TSH values for the older person

I read that the normal TSH value increases with age and for the age range 55-87 years it is 0.5-8.9 mIU/L. I recently had my bloods redone and my TSH value is 6.2 which is within the range for my age, my T4 value was 15.5. After a chat with my doctor I am feeling well enough to leave my Levo at 50 mcg for 6 months.

I take Beta Blockers (Propranolol) every day, one of the side effects of Beta Blockers is that it stops the terrible migraines I used to have. I am now retired and not subject to the daily work pressures, so I want to see if I can cut out the Beta Blockers over the next few months. I understand that the Beta Blockers can mask the symptoms of Hypothyroidism so if I can drop the Beta blockers without the migraine attacks returning any symptoms of Hypothyroidism will be more easily seen. I know that I cannot just drop Beta Blockers, my Doctor who agrees with my Beta Blockers trial says I should stop them gradually, so I am going to drop 1 daily tablet every very two weeks until so over 14 week I reduce my Beta Blocker intake to zero.

Has anyone had any experience with Beat Blockers and Hypothyroidism\Levo I would be interested to hear.

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27 Replies

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  • You can get some idea of the difference that age makes to TSH from looking at this paper :

    eje-online.org/content/143/...

    The important bit is the right hand half of Table 3.

    Comparing healthy women under 40 with healthy women in the age range 70 - 79 :

    Woman < 40

    Median TSH = 1.30

    2.5% of women have a TSH less than or equal to 0.37

    2.5% of women have a TSH greater than or equal to 3.30

    Women aged 70 - 79

    Median TSH = 1.70

    2.5% of women have a TSH less than or equal to 0.97

    2.5% of women have a TSH greater than or equal to 3.70

    So, as you can see the ranges in older healthy women aren't wildly different to the ranges in younger women.

    I suspect the range of 0.5-8.9 for your age group must have included lots of women with hypothyroidism (untreated or under-treated) pushing the top of the range substantially upwards.

    If you are happy with how you feel, then there isn't a problem. But you might actually get rid of the migraines if you had sufficient Free T3. But you don't know if you do or not because it hasn't been measured.

    If you look at the patient information leaflet (PIL) for your beta blockers, does it mention hypothyroidism? I am prescribed beta blockers and the PIL for mine mentions "thyroid problems" with no other info in the "Take special care if" section.

  • Once you are on thyroid hormone replacement, the TSH is irrelevant, unless it goes high - and by high, I mean over one. There's just no point in comparing health people with hypo people. On many levels, we're not the same.

    I've never heard that beta-blockers mask the symptoms of hypo - it would be lovely if they did! On the contrary, beta-blockers make me feel pretty bad. I've been put on them twice in the last ten years, and both times had to come off them quickly. Certain beta-blockers are given to hyper patients, to bring their thyroid hormone levels down. So, all in all, you might feel better if you come off them. :)

  • There are quite a few references to Beta Blockers and their interaction with Hypothyroidism which is the reason I am keen to drop the Beta Blockers, if I don't need the Beta Blockers any more getting then rid of them will provide a much clearer view of my hypothyroidism.

    drvaughan.com/2012/12/hidde...

    uptodate.com/contents/beta-...

    ncbi.nlm.nih.gov/pmc/articl...

  • This is a prime example of poor statistics giving strange results that doctors treat as gospel. The incidence of hypothyroidism increases with age. So the number of people with raised TSH but no clinical signs as yet will be higher, and they will skew the 'healthy' group numbers.

  • I agree with other comments made here about the stats.

    Beta-blockers, far from masking hypo-T, inhibit deiodination of T4 to T3, the active hormone. The BBs may be helping your headaches, but I found that once I'd pushed my thyroid replacement sufficiently high, the headaches disappeared anyway. Ditto the muscle pain - and a string of other problems which had been given diagnoses unrelated to my Hashi's/hypo-T.

  • The point I was trying to make is the BBs distort the effects\treatment of my Hypothyroidism, removing the BBs should provide a clearer picture, I don't want to continue taking BBs if there is no need.

  • No, quite.

  • if your hypothyroid was better controlled and your TSH was lower and your t4 and the important t3 were near the top of their ranges its likely your BP would be less of a problem

    many many hypothyroids have a higher than normal BP its a fact of hypothyroid but well informed cardiologists look at the patirnt as a whole not the blood tests

    they run a cardiac ultrasound ,,,,do stress tests and then decide and do not use Beta blockers but prefer ace inhibitors

  • Never had an issue with my BP

  • I was on propranolol for over 20 years - much more on my profile. I was only started on it as was unable to tolerate taking Levo without it. I actually had very low blood pressure before starting (adrenal issues)

    Discovered last year that issues due really to undiagnosed/unrealised gluten intolerance. (Very common with Hashimoto's - see The Thyroid Pharmacist)

    Once on gluten free diet I was finally able to slowly reduce propranolol. I dropped 5mg (half tablet) every 10-14 days. The last 10mg was the hardest....did that in 2.5mg reduction each 10-14 days. Last 2.5mg even slower. Dropped to zero 1 day a week, then 2 days etc.

    Propranolol (in my experience) certainly changed my conversion/uptake of Levo.

    According to the book "The magnesium miracle" Propranolol can lower magnesium. I certainly found magnesium helpful, but many with Hashimoto's do anyway.

    Propranolol also lowers PTH - Parathyroid hormone - not good if you have low vitamin D

    labtestsonline.org.uk/under...

  • Slowdragon

    Propranolol (in my experience) certainly changed my conversion/uptake of Levo

    Your observation matches with what I have read this is why I want to get off Propranolol I just hope the migraines don't come back. I have been on Propranolol for 20 +years.

  • Reading your previous post, you only had a Levo increased to 50mcg fairly recently.

    You should have had thyroid levels rechecked 6-8 weeks after increase.

    Also would be very good idea to check levels of folate, ferritin, B12 and vitamin D. Common when hypo to be low in some, or all of these. We need good levels of these in order for thyroid hormones to be able to work

    Also have you had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

    TPO is rarely checked and TG almost never checked. More common to have high TPO or high TPO and high TG, but negative TPO and raised TG is possible, though much rarer.

    Also perhaps ask for magnesium to be checked.

    ALWAYS Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to copies of your own results

    Usual advice on ALL thyroid tests, is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

    If you can not get GP to do these tests, then like many of us, you can get them done privately

    thyroiduk.org.uk/tuk/testin...

  • SlowDragon

    Once I get off the propranolol it is my plan to get a blood test done privately and for all things you list above, I want the test to be an accurate reflection of all the elements affecting my Thyroid I don't want the propranolol skewing the results. I take 80mg of slow release propranolol a day and have been warned to come off the propranolol slowly, going to start on Monday. Its going to take me 14 weeks to come off the propranolol, then I will book my private test, once I have the results and fully understand them I will book another trip to see my doctor, this time with me in the driving seat. Just hope that I don't get migraine again.

    Thank you for your advice, much appreciated.

  • Might be good idea to ask GP to do re-thyroid tests first (6-8 weeks after increase to 50mcg), and also check vitamin D, folate, B12 & ferritin, BEFORE you start reducing propranolol.

    If these vitamins are too low or thyroid dose still not enough (50mcg is normally considered a starting low dose) then you will still be hypo. Therefore if headaches due to being hypo, they might return.

    Also ask if your thyroid antibodies have been tested, and if not could they be checked to determine if you have autoimmune thyroid (Hashimoto's) - in developed world 90% of hypo thyroid is due to Hashimoto's

    If he asks where are you getting information from, this site is the recommended NHS support group.

    Slow release propranolol would perhaps be more difficult to reduce. Is it capsule with small grains in? If so, you could perhaps ask GP if can swop to standard propranolol, but then have to spread dose 3 or 4 times through day. But perhaps easier to reduce in controlled steps.

  • I just had the results of my latest blood test on Monday, two months after my increase in Levo from 25mcg to 50 mcg, T4 15.5, TSH down from 9.3 to 6.2, it was after my conversation with the Doctor that I decided to get tested privately. I did ask the Doctor about the other Thyroid indicators and he said they hadn't been tested!!!!!!! My concern is, without the full picture how can an effective treatment plan be put into place.

    My wife is disabled if I'm ill who is going to look after her?

    Your advice is good advice, I simply need to get control of my own health and I think the propranolol and the private test is the place to start.

  • You haven't said what the TSH range is, but this looks to still above range at 6.2 If it is, presumably (hopefully) the GP has increased your dose to 75mcg.

    If they haven't, ask why not and/or ask for a referral to endocrinologist- just make sure endo is Thyroid specialist, not diabetes

    We have to increase thyroid dose slowly (25mcg max each increase in order to give body time to adjust)

  • What I am hoping for is a two pronged attack, as I reduce the amount of propranolol this should allow my body to absorb the Levo more effectively that way I get rid of the propranolol and, hopefully, negate the need for additional Levo. After 14 weeks I want to present my Doctor with the results of a full private test which is free of propranolol and shows the true benefit\affects of the 50mcg Levo.

    I'm not sure that Doctors really like patients to become involved\knowledgeable in their own treatment. To be fair a 10 minute appointment does don't really give either of us much time to discuss what is a fairly complex issue.

  • Because beta blockers have an anti-thyroid effect, I did not stay on propanolol very long. I went on that BB even before my hypothyroid was diagnosed, and in retrospect, the BB was a poor substitute for in-range FT3 & FT4.

    I don't know of ANY doctor who subscribes to anti-aging philosophies, who will go along with letting TSH drift upward to 6.2 (or 8.9) as the patient ages. Of course, the bottom line is how you feel. I suspect you would feel better if you stopped paying attention to TSH, and used enough T3 & T4 to put your FT3 & FT4 into appropriate places in their ranges.

  • Eddie83

    I was simply stating what I had read about aging and even posted some links in a subsequent post did you follow the links?

  • I looked at the Vaughan article. But what I forgot to mention is that the one period in my lifetime during which I had many headaches, was when I was hypothyroid. When I became euthyroid, the headaches disappeared. It is unfortunate that so many doctors first select traditional pharmaceuticals as a headache remedy, and don't consider that the endocrine system might be reponsible.

  • TSH becomes irrelevent at low levels especially if you have NO thyroid.

  • An article on Hypothyroidism on the BBC news site this morning

    bbc.co.uk/news/health-38895877

  • Whilst welcome to see hypothyroidism covered at all, I do wish BBC news were not acting as an advertising medium for BBC programs.

    Also, the article uses "I" and "me" - but doesn't have a by-line.

    [I read right past the first paragraph which says Dr Mosley - and scrabbled round for a by-line. I can be an idiot!]

    Shame it says:

    I have none of the other symptoms such as weight gain, tiredness and feeling the cold easily, so I've decided not to go and get myself tested.

    I'd much rather the person had gone ahead even just to prove they are OK. What is the cost of a test in the context of a program budget? Truly bad choice.

  • Its good that the profile of Hypothyroidism is raised in my experience symptoms such as weight gain, tiredness and feeling the cold creep up on you so slowly it can be very difficult to notice. I am sure that many people simply attribute weight gain, tiredness and feeling the cold as the effects of getting older.

  • I was put on BB's for bad headaches 3 years ago. I took them for 3 months and decided no more. They made me feel even worse as they block thyroid hormone. I discovered my headaches were down to iodine and selenium defficiency. Im not on thyroid meds as doc says Im normal. The iodine and selenium have pushed my tsh back from 4.1 to 2.8. I still have many hypo symptoms and dont feel well but the headaches have gone with the change in tsh. Prolonged BB use will also cause type 2 diabetes eventually as they slow your whole system down best to wean yourself off as soon as safely to do so. You will probably find your tsh will improve a bit without them x

  • Getting rid of the BBs provides a clearer view of the problem, perhaps when the BBs are gone my 50 mcg of levo will be an appropriate dose to treat my Hypothyroidism.

    Getting rid of the propranolol can't be a bad thing and if it allows me to absorb the Levo more effectively so much the better. The only fly in the ointment may be the return of the migraines but it could be that my migraines were associated with my raised TSH values, who knows.

  • An update on the initial post on this thread

    I have now been free of Beta Blockers for about 2 months I eased myself off them gently with my Doctors blessing. I had been on Beta Blockers for over 20 years to stop migraine, being Beta Blocker free wasn't without problems my blood pressure went north but now its starting to settle down now (135/90) but it go up to 168/90.

    My TSH value is 5.7 and T3 13.8 and I have not any migraines, I feel so much better, I am more active and beginning to lose weight, one of the strange things is I seem to have lost my "sweet tooth" I stopped sugar in my tea and even turned down a fresh cream cake the other day, probably attributable to the onset of madness.

    All in all dropping the Beta blockers has been a success I must admit to being worried when my blood pressure went up, to use a car analogy I feel that I am running on 4 cylinders now instead of 3.

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