High TSH - When do docs start worrying? - Thyroid UK

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High TSH - When do docs start worrying?

Chancery profile image
13 Replies

Hi, my TSH has been 'high' for the past year. It went from 2.6 to 5.2 sometime during 2019. It's done this occasionally in the past, particularly when on medications (not thyroid meds), possibly as a result of drug hypersensitivity. However I'm not on any meds (other than omeprazole) yet in the space of one month it's gone from 5.2 to 6.0. It's never been this high before and I'm not taking medications, so what's going on, if anything?

My Free T4 stays around 11/12 and never changes. I also have high ferritin (348), which I may have had for a full year.

My doc is checking these again in 2 months time but anybody any ideas what could be causing my TSH to rise, and is it related to that high ferritin figure?

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Chancery
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SlowDragon profile image
SlowDragonAdministrator

Why are you on omeprazole?

Acid reflux is common when hypothyroid and is usually due to low stomach acid, rather than high stomach acid. Similar symptoms, but different treatment

However no one should suddenly stop taking a

Links about low stomach acid and hypothyroidism

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

scdlifestyle.com/2012/03/3-...

naturalendocrinesolutions.c...

Any ppi can tend to lower vitamin levels, especially B12 and magnesium.

Have you had vitamins tested?

What vitamin supplements do you currently take?

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

What's the range on FT4?

TSH high and low FT4 suggests you may be hypothyroid

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Have you had both TPO and TG thyroid antibodies tested?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

High ferritin can be due to inflammation of Hashimoto's. But Hashimoto's patients are possibly more likely to have Hemochromatosis

ncbi.nlm.nih.gov/pubmed/182...

Chancery profile image
Chancery in reply toSlowDragon

Thanks, SlowDragon. I shouldn't have any vitamin deficiencies as I eat well. My B12 & Vit D are both supplemented. I have oesophagitis, hence the Omeprazole. I don't think I have a thyroid issue, other than the general deterioration of old age (I'll be 62 in Dec), but I find the sudden rise worrying and was really looking for info on what other conditions/ problems could be causing a sudden spike in TSH, particularly if they were connected with high ferritin.

I appreciate most people on here have thyroid issues, but I was hoping some of the more expert members might know of other conditions which can cause spikes in TSH. My Free T4 sits at the lower end, I suppose, as the range is 9-21 and I'm nearly always a 12, regardless of what that TSH is doing!

SlowDragon profile image
SlowDragonAdministrator in reply toChancery

Well your high TSH and low FT4 definitely suggests you are perhaps hypothyroid

When hypothyroid, good diet is frequently irrelevant. Malabsorption of vitamins is extremely common as is acid reflux

healthline.com/health/gerd/...

Majority of Hashimoto's patients have low ferritin

But significant minority have high ferritin

Suggest you get FULL Thyroid and vitamin testing

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Chancery profile image
Chancery in reply toSlowDragon

Yes, the good old 'subclinical hypothyroidism'. I've had that hovering around me like a bad smell since my fifties. I've had my antibodies tested way back at the beginning but I was all clear. I suspect my thyroid plays up due to another condition rather than of itself. Either way they wouldn't treat it at this stage anyway.

Lalatoot profile image
Lalatoot

When you were on other meds presumably you were ill. Free T3 drops during severe illness or in cases of reduced calorie intake or starvation. Free T3 levels in your blood feedback to eventually the pituitary to produce more stimulating hormone to increase release of T4 hormones and thus to increase FT3.

Please correct me if I am way off Helvella!

Chancery profile image
Chancery in reply toLalatoot

So, Lalatoot, am I right in thinking that suggests my TSH could be high because my body could be trying to increase T3 due to "illness"? Is that the correct interpretation? I haven't been ill, that I know of, although I have been in in constant pain, but could stress/anxiety or depression do the same thing?

Lalatoot profile image
Lalatoot in reply toChancery

That is one possibility.

In the Uk, they don't usually bother to treat until TSH is over 10, or TSH is over range for multiple tests and free T4 is under range, or TSH is over range and TPO antibodies are raised for multiple tests. They never worry ...

Chancery profile image
Chancery in reply toAngel_of_the_North

Many thanks, Angel - that's what I was looking for! It's concerning, to put it mildly, when the most recent research suggests anything over 2.5 should be considered hypothyroid, but apparently the reason for not treating it till it's effectively skyrocketing is because the meds don't 'make any difference'. I'm not sure how they managed to reach that conclusion, since they've never treated it at a lower level, as far as I can tell. Maybe some healthy male doctors took it and thought "Nope, I don't feel any different."

PPIs will be stopping you from absorbing vitamins from your food, which can affect thyroid. I (and your GP) would be far more worried about that high ferritin, which can be very dangerous

Chancery profile image
Chancery

Yes, the ferritin worries me, but it's been at that exact same level, apparently (only two tests exactly a year apart showing the exact same result), for the past year. It might be being caused by me treating Restless Leg Syndrome with Iron tablets. I only take them as and when I need them, but I could have taken them the night before each test, so I don't know if that's influencing it. I wouldn't have said I take it often enough, but you never know.... I will NOT be taking them before the next test, now that I know they might be an issue.

SlowDragon profile image
SlowDragonAdministrator in reply toChancery

Taking omeprazole long term can lower magnesium

gov.uk/drug-safety-update/p...

Low Magnesium is often cause of restless legs

healthline.com/health/restl...

Low vitamin D and low magnesium often go together

Chancery profile image
Chancery in reply toSlowDragon

That is exceptionally interesting, Slowdragon - many thanks for the info! I did not know that, and I've been taking Omeprazole for many years, every day, so that could very much be an issue. It does make you wonder whether doctors EVER think to question or test for drug effects. I only just attended my first ever appt with a new doc to run through my repeat prescriptions and she questioned nothing. My 'health check' with the nurse was even more ridiculous. She took my weight and asked about diabetes and heart disease - that was it. I shall look into this and start supplementing, even although I don't generally do that, but it is definitely worth a shot to see if it is playing a part in my current health problems, which include severe fatigue and shortness of breath, both of which I see you can have with low magnesium. Thanks again!

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