High TSH and headaches

[Ruthie1969]

My mother (83 yrs) has been suffering from hypothyroid for 5 years, and had been stable. However, her latest blood tests show a TSH of 15.72, and T4 of 17.8. For the last 5 weeks she has been suffering terrible headaches. Could this be linked to her thyroid. Anyone experienced these headaches? Thank you for any advice.

[Flower3]

Strange to see such a high TSH and a quite normal FT4, do you have the ranges? What did the doctor say?

From my own experience I can say headaches is definitely a symptom of the thyroid. And for sure such a high TSH tells you there is not enough T4 in her system.

[Ruthie1969 in reply to Flower3]

Thanks for reply. I am a nurse but have no experience in endocrinology so am trying hard to find a cause for her headaches. She is also feeling very cold all the time. The GP has not mentioned a correlation between high TSH and headaches, but on my research there does seem to be a link. Her GP is sending her for a brain scan!! (she is now convinced she has a tumour). The readings on her bloods are as follows Serum TSH level 15.72 mU/L (0.35-5.50), serum free T4 level 17.8 pmo1/L (10.0-19.8). Thank you.

[Flower3 in reply to Ruthie1969]

How awful, the high TSH normally means there is not enough hormone (FT4). The high TSH and low FT4 means you are hypo and this can also give headaches. With your mother the FT4 level is good, so something isn't going right.

If I were you I would try to get a referral to a endocrinologist. The TSH is made in the pituitary gland (in the brain), a endo also treats people with pituitary problems and of course thyroid problems. This would make more sense to me then a brain scan. GPs don't know enough about this subject.

[galathea in reply to Flower3]

Chances are she has good levels of free t4 but cannot convert the free t4 into free t3. (the useable active hormone). There are lots of reasons for non conversion..... Low selenium, low iron for starters.... Easiest soliution is to try some t 3, liothyronine and see if it helps. Or better still, swap to an ndt, like naturethroid. This contains both t4 and t3,

If your mum cannot use the t4, increasing her dose may just make her feel worse.....

Xx g

[jimh111 in reply to galathea]

Low selenium could be an explanation of the highish TSH and fT4. Given these unusual results your doctor is justified in requesting a full thyroid profile including fT3 (they should put a note on the request explaining why fT3 is required). An endocrinologist referral would help but I suspect it would introduce delay. They should also measure her selenium level. If this is the cause there could be a very simple cure. I wouldn't increase the levothyroxine dose as I don't think it would help as although her fT3 would go up she would start to produce 'reverse T3' which blocks the action of the T3.

I'd check out the fT3 and selium levels before considering liothyronine (L-T3).

[Angel_of_the_North in reply to Flower3]

She is probably not converting T4 to T3 very well. I'd try to get GP to test B12 (needs to be well over 500), folate and ferritin. A relaxing magnesium supplement like Magnesium threonate might help with headaches, too.

[SeasideSusie Remembering]

I've suffered with headaches for more years than I can remember, and been hypo for over 40 years, so I think there is a connection.

However, there are a lot of reasons for headaches and it may not be her thyroid.

But as already mentioned, that is a very high TSH considering the FT4, something isn't right.

Poor Mum thinking she has a brain tumour. I hope the scan appointment comes through quickly and puts her mind at ease.

[Ruthie1969]

Thank you both. Yes Flower3, GP doesn't seem that clued up on thyroid at all. In fact he told her her blood results are normal, its only when I asked for a print out I see her TSH is so high. He hasn't even suggested to increase her levothyroxine (which I assume is necessary?). I will ask him to refer her to an endocrinologist, which does make sense, thank you.

[Flower3 in reply to Ruthie1969]

If this were my results I would not increase. Normally you do but this is because the FT4 is low (and TSH high). If you increase now with this results there is a good possibility her FT4 will get too high and she will get hyper symptoms.

[greygoose in reply to Flower3]

Flower, high T4 does not give you 'hyper symptoms'. High T3 gives you 'hyper symptoms'. The TSH does not tell you very much about your T4 level at all. The TSH can be suppressed and the T4 quite low. In fact, the TSH isn't a very good test on its own.

As others have suggested, the TSH is more than likely high because the FT3 - the most important number - is low, meaning she can't convert the T4 she has. So, increasing the T4 is not likely to help.

[Jazzw]

Did she take her levothyroxine right before the test? That might be the reason the FT4 appears higher.

[shaws Administrator]

This test was used to confirm hypothyroidism so you could maybe try it for a few days. Doctors nowadays are unaware that we have low temps/pulse when undermedicated or undiagnosed.

healthunlocked.com/thyroidu...

[Ruthi]

If she isn't normally a headache sufferer you should be jumping up and down for investigations. Yes, headaches are linked to hypo, but wouldn't start suddenly, just get gradually worse over the years.

And, if she has high TSH, and above normal T4, it could be that either her pituitary or parathyroid are misbehaving, or even that there is a tumour present, and that could also cause headaches.

This really, really needs investigating properly. If that were me and my GP wasn't helping, I would probably wait until Easter and then present at A and E! Mind you, Easter is a long way away. Just go to the doctors and refuse to leave!

[Angel_of_the_North in reply to Ruthi]

Actually, given how long it takes to get an appt round here, Easter is quite close!

[faith63]

if it were my mom, i would get a free t3 done and a reverse t3. Maybe blue horizons offers those. They are at home tests. Low t3 and hashimotos and high reverse t3 can cause headaches. A person has to convert the t4 in levo to the active t3 and some people don't convert well..like me. Then you get a high reverse t3. google it.

[Ruthie1969]

Thanks for all the replies.. Much appreciated.😊