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What Causes Increase In TSH Levels?

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Posted on Tue, 31 Mar 2015
Question: I had labs in February with TSH of 80. Just retested (not yet medicated) and tsh was 130. PA said go to emergency room but I feel okay, and will be starting synthroid tomorrow. Should I panic?
doctor
Answered by Dr. Binu Parameswaran Pillai (9 minutes later)
Brief Answer:
Not to worry.

Detailed Answer:
Good day
Noted your concern. Glad that you have no symptoms. The basic teaching in medicine is to "treat the patient, not the labs"

If you feel fine, not to worry. However it is important to do a thyroid examination, Free T4 and Free T3 levels as well as an Anti TPO antibody levels. This will give more clarity. I hope your doctors would order for a Free T4 and Free T3 before starting medications tomorrow.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (5 minutes later)
thank you very much for your answer - truly a relief (I suspected the PA was over-reacting). They did do the t3 and t4 but I forgot to ask and I probably won't be able to check until tomorrow. Unless you suggest otherwise, I'll just start on the synthroid tomorrow and check on the t3/t4. In the interim, if I get the t3/t4 info today, is there some level that is a panic point, or still just use the info with my doctor and start medicating as needed in a timely fashion?
doctor
Answered by Dr. Binu Parameswaran Pillai (10 minutes later)
Brief Answer:
may start medications if all ready seen by a doc

Detailed Answer:
Thank you for the reply. There are many causes of TSH elevation and knowing T4 and T3 is important to come to a correct diagnosis and treatment. I was interested if T4 and T3 were low , normal or high. In hypothyroidism we expect T3 and T4 to be low when TSH is so high. But rarely there is a disease called central hyperthyroidism where TSH is high and T4 and T3 are high or high normal. Treatment is different here. It is rare though.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
that confirms what I thought. I'll start the meds tomorrow, and go over results with Dr (now knowing better what to discuss thanks to you) but I understand "not to worry". Thank you very much, you explained it very well and I feel much better, and more confident that I can intelligently deal with it. BTW getting a new dr. soon anyway. Hard to get ahold of him and I get only short, uninformative answers. Best to you.
doctor
Answered by Dr. Binu Parameswaran Pillai (3 minutes later)
Brief Answer:
Good health

Detailed Answer:
Your doctor will surely have a look at full thyroid proile ( not just TSH) before deciding treatment. However, to be on the safer side, make sure he has seen the T4 and T3 reports.

Wish you good health

Regards
Binu
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1438 Questions

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What Causes Increase In TSH Levels?

Brief Answer: Not to worry. Detailed Answer: Good day Noted your concern. Glad that you have no symptoms. The basic teaching in medicine is to "treat the patient, not the labs" If you feel fine, not to worry. However it is important to do a thyroid examination, Free T4 and Free T3 levels as well as an Anti TPO antibody levels. This will give more clarity. I hope your doctors would order for a Free T4 and Free T3 before starting medications tomorrow. Regards Binu