497.0 tsh level is

[Dragon63]

Tsh 497.0 t3 low t4 normal. Synthroid 300mcg/armour 60 MCG daily. My body seems to be rejecting the meds after taking for over 40 yrs. Weak, extreme fatigue. Confusion, brain fog, no control over balance !!!!!!!!

[jimh111]

Do you have the full results with reference intervals? When did this start happening? Is this a different blood test to the ones you have had in the past (possibility of assay interference). Have you had any operations, medications which might inhibit your absorption of the tablets? What does your doctor say? Just a few questions !

[Dragon63 in reply to jimh111]

For yrs they have been unable to stabilize. My levels float up to down to up. Last may level was 597.0 their concern is myexdema coma. Problem I'd the drs. They keep pumping meds with no results. Had ultrasound yesterday waiting on results. Heading to hospital now. Very worried/stressing out

[Dragon63 in reply to jimh111]

No operations. No new meds.

[shaws Administrator in reply to Dragon63]

Have you ever been prescribed liothyronine (T3) instead of T4 (levothyroxine) - Synthroid.

Some people are resistant to levothyroxine and need high doses of T3 if they are to recover from their unpleasant symptoms.

I hope someone comes up with a solution for you soon.

I note you take Synthroid (levothyroxine) and Armour but if you cannot convert T4 (in levo and Armour) you may need T3 only. I'd ask for a trial of liothyronine.web.archive.org/web/2010103...

[greygoose]

Sounds to me very much like you're having problems a) absorbing b) converting. But, would need to see the actual figures and ranges to be sure.

Do you take your hormone well away from food, caffeine, and other supplements and medication?

[helvella Administrator]

Have you ever been checked for antibodies to TSH?

[shaws Administrator in reply to helvella]

I never knew there was such a thing as antibodies to TSH.

[helvella Administrator in reply to shaws]

Antibodies to TSH are not exactly common. The TSH antibody attaches to a molecule of TSH. The combined unit, called macro-TSH, then looks on a TSH test as a much higher level of TSH than would otherwise be expected.

This can be eliminated as a possibility by having a TSH test done by an assay process known not to be susceptible to interference by macro-TSH.

Just as an extra note, it is also possible for people to have antibodies to T4 and to T3.

[Hillwoman in reply to helvella]

Just as an extra note, it is also possible for people to have antibodies to T4 and to T3.

I didn't know this, though perhaps I should have worked it out... Which UK labs would test for T4 and T3 abs?

[helvella Administrator in reply to Hillwoman]

No idea!

But you could have a read here:

healthunlocked.com/thyroidu...

[Hillwoman in reply to helvella]

Thank you. I didn't spot that post.

[helvella Administrator in reply to Hillwoman]

I assure you, I don't notice all posts here. However hard I might try.

[Justiina in reply to helvella]

In finland those antibodies should be tested in any lab in case there is any doubt.

But in reality there are not many who have even heard of them

I know few patients whose doctor has been educated enough to suspect that antibodies to TSH , T4 or T3 could be the cause of weird results.

[diogenes Remembering in reply to helvella]

TSH values like those in this post are so ludicrously high that they are almost certainly due to antibody interference in the TSH assay. Many if not most TSH assays use monoclonal antibodies originating from mouse cells, as the detecting method. Some people unfortunately have antibodies to mouse proteins in their blood. These can attach to or compete with the assay antibodies, thus ruining the test. Some tests do not use mouse monoclonals but from other eg rabbit sources. Regarding patients with T4 or T3 antibodies in their blood. This is commonest in patients on T4 therapy. The antibody load fluctuates day to day so quite different answers can be obtained on different occasions if the antibodies are interfering. There are classes of tests that are much more robust to these antibody interferences than others. If you have a tracer label that attaches both to the blood and the test antibodies then false high results occur. If this is suspected, the lab doing the test should add polyethylene glycol to the sample, remove the protein that comes out of solution (contains the antibodies) and then retest. It's a simple method, wellknown in the literature.

[Jackiez]

I have read that a sudden rise in TSH can happen after a head injury. The pituitary gets shaken up and can go into overdrive. Have you had a fall or accident resulting in head or face trauma? It may not be relevant here, but certainly applied to me when my levels went haywire. I'm still struggling to get things back to normal 3 years later.

I hope you start to feel better soon.

[UrsaP]

If you are struggling with uptake of meds could your adrenals be compromised? Might be worth checking. I was on t4 for 20+ years, never felt better, got worse and worse. Migraines developed, got more and more frequent, and fibromyalgia also. Adrenals were low and when changed to t3 only problems went -quickly. Returned every time tried to reintroduce t4 - hence t3 only. Same problems arose recently -now on different brand of t3 - problems gone. But adrenals still an issue. Adrenal problems can inhibit correct uptake of meds. Couple of things to consider - brands and adrenal failings.

[Hormone-mess]

Just thought I'd throw an idea out.....A friend of mine with an absolutely ridiculous TSH like that had a pituitary tumor. May want to ask Dr. his thoughts on that.