Thyroid UK
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TSH suddenly gone up

I was diagnosed with hypothyroidism last January (2017). I also had a scan of the thyroid to rule out anything more nasty. My TSH was around 14 at the time, FT4 was 10 (within region) and FT3 was 4 (again within range). I was put on 50 mg Euthyrox (levothyroxine sodium) and told to go back in a month.

A month later I was re-tested and TSH was down to 5.15. My glucose was found to be a tiny bit high. Anti-Tg/TAT was done and was ok. MAT done (not sure what that is) and was high at 371.49. My dose was increased to 50mg Euthyrox 5 days a week and at the weekends 75mg. And 2 go back in 2 months.

In April I went back TSH was down to 2.7, glucose still the same at a little high.

Dose kept the same and told to go back in 6 months for re-testing of TSH and glucose.

Due to travelling etc I have only just managed to get blood tests done. I live abroad and its quite hard with language and the health system here. I got the blood tests done this morning and while my glucose has gone down to just under the top range of "normal" my TSH has suddenly gone up to 11.4.

Could this be because I had the tests at 8am in the morning, compared to usually going at around 10.30 am - I think I read results of TSH can be higher in the morning?

I took my pill when I got up at 7am as I would normally - could this have led to the spike? Nothing to eat of course since night before.

I don't have any particular symptoms but never did really. My period is due in next couple of days - could this effect TSH levels?

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Suelakes,

Taking Levothyroxine before the test and having the test a couple of hours earlier than usual hasn't spiked TSH. TSH has risen because you are undermedicated. Your doctor needs to increase dose.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

You should have a follow up thyroid test 6-8 weeks after increasing Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

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Taking your levo before your test made your FT4 spike. So, the result you have there - whatever it is - is a false high, and therefore bears no relation to the TSH. It's always best to give us the numbers, when you talk about your results : results and ranges.

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Do you have Hashimoto's diagnosed by high thyroid antibodies

Have you had vitamin D, folate, ferritin and B12 tested recently? Very often too low and may need supplementing

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Yes possible Hashimoto's I think (I am not in the UK so not always easy with language differences although most consultants speak some English). Hypothyroidism but did get anti-Tg test when first diagnosed.

Clutter -> I had follow up tests and dosage slowly increased and my TSH levels came down, at first not enough and so dose was upped a little and then was good.

Greygoose -> my numbers are all above.

But to maybe explain better.

January 2017, no symptoms but general health check revealed possibly enlarged Thyroid and blood tests showed:

TSH 14.08 mU/l (range 0.35 to 4.94)

FT4 10.49 (range 9.01 to 19.05)

FT3 4.04 (range 2.62 to 5.7)

Saw endocrinologist and had scan of thyroid and all ok and so put on 50 mg Euthyrox (levothyroxine sodium).

February 2017 (one month later) back for follow up blood tests.

Anti-TG/TAT ( antithyroglobulin) : 3.93 (not sure of range but its within normal)

MAT (antimicrosomal antibodies): 371.49 (not sure of range but was high)

TSH: down to 5.15 but still a little high (range 0.35 to 4.94) so was put onto 50mg Euthyrox for 5 days a week and on Saturdays and Sundays take 75mg.

Told to go back in 2 months

April 2017 :

TSH down to 2.7 so within range (range 0.35 to 4.94) and kept on same dosage.

I am pretty good with taking tablets, take when I get up each morning, usually around half an hour before have anything to drink (cup of tea, no sugar, just milk) and an hour before any food.

Told to go back end of October/November (in 6 months) for check of TSH levels. We were travelling so only managed to get blood tests done today and the results show my TSH is back up to 11.4 (range 0.27 to 4.2 as different clinic).

No not had vitamin levels tested etc.

I did wonder whether to take my pill when I got up at 7am, was tested at just after 8am. Usually with other tests I suppose I take pill at around 7.30 to 8am when up and tested at around 10.30am. Never any food or drink after 7pm or so the preceding evening.

I will try and get to see an edinocrinologist next week but I am a bit of a worrier so............

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