old and had heart diseases etc, we would go slow).
Again, one other important clue for auto immune hypothyroidism would be to do Anti TPO antibody test. Once you increase the dose, please do repeat thyroid function tests after 6 weeks. I recommend Free T4 ( Ft4) instead if T4 when you do the test next time.
In summary, your symptoms are suggestive of hypothyroidism and you may safely increase the dose to 75 mcg Thyronorm. ( before food). Store Thyronorm in a cool and dry place away from sunlight and heat. Once you increase the dose, repeat Free T4 and TSH ( empty stomach) and Anti TPO after 6 weeks. Please let us know the reports then. Thyronorm is a very safe medicine.
Wish you good health
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the response,
1. What I am concerned is that this started at a very early age for me , when I was 16 years. does this happen ? what could be the reason to develop this deficiency. I am scared to think that I have to take life long medication at increasing dosages .
2. As I observe from the lab tests as sent to you that T3 levels are very low( 42) , even though T4 is normal (8.5) . FT4 results which were done just about 30 days prior to this test was at 1.29 . Does that indicate that T4 is not getting sufficiently converted to T3? . Will T4 supplement only be able to rectify this problem.
I have heard certain endocrinologist recommend a mixture of T3 as well as T4 supplements instead of only T4. Is this advisable in my case too? The endocrinologist I am consulting locally does not support this view
3. Please advise how are the tests for TPO performed and are they readily available in XXXXXXX in normal pathologies.
4. What are the recommended limits of TSH, T3 and FT4 one should try to reach once under thyroid medication, as in my case.
5.Additionally a couple of months back my endocrinologist detected a very low blood pressure ( 50 and 90 instead of normal 80/120) . He did an overnight recording of blood pressure using a machine which automatically tested and recorded blood pressure every hour. There were many instance noted especially at night when the pressure was extremely low. Then we realized that this was probably the reason for a couple of occasions when I fainted when giving blood samples. The endocrinologist has since put me on additional dosage of multivitamins, folic acid etc. After about 2 months of this treatment my blood pressure has improved and close to normal. but still on the lower side.
Why did this happen , what could be the causes and the treatment. I believe this was due to weak adrenals ( adrenal fatigue) associated with hypothyroidism. Is this treatable or will this treatment also continue life long just as for hypothyroidism? How does this complicate hypothyroid treatment if at all . Will I be able to stop these multivitamins at any stage . I am concerned .
I am from XXXXXXX , XXXXXXX can you suggest any endocrinologist in this area or any other hospital/ specialty services where I can get checked up in person. Many hospitals that I visited do not have endocrinologists
1. What I am concerned is that this started at a very early age for me , when I was 16 years. does this happen ? what could be the reason to develop this deficiency. I am scared to think that I have to take life long medication at increasing dosages .
2. As I observe from the lab tests as sent to you that T3 levels are very low( 42) , even though T4 is normal (8.5) . FT4 results which were done just about 30 days prior to this test was at 1.29 . Does that indicate that T4 is not getting sufficiently converted to T3? . Will T4 supplement only be able to rectify this problem.
I have heard certain endocrinologist recommend a mixture of T3 as well as T4 supplements instead of only T4. Is this advisable in my case too? The endocrinologist I am consulting locally does not support this view
3. Please advise how are the tests for TPO performed and are they readily available in XXXXXXX in normal pathologies.
4. What are the recommended limits of TSH, T3 and FT4 one should try to reach once under thyroid medication, as in my case.
5.Additionally a couple of months back my endocrinologist detected a very low blood pressure ( 50 and 90 instead of normal 80/120) . He did an overnight recording of blood pressure using a machine which automatically tested and recorded blood pressure every hour. There were many instance noted especially at night when the pressure was extremely low. Then we realized that this was probably the reason for a couple of occasions when I fainted when giving blood samples. The endocrinologist has since put me on additional dosage of multivitamins, folic acid etc. After about 2 months of this treatment my blood pressure has improved and close to normal. but still on the lower side.
Why did this happen , what could be the causes and the treatment. I believe this was due to weak adrenals ( adrenal fatigue) associated with hypothyroidism. Is this treatable or will this treatment also continue life long just as for hypothyroidism? How does this complicate hypothyroid treatment if at all . Will I be able to stop these multivitamins at any stage . I am concerned .
I am from XXXXXXX , XXXXXXX can you suggest any endocrinologist in this area or any other hospital/ specialty services where I can get checked up in person. Many hospitals that I visited do not have endocrinologists
Brief Answer:
HEllo
Detailed Answer:
Thank you for writing back.
Let us discuss your questions one by one
1. Yes, Last week I had a child of 4 years with hypothyroidism. Most likely cause is auto immune hypothyroidism, ( Hashimotos). This is a simple disease and nothing to worry.
2). No, we do not generally make the adjustment based on T3. We go by Free T4 and TSH levels. All major endocrinology organizations recommend only T4 supplementation. Mixture of T3 and T4 is not available in XXXXXXX and it is not necessary too. It is rarely needed.
3.) TPO is a simple test and cost around 500 rupees. All major labs do it. Thyrocare is a reliable lab. No need to do fasting for this test
4 ) .I generally aim to keep TSH less than 3 and T4 in upper half of normal.. In pregnancy, I try to keep TSH less than 2.5 during first three months. That is the recommendation.
5) in Auto immune Hypothyroidism, there is a rare chance of adrenal fatigue ( Addison's disease). If the BP was low, it may be worth doing an 8 AM cortisol level and serum potassium level. If cortisol is low, we may have to do a stimulation test ( short synacthene test). Multivitamins have no role in any of thyroid or adrenal disorders.
In XXXXXXX you are lucky to have SGPGI hospital. This is a central institute and the department of endocrinology is a very strong and good department
HEllo
Detailed Answer:
Thank you for writing back.
Let us discuss your questions one by one
1. Yes, Last week I had a child of 4 years with hypothyroidism. Most likely cause is auto immune hypothyroidism, ( Hashimotos). This is a simple disease and nothing to worry.
2). No, we do not generally make the adjustment based on T3. We go by Free T4 and TSH levels. All major endocrinology organizations recommend only T4 supplementation. Mixture of T3 and T4 is not available in XXXXXXX and it is not necessary too. It is rarely needed.
3.) TPO is a simple test and cost around 500 rupees. All major labs do it. Thyrocare is a reliable lab. No need to do fasting for this test
4 ) .I generally aim to keep TSH less than 3 and T4 in upper half of normal.. In pregnancy, I try to keep TSH less than 2.5 during first three months. That is the recommendation.
5) in Auto immune Hypothyroidism, there is a rare chance of adrenal fatigue ( Addison's disease). If the BP was low, it may be worth doing an 8 AM cortisol level and serum potassium level. If cortisol is low, we may have to do a stimulation test ( short synacthene test). Multivitamins have no role in any of thyroid or adrenal disorders.
In XXXXXXX you are lucky to have SGPGI hospital. This is a central institute and the department of endocrinology is a very strong and good department
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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