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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Low TSH Level?

i collapsed yesterday and ended up in the emergency room. i have had my thyroid removed 4 years ago the last 7 months i have been on the same dose of levoxyl of 200mcg and two weeks ago my t4 and t3 were normal and my tsh was normal as well last night my t4 and t3 were normal and now my tsh is very low .08 what can cause it to drop that low in two weeks and make me collapse? all other labs were normal.
Mon, 7 Nov 2016
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General & Family Physician,  's  Response
Hi & Welcome.

Based on the history given, you seem to be had developed toxicity due to Levoxyl overdosage.

The common clinical signs and symptoms include nervousness, insomnia, tremor of hands, tachycardia, arrhythmias, elevation of body temperature, blood pressure elevation and loose stools. Rarely more serious late effects occur, including coma, convulsions and acute psychosis.

Following thyroidectomy (surgical removal of thyroid gland) you need to take thyroid replacement therapy (like Levoxyl) for life long.

However, the usual recommended dose is 1.5-μg/kg per day.

This is based on actual body weight that is the best estimation for thyroid replacement therapy after thyroidectomy. You need to have a follow-up 2-4 weeks after to check the efficacy of the treatment and to adjust the dose of Levoxyl until the TSH level is normalized. TSH level should be maintained in the range of 0.1 to 0.5 mU/L.

In view of the above, you should consult your treating physician to calculate the optimal dose requirement of Levoxyl to prevent overdose.
Hope this will help.

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What Causes Low TSH Level?

Hi & Welcome. Based on the history given, you seem to be had developed toxicity due to Levoxyl overdosage. The common clinical signs and symptoms include nervousness, insomnia, tremor of hands, tachycardia, arrhythmias, elevation of body temperature, blood pressure elevation and loose stools. Rarely more serious late effects occur, including coma, convulsions and acute psychosis. Following thyroidectomy (surgical removal of thyroid gland) you need to take thyroid replacement therapy (like Levoxyl) for life long. However, the usual recommended dose is 1.5-μg/kg per day. This is based on actual body weight that is the best estimation for thyroid replacement therapy after thyroidectomy. You need to have a follow-up 2-4 weeks after to check the efficacy of the treatment and to adjust the dose of Levoxyl until the TSH level is normalized. TSH level should be maintained in the range of 0.1 to 0.5 mU/L. In view of the above, you should consult your treating physician to calculate the optimal dose requirement of Levoxyl to prevent overdose. Hope this will help.