TSH level of 37 - What does this mean?

Hi. I've been browsing posts on here and have seen a few talking about low TSH levels, but none about very high levels.

I was diagnosed in April of this year. I am a 34 year old female. I have recently had my levothyroxine dose increased from 25mcg to 75mcg and my doctor has said that she thinks it should be increased again to 100mcg by December.

My thyroxine levels are within the normal range, but my TSH level is steadily increasing. It recently surged to 37. What does this mean? The doctor couldn't explain why it had suddenly increased so much, but increased my medication to hopefully combat it.

I have been feeling exhausted and also experiencing brain fog / sensory overload / migraines - basically my perception of the world feels wrong and it feels as though bright lights and loud noises attack my brain - I get totally overloaded and end up feeling panic and nausea.

As I stated in my previous post, I also have a stressful job and a toddler to contend with, so I have other reasons for feeling so tired besides the thyroid issues.

Has anyone else experienced high TSH levels and, if so, did you find out the cause? Did it get resolved? What happened?

Thanks.

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  • Tiredbear82 A TSH level of 37 means you are very hypothyroid and your GP is right to increase your dose to try and reduce it.

    Do you have your full thyroid results with reference ranges? If so then please post them for members to comment. If you don't have them then ask your surgery for a print out, it is your legal right.

    I would ask your GP to test for thyroid antibodies, Thyroid Peroxidase and Thyroglobulin (they may not do the second one), to see whether you have autoimmune thyroid disease. Also ask for Vit D, N12, ferritin and folate to be tested. All these vitamins and minerals are important for thyroid hormone to work properly and need to be at optimal levels (not just in range).

    When arranging thyroid tests from now on, always book the first appointment of the day, fast overnight (water only) and don't take Levo for 24 hours (take it after the blood draw). This ensures the highest possible TSH which is what you need when looking for a dose increase, plus it gives continuity of conditions so test results can be compared like for like.

    Always take your Levo on a empty stomach with water, one hour before or two hours after food, and away from other meds and supplements as absorption can be affected.

  • Your TSH has jumped up because your thyroid is beginning to fail more rapidly. I would ask your GP to increase your dose to 100 mcg now as an extra 25 will not be enough and you are having lots of symptoms. As you are likely to need a little more hormone in the future it makes sense to catch up now

    I take the view that it is not a good idea to try and fiddle the blood test by having the blood taken early morning as the TSH is on a downward slope at this time and it is therfore difficult to compare one result with another. The TSH levels are more stable during the day.

  • I have responded to your post you made two hours ago. My TSH was 100 when finally diagnosed.

    I believe your doctor has kept you on too low a dose of 25mcg levothyroxine for several months (If I've read your previous post correctly) then eventually increased it to 50mcg (doses should be increased every six weeks), then when your TSH was 37 she increased by another 25mcg = 75mcg

    So it has taken 7 months to go from 25mcg to 75mcg! She thinks she'll increase by another 25mcg in December!

    Usually, when first diagnosed, we begin on a 50mcg of T4 with increases around every six weeks until we have no clinical symptoms and feel better.

    Your doctor tells you that you are now in 'normal' range and is ignoring your clinical symptoms which seem quite disabling.

    I know how disabling a high TSH is and you have my commiserations and you also have a little baby to contend with as well when you feel so bad yourself.

    Your doctor, like many, has no idea how to deal with a patient who is hypothyroid and the fact that your TSH rose to 37 shows you were very badly undermedicated.

    Ask for a new blood test a.s.a.p. and it should include Free T4 and Free T3. These are the really informative tests. if either too low we don't feel well.

    All thyroid tests should be at the very earliest possible and fasting. Leave about 24 hours between last dose and test and take afterwards.

    While you're at it, ask for B12, Vit D, iron, ferritin and folate.

  • I think the doctor I have now is pretty good. She suffers from hypothyroidism herself, so is sympathetic. It was this doctor who has been raising my medication.

    I saw 4 different doctors over the last two years who looked at my test results and were reluctant to put me on any medication.

    She was the first to say, "look, you definitely have hypothyroidism and we need to treat you."

    I don't know my T3/T4 levels, but all drs have said they are within normal range - which is why they didn't want to give me levothyroxine initially (and why they started me on such a small dose).

    The doctor I saw before my current doctor said that it was fairly unusual to have high TSH alone, but would not suggest any possible causes.

    I had tests for immune issues and aneamia, but all came back "normal".

    I have had so many symptoms over the past two years - including depression, dry skin, zero libido (virtually asexual now), headaches, weight gain and exhaustion (that's the worst) - I was almost relieved when this latest doctor confirmed the hormone imbalance. I honestly thought I was going mad!

    Do you have to ask your doctor to request tests for T3/4, folate, vitamin D etc. Or can you just ask the nurse to flag it when they take your blood?

  • Also, can hypothyroidism be triggered by pregnancy / childbirth?

    I had blood tests about 7 years ago for an unrelated issue and they said then that my TSH was above average, but that I was subclinical. That doctor told me to wait a few years and then request another blood test. He said it was likely I would develop hypothyroidism as I got older. I was in my 20s at the time.

    It's since the birth of my son (2.5 years ago) that the symptoms have exploded. So I wondered if there was a link or if it's just coincidence / my age.

  • There are several things that seem to trigger hypothyroidism - or worsening of hypothyroidism. Right at the top of the list is pregnancy.

    Also - other hormonal changes such as menopause, giving up smoking, and various other diseases.

    Don't believe in age as a cause of anything - just because some things seem to happen as we get older, doesn't mean that age is, in and of itself, the cause.

  • If your doctor has hypothyroidism, she might be feeling well when on levothyroxine but not everyone is, so she might not be aware there are so many on this forum looking for help.

    The other two responses ( helvella and jimh111) are also informative.

    I have no idea why a previous doctor said "that it was fairly unusual to have high TSH alone'. As far as I know the BTA guidelines state we mustn't be diagnosed untill TSH reaches 10 and were you not referred to an Endocrinologist. A high TSH is a signal. I assume they didn't do either FT4 or FT3.

  • If they did T3 and T4, they didn't show me the results of these or mention them directly.

  • We have to ask for a print-out of our blood test results for our own records, with the ranges and that will help members answer.

    Normally, doctors only look at the TSH and T4 if taken, and if anywhere in the range they say we're fine even if we feel rough.

  • It's difficult because your current doctor is better than the rest. It seems like they are all rather lacking in thyroid knowledge and just going according to a flowchart. I would see your doctor and explain the effects on your life, like you have done so well here. Perhaps take your partner along. I'd say that you have suffered too long and want to get your TSH down now, not continue chasing it and being ill. Say you would like an increase now with a review in four weeks or have an urgent appointment to see an endocrinologist (they won't want that and it might encourage them to stop dithering).

    In your other post you say going part time isn't an option. It is an option because you are ill, have been for over a year, it has affected your day to day life and so comes under the Equalities Act which used to be called the Diasability Act. Your employer is obliged to make allowances and also your doctor should sign you off if you are not well. So I wouldn't feel guilty about this option. It's not your fault. It would though be far better to get you well soon. I'd discuss these options with your doctor.

    Make sure your doctor understands the effects on your life, this means far more to a doctor than telling them you don't feel well. Effects are quantifiable and so easier to appreciate.

    It is very common for women to become hypothyroid after pregnancy. If you plan another pregnancy your TSH should be kept below 2.5, this is the official guidance.

  • I forgot to say that it is a good idea to ask for a copy of all your blood tests. Usually fT4 can vary in its interval but the body keeps the fT3 fairly stable or even a little higher if fT4 is low. If both fT3 and fT4 are low but still within their reference intervals this is not normal and might explain why your TSH is high. If this is so it is worth asking for a selenium blood test (don't supplement until after the test) as selenium deficiency can impair T4 to T3 conversion and shows up with a high TSH.

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