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What Do My Thyroid Test Results Indicate?
Question:
I need an endocrinologist to answer to my question please. I had pituitary adenoma(pituitary tumor) which was small in size so my doctor started me with cabergoline 0.25mg and i took it for about 2 years and i got an MRI done after 2 years which is now and the tumor has melted but my doctor has asked me to continue half of cabergoline 0.25mg per week for another 2 years so that it does not recur. Meanwhile i got my thyroid tests done and i have attached my report. I had got TSH done one month back and it was 4.6 and i got it done again today which is 6.0. Please advice. Is TSH increasing because i am taking cabergoline? Please tell me how to control my thyroid levels and whether i should start with medication of thyroid or leave it as it is since i am having cabergoline?
I need an endocrinologist to answer to my question please. I had pituitary adenoma(pituitary tumor) which was small in size so my doctor started me with cabergoline 0.25mg and i took it for about 2 years and i got an MRI done after 2 years which is now and the tumor has melted but my doctor has asked me to continue half of cabergoline 0.25mg per week for another 2 years so that it does not recur. Meanwhile i got my thyroid tests done and i have attached my report. I had got TSH done one month back and it was 4.6 and i got it done again today which is 6.0. Please advice. Is TSH increasing because i am taking cabergoline? Please tell me how to control my thyroid levels and whether i should start with medication of thyroid or leave it as it is since i am having cabergoline?
Brief Answer:
Hypothyroidism need to be treated at this age
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I have gone through the question and understand your concerns.
Regarding your 2 issues, the appropriate treatments are:
1. Pituitary adenoma
We give cabergoline mainly for prolactin secreting adenoma- which usually present with milk discharge from breast and menstrual irregularities. On treatment we keep the prolactin under control for 1 1/2 to 2 years, repeat an MRI and stop the treatment. There is very less chance of recurrence when treatment is given for 1 1/2 to 2 years. So no need to continue medications. You can repeat prolactin after 3 months.
2. Thyroid
You are having sub clinical hypothyroidism- a small elevation in TSH with normal T3 and T4. This condition is treated if any of the following are there
a. Increased antibodies - normal in your report
b. Thyroid swelling
c. High cholesterol
d. Pregnant or planning for pregnancy
If any of the above is present you should be started on thyroid hormone replacement. Since your age is 27, if you haven't completed your family, it's better to start treatment.
Canergoline is not the cause of change in TSH.
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
Hypothyroidism need to be treated at this age
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I have gone through the question and understand your concerns.
Regarding your 2 issues, the appropriate treatments are:
1. Pituitary adenoma
We give cabergoline mainly for prolactin secreting adenoma- which usually present with milk discharge from breast and menstrual irregularities. On treatment we keep the prolactin under control for 1 1/2 to 2 years, repeat an MRI and stop the treatment. There is very less chance of recurrence when treatment is given for 1 1/2 to 2 years. So no need to continue medications. You can repeat prolactin after 3 months.
2. Thyroid
You are having sub clinical hypothyroidism- a small elevation in TSH with normal T3 and T4. This condition is treated if any of the following are there
a. Increased antibodies - normal in your report
b. Thyroid swelling
c. High cholesterol
d. Pregnant or planning for pregnancy
If any of the above is present you should be started on thyroid hormone replacement. Since your age is 27, if you haven't completed your family, it's better to start treatment.
Canergoline is not the cause of change in TSH.
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
I am still single so please tell me what medication should i take for thyroid treatment and dosage too .
Brief Answer:
See detailed answer
Detailed Answer:
Hi XXXXXXX
Welcome back.
We don't offer medical prescription in this site.
In a similar case I will start with Thyroxine sodium ( available as Eltroxin or Thyronorm or Synthyroid brands) at a dose of 25 mcg - one tablet in the morning empty stomach. You can take food/ tea coffee 1 hour after medications.
You can repeat the thyroid function after 2 months.
Regards
Dr Ajish TP
See detailed answer
Detailed Answer:
Hi XXXXXXX
Welcome back.
We don't offer medical prescription in this site.
In a similar case I will start with Thyroxine sodium ( available as Eltroxin or Thyronorm or Synthyroid brands) at a dose of 25 mcg - one tablet in the morning empty stomach. You can take food/ tea coffee 1 hour after medications.
You can repeat the thyroid function after 2 months.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor
Also before the pituitary adenoma was detected my tsh used to be on the higher side 4.5 or something but FT
3 and FT4 was always normal but i was not taking any thyroid medicine. When my treatment got started for adenoma then i got my TSH tested in between and it was normal but again for the past 2-3 months TSH is coming to higher side even when i have not stopped cabergoline. Please help me with this situation as i am putting on weight and i am also having leg and hand pain most of the time. I have attached all the reports done yesterday only. Also tell me whether my thyroid problem is related to the pituitary adenoma? Are you sure that i have to start taking Eltroxin 25mg from now or wait and repeat the test again after 2 months? Please advis
Thank youe
Also before the pituitary adenoma was detected my tsh used to be on the higher side 4.5 or something but FT
3 and FT4 was always normal but i was not taking any thyroid medicine. When my treatment got started for adenoma then i got my TSH tested in between and it was normal but again for the past 2-3 months TSH is coming to higher side even when i have not stopped cabergoline. Please help me with this situation as i am putting on weight and i am also having leg and hand pain most of the time. I have attached all the reports done yesterday only. Also tell me whether my thyroid problem is related to the pituitary adenoma? Are you sure that i have to start taking Eltroxin 25mg from now or wait and repeat the test again after 2 months? Please advis
Thank youe
Brief Answer:
See detailed answer
Detailed Answer:
Hi XXXXXXX
welcome back. I have seen the uploaded reports.
Hypothyroidism due to pituitary adenoma is called central hypothyroidism in which TSH,T3 andT4 is all low. Here TSHis high suggesting problem with thyroid rather than pituitary.
Since you are single, treating hypothyroidism is not an emergency. Increase the intake of iodine rich diet ( iodised salt, sea foods etc) and repeat the thyroid function after 2-3 months.
If TSH is still elevated, it is better to start on Eltroxin as it will also help with your weight gain.
Regards
Dr Ajish TP
See detailed answer
Detailed Answer:
Hi XXXXXXX
welcome back. I have seen the uploaded reports.
Hypothyroidism due to pituitary adenoma is called central hypothyroidism in which TSH,T3 andT4 is all low. Here TSHis high suggesting problem with thyroid rather than pituitary.
Since you are single, treating hypothyroidism is not an emergency. Increase the intake of iodine rich diet ( iodised salt, sea foods etc) and repeat the thyroid function after 2-3 months.
If TSH is still elevated, it is better to start on Eltroxin as it will also help with your weight gain.
Regards
Dr Ajish TP
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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