Thyroid UK
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TSH 43, no thyroid

My husband had a total thyroidectomy in April 6 months ago, he's been on 100mg of synthroid, he's tired, depressed, and just sleeps , today he had a follow up with a family doctor that he is going to be seeing and that is also going to be refilling his medication they did a blood test and his TSH level was 43 they said that most likely the blood test is wrong because that number is way off what could that mean if it is not way off ?? Not sure if they checked his FT3 or FT4 levels

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He is on a pathetic amount of synthroid, so its very likely that the tsh us correct. A more realistic replacement dose is closer to 225 than 100.

If he has previously been hyperthyroid, he probably needs some t3 and if he has had thyroid cancer then he needs to keep his tsh Suppressed. The surprising thing isnt that he sleeps all day, its that he wakes up at all. Bears lower their thyroid hormones when they want to hibernate!

Xx

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Thank you for the reply, he's a overall very healthy guy, 5'9" 150 pounds works his butt off with horses, the 100mg of synthroid had been fine the first few months as they were checking his levels, now today we received this news, he's never had thyroid cancer just hyperthyroidism.

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Hyperthyroidism means he has probably had high t3 levels, so its not really that likely that replacing t4 only will make him better....... He will probably need some t3, or better still dessicated thyroid, like the stuff that Hilary Clinton uses. Lets face it, she can choose any medication she pleases and opts for dessicated thyroid rather than the synthetics.

Xx

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100mcg of Levothyroxine is not a high dose. He probably needs at least twice as much. I despair of modern medicine...

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Thank you, we go back in 4 weeks on nov 17th to see his doctor again.

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If they believe the TSH assay is faulty they should do a repeat using a better assay called 'Equilibrium Dialysis' which is more expensive. However, his symptoms are consistent with a TSH of 43 and this can be confirmed by checking his fT3, fT4 levels. I assume they didn't think his previous blood tests were wrong so why this time? If there is antibody interference with the assay I think it would happen all the time, every blood test.

I wouldn't wait until November, I would ask for an increase to 150 mcg now and a follow up blood test in four weeks. The longer you remain hypo the longer it takes to get better. I'm guessing you are from the USA (they use Synthroid), how does healthcare work there? Do you pay the doctor directly or through insurance? I'm not sure if you are in a position to 'kick butt' as they say over the pond! I'd be very polite but tell the doctor you want it sorted now, not hang around for another month doing nothing.

I'm a patient not a doctor.

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His insurance pays for everything, I will contact his doctor in the morning and ask for that and a blood test sooner than 4 weeks, you're so helpful thank you

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my husband had thyroidectomy for graves /hyperthyroid

he was on 350mcg of levothyroxine that did not resolve the hypo symptoms

they tried a combo of levo plus t3,then 120mcg t3 alone the only way he is well is on 5 grains of NDT

100mcg of levo is a starting dose and is no way any good for anyone after thyroidectomy

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Reallyfedup123, I hope you don't mind me asking a question about your husband's experience. Were his blood results consistent with his symptoms when going up to that high dose? Or at some point did he have to go over what the blood tests suggested?

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my husbands test results were considered perfect but his symptoms were horrendous

any amount of levothyroxine will reduce TSH but will never resolve symptoms especially in those who have had RAI or a thyroidectomy

thats the thing the doctors refuse to face

only NDT works for these patients and unless

ferritin

folate

b12

vit d3

are all at least halfway in their ranges your body simply cannot utilise any form of thyroid hormone

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Does that include freeT3, too? Did he have to go over range in order to feel well?

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He should be under the care of a board certified endo. What is his weight? i had mine removed. I weigh 210 and am on 137 mic. Also, the generics are crap. Make sure he uses actual Synthroid and that he takes it the same way each day as far as time of day and what he takes it with. Unless he is quite small in stature 100 mics is probably too low.

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I have had a thyroidectomy, and can confirm that a TSH of 43 is very possible and reasonable. Probably the doctor is more used to people with Hashimotos, for which it might be surprising to see such a high result as the thyroid is breaking down slowly.

With no medication at all, my TSH is untestably high, but well over 200. So it's very possible to get other high numbers when on a small amount of medication.

You've had good advice above, but I think one important thing is to emphasise to doctors that he's very very ill. Use words like weak and immobile rather than 'tired', as tired can easily be brushed under the rug. This illness is so incidious, and creeps up on you, that people often feel reluctant to see themselves as sick exactly.

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