TSH 31

[Karen942]

I am on 200mg of levo a day but my levels are going up my last one was 9 six weeks ago now 31. Is 200 a high dose? Any ideas as to why my levels keep going up???

[Clutter]

Karen, it looks like 200mcg isn't enough and should have been increased six weeks ago. Please be very cautious driving as TSH >20 can impair driving reactions more than being over the drink drive limit.

Have you started taking a new medication which may be interfering with the absorption and uptake of Levothyroxine?

Are you taking Levothyroxine on an empty stomach? It can bind to food and drink reducing absorption and uptake. Levothyroxine should be taken with water on an empty stomach, one hour before or two hours after food and drink, two hours away from medication and supplements, and four hours away from iron, calcium, vitamin D and iron.

If medicines and food aren't causing malabsorption the other likely reason is resistance to thyroid hormone which should be investigated by an endocrinologist.

[Karen942 in reply to Clutter]

Thank you for the reply, you might have a point with quite a few of your comments. I tend to take them in the mornings but take with a high dose multivitamin and vitamin D supplement ... I also have coeliac disease and wonder if this is affecting how well I absorb it. My doctor did up the dosage from 150 about eight weeks ago but my levels are going up. Strange when it was stable for about 6 months

[Clutter in reply to Karen942]

Karen, Coeliac disease can certainly affect absorption and uptake of Levothyroxine and taking it with vitD and a multivit which may contain iron and calcium will make it worse. Take the supplements well away from Levothyroxine as I advised above but your dose still needs increasing to bring down your TSH.

[Karen942 in reply to Clutter]

Thank you for the reply I will change my routine and see if that helps

[Clutter in reply to Karen942]

Karen, by all means change your routine, it may help but won't harm, but please also get a dose increase and have a follow up test 6 weeks later. Your GP can increase dose but should refer you to an endocrinologist to manage this.

[faith63]

Do you have any other Thyroid labs? I ran into someone who had a really high TSH, but low ft4 and ft3..they had a Pituitary issue, so TSH was totally useless. Or, maybe your meds aren't being absorbed. Are you taking them on an empty stomach? Celiac's could indeed cause malabsorption.

[Karen942 in reply to faith63]

Hi Faith, thank you for your reply , I think I should change the times I take them and avoid taking with other medication and see if that helps any. Bloods back today were also high so have to go and see the doctor again. I am sure he thinks I don't take them but I do everyday

The only tests I have are Plasma TSH which is 31.31 (0.34-5.6) maybe it us to do with the coeliac but that is under control and my levels have been ok ish for most of the time ....

[helvella Administrator Thyroid UK in reply to Karen942]

If someone has high TSH and is already taking what would often be a full replacement dose, further investigation is important. One issue is that the pituitary can have a tiny benign tumour which is pushing out TSH. Another possibility is interference with the TSH test - one possible cause is having antibodies to TSH in your bloodstream.

You should have a Free T4 test (at the minimum). And have your TSH tested at another lab that uses a different technology for performing the analysis. It is important to see if the TSH and FT4 numbers reflect each other.

[faith63 in reply to Karen942]

With a TSH, that high, you need free t4 and free t3 done as well. You need to find a new doctor. He obviously doesn't know what he is doing, if that is the only test he is doing for thyroid. How do you feel?

[Karen942 in reply to faith63]

I actually feel ok just tired sometimes in the afternoons, work fill time and cope with that ... Saying that it's better than I was two years ago when diagnosed with thyroid and coeliac after feeling ill for years . My GP is pretty good as a rule and let's me inject B12 as I feel I need to which is more than most do from what I hear. Had an MRI last year due to problems with my spine due to B12 so no pituitary problems . Thanks for reply

[faith63 in reply to Karen942]

The MRI took an indepth image of your Pituitary, then? One of the Spine would not show Pituitary..i wouldn't think.

Sounds like you feel better than most Hypo's.

[Karen942 in reply to faith63]

Hi Faith, not an in depth scan of pituatairy but I did have my brain and spine scanned and would hope it would have shown up on that ... Lots of family have hypo so it's not thought of as a big deal to be honest but maybe some things I am putting down to B12 deficiency are actually to do with my thyroid

[faith63 in reply to Karen942]

Not a big deal ??? and i guess just take the pil and you are ok??l!!! Wow..you are so lucky! I have been homebound for nearly 5 years, pain, swollen everywhere..so many symptoms.

[Karen942 in reply to faith63]

I didn't realise it could cause such huge problems. Was it years before you were diagnosed ? I know none of my family have too much trouble with the condition once levels are ok.... Everyone is different I guess and maybe we are lucky

[faith63 in reply to Karen942]

I have Autoimmune Thyroid Disease, so i have symptoms from just having that. Yes!!! Many on this forum are quite ill, crippled, homebound, have all kinds of other health issues due to having low thyroid and Hashimoto. I don't know how long i had it until my thyroid began to show symptoms.

[Karen942]

Thanks for reply . I had all those things tested when first diagnosed and was put on folic acid 5mg and adcal 2 a day, I have osteoporosis now due tithe coeliac. I also inject B12 as and when I need down to every few weeks now . Was told to stop the folic acid as levels were good so have not taken them for a year now. Still take multivitamin and adcal daily

[Hidden]

Hi faith I have never felt so I'll from becoming hypo 4 years ago I've been searching the net for answers to all my symtoms sometimes I think do I imagine this bones painful muscles really bad pain all the time my neck is driving me mad . I've lost interest in all the things I loved to do. I'm out of work again can't b bothered just try to get the day in to go to bed .