Thyroid UK
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Fluctuating tsh levels?

TSH range is 0.20-4.50 mU/L Free T4 range is 9-21 pmo1/L

30/09/2011 TSH 1.44 T4 14

19/04/2012 TSH 9.09 H., T4 14.

01/06/2012 TSH 4.54 H., T4 14.,

29/08/2012 TSH 2.9., and

08/11/2012 TSH 4.5

June 2013 TSH 7.1., T4 12

Was tested on Thursday 29/8/13 and found its back within normal range! (Don't know actual results)

Dr phoned today to say he's spoke to an endocrinologist and they have advised me to start on 25mg levothyroxine for three weeks, then if i feel better increase to 50mg.

Does anyone know why my results fluctuate so much and if I'm to take meds do I have hypothyroidism. The doctor also felt my thyroid was slightly enlarged on the right side of my neck?

2 Replies

It sounds like what may be happening is your TSH is fluctuating as your body is trying to compensate for low T4 levels. This could also explain why your thyroid is enlarged.

It could also be that you have Hashimoto's disease, which is autoimmune, and that your TSH is varying as the disease is becoming more or less active. Sometimes taking levothyroxine can help to stop this happening so much.

It is also possible that some of the variation is to do with the time of day the blood was drawn. TSH is highest first thing in the morning, tailing off as the day goes on. This could explain some of the variation.

Looking at your results, you are hypothyroid. Your TSH tends to be high or high in range and your T4 is relatively low within the range. It looks like you might be in the early stages of hypothyroidism or perhaps you are having trouble with Hashimoto's or some other type of thyroiditis.

Are they going to investigate the swelling? It would probably be a good idea if it doesn't go down after starting the levothyroxine. Swelling can be the thyroid trying to compensate for the lack of thyroid hormones in your body. It can also be due to the autoimmune disease attacking the thyroid.

I'm afraid I can't really tell you what you have without knowing whether you have thyroid antibodies or knowing what exactly the swelling is. Hopefully your doctor will be able to answer those questions for you. The above will give you an idea of what might be happening :)

You might want to have a look around the main Thyroid UK website for more information about thyroid disease.

Sorry I couldn't be more specific. I hope you start to feel better with the thyroxine. It works well for most people once they are on the correct dose.

Carolyn x


Hi Carolyn,

Thanks for the reply, very helpful as the doctor didn't go into any details on the phone. He said he'd send a letter to my gp, so will make an appointment with him to see if they are planning on checking out the swelling or not. It's only now I realise this could apparently explain a lot re me having difficulty swallowing at times and even feeling as if I'm choking! Not pleasant at all.

It was strange it was my respiratory doctor that investigated this further and even though my results are supposedly within "normal" range again was prepared to speak to an endo for advice. I feel like I've been banging my head against a brick wall so far, but this might finally be the start to figuring out what's wrong.

Thanks again for your help


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