
What Is The Dosage Of Thyronorm For Elevated TSH Levels?

I am 38, Male and have hypothyroidism with the following TSH history over a period of time. I have been consulting a physician and based on the test reports the dosage of Thyronorm has been increasing as show below.
16/08/2014 - TSH: 9.244 - Started with Thyronorm - 25mcg
27/12/2014 - TSH: 8.74 - Dosage increased to 50 mcg - Thyronorm
07/03/2015 - TSH: 5.43, T3: 91, T4: 10, FT3: 2.8, FT4: 1.39 - Continued with 50mcg
08/06/2015 - TSH: 7.49, T3: 88, T4: 10.5, FT3: 2.5, FT4: 1.17 - Dosage increased to 75mcg.
Especially the last test showed an increase in the value of TSH inspite of regular consumption of Thyronorm. My questions are:
1. Except for TSH, rest of the values seem to be within the specified range? Is it normal that only TSH is not in range?
2. Should I now increase the dosage to 75 mcg?
3. I usually take the tablet in the morning. How much time gap should I give before consuming breakfast and does this matter?
Thanks, XXXXXXX
Yes,It is possible to have only TSH value is elevated while normal T3,T4
Detailed Answer:
Hi,
Welcome to health care magic,
I have read your query the and understand the concerns.
1) Yes,It is possible to have only TSH value is elevated while thyroid hormone T3 and T4 are within the normal range because of the reason is,
i) Pituitary resistance to thyroid hormone means that even when you have adequate thyroid hormone, the pituitary does not react to it properly and continues to push out more TSH.
ii) Another possible reason is the presence of a pituitary adenoma which could be pushing out TSH irrespective of the cause.
In both of these you could have sufficient thyroid hormone but still have a high TSH level.
You can discuss these two possibilities with your treating doctor.
2) Yes,considering your last 2 reading of TSH value you should increase the dose to 75 mcg and get thyroid tests again after 3 months.
3) Thyroid tablet (Thyronorm) must be taken on empty stomach to get maximum absorption from the stomach as food might interfere with its absorption.
Ideally it is taken after 2 hours of having meal or before 45 minutes of meal.
Means it is best not to eat anything for at least 1 hour after taking thyronorm.
Hope this detailed answer will be helpful.
Regards,
Dr.SandipKabra


Thanks for answering my previous questions. I have a question based on your analysis:
"1) Yes,It is possible to have only TSH value is elevated while thyroid hormone T3 and T4 are within the normal range because of the reason is,"
Assuming I have adequate thyroid hormone, but the pituitary is pushing out TSH because of some anomaly, Shouldnt the T3/T4 and FT3/FT4 also show anomalous values because of the additional thyroid hormone consumption (50mcg of Thyronorm)? I hope I was clear above.
Basically, if my pituitary is pushing out TSH even though I have adequate thyroid hormone, shouldnt the T3/T4 or FT3/FT4 values be affected because of the additional 50mcg of Thyronorm?
Thanks, XXXXXXX
Yes,it is possible but when you will take high doses of thyronorm
Detailed Answer:
Hi,
If your thyronorm dosage is increased say to more than 100mcg then it may possibly elevate T3 and T4. It occurs only on very high dose (100 mcg or more) and especially when it is taken for a long time without monitoring your thyroid profile periodically.
One more thing it might require some time to stabilize the exact dosage initially; but once your dosage will be set then there will be no issue with elevation of thyroid hormones. So no need to worry.
Continue your thyroid treatment and if possible you can also check your thyroid profile on every alternative months at initial stages. And when the dosage will be set you can go for testing every 3 to 6 monthly.
Regards,

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