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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do The Findings In Thyroid Profile Test Report Suggest And What Could Cause This?

I have had a fluctuating TSH over the last year with a normal free T4 and negative antibodies. Originally when the TSH was elevated, I had been taking iodine drops. It was rechecked 4 weeks later (after stopping the iodine drops) and was normal. I'm preparing to go through a FET and doc wanted to recheck thyroid again. This time, TSH was back up to 3.94 and still normal fT4. Here are the specific values:

12-13-12: TSH - 2.84, fT4 - 0.80, Thyroid Peroxidase AB - 9, Antithyroblobulin Ab-8-21-13: TSH - 4.64, fT4 - 1.30 (had been on iodine drops X 4 weeks)
9-20-13: TSH - 2.41, fT4 - 1.19, Thyroid Perox - 10, Antithyro - not done (had been off iodine drops X 4 weeks)
11-27-13: TSH - 3.94, fT4 - 1.25 (Doctor wants me to go on Synthroid 25mcg qday and recheck in 1 month :()
Why would this be happening? The iodine explained it last time but nothing has changed for it to happen this time.... :(

Wed, 11 Dec 2013
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Endocrinologist,  's  Response
Hi, This kind of variation is expected to occur with TSH, Are you sure about the lab assay used for all tests are the same ?Even TSH of same sample can vary with different assay.. Reliability of lab method , internal quality control also matters, even calibration change of the machine can result changes in TSH level, for FET( I assume its Embryo Transfer) since you have to achieve a TSH level < 2.5, its better to recheck the value from another very good lab, before considering levothyroxine(synthroid)
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What Do The Findings In Thyroid Profile Test Report Suggest And What Could Cause This?

Hi, This kind of variation is expected to occur with TSH, Are you sure about the lab assay used for all tests are the same ?Even TSH of same sample can vary with different assay.. Reliability of lab method , internal quality control also matters, even calibration change of the machine can result changes in TSH level, for FET( I assume its Embryo Transfer) since you have to achieve a TSH level 2.5, its better to recheck the value from another very good lab, before considering levothyroxine(synthroid)