TSH rising despite being on 150mcg of thyroxine?

[rillo1472]

I had Graves years ago and eventually have become hypothyroid in later years since it was treated. I have been been stable for a while but over the years lots of ups and downs with vitamin D, calcium levels and rising parathyroid hormone levels and severe anemia. I have suffered with a flare up of GERD in the last few years and even with a small hiatus hernia repair it has carried on and the hernia is back. I take 40mg of esomeprazole daily and now have a small ulcer so have to double the dose. Historically my GERD is worse when thyroid is not well controlled. So basically my TSH has gone from 1.5 in December 2020 to 4.73 in February 2021. My vitamin D has gone from 105 to 51 in Dec and in February was at 33. Calcium was raised in December but has since normalised. GP has prescribed high dose vitamin D to bring the levels up. But I think the esomeprazole is blocking the absorption of Thyroxine and vitamin D etc but because of the ulcer and areas of erosion I can stop taking it. Any ideas I have gained 10kg from December till now and am on a huge cocktail of gynae related hormones due to Covid to avoid surgery (Zoladex, Tibolone and a Mirena coil) it's exhausting. Also on ferrous fumerate 210mg twice daily for the anaemia. Just want to know how to sort out the Thyroid function. My endo always said on treatment TSH levels should remain below 1 to be optimal.

[pennyannie]

Hello Rillo and welcome to the forum :

I too have Graves Disease and was treated with RAI thyroid ablation in 2005 and became very unwell around 8 years later and found myself on here looking for answers.

I was dosed and monitored on my TSH to be in the range and when I became increasing unwell prescribed anti depressants rather than the appropriate blood tests being run.

It is essential that we are dosed and monitored on both our T3 and T4 blood test results to be in range, and balanced and not a TSH reading.

First and foremost we need to see a full thyroid panel to include TSH, T3, T4, antibodies, inflammation, ferritin, folate, B12 and vitamin D blood test results and ranges.

If you doctor can't run these there are private companies listed n the Thyroid uk website who are the charity who support this amazing forum, and there are options, with some of these companies for a nurse to visit you at home to take the blood draw.

This is where I started and am now so much better having been able to turn much of this around for myself with the help and support I found here.

There are a couple of books I found very useful :

Your Thyroid and How To Keep It Healthy - written by a doctor who has hypothyroidism Barry Durrant - Peatfield :

Graves Disease - A - Practical Guide : written by Elaine Moore who has Graves and went through RAI in around late 1990's/ early 200's : finding no help with her continued ill help after treatment wit RAI, she started researching this poorly understand and badly treated auto immune disease herself and now written several books and runs a very useful, probably more easier read, on the Elaine Moore Graves Disease Foundation website.

[rillo1472 in reply to pennyannie]

Thanks pennyannie. The only thing that is never checked is T3 and my Graves was a T3 not T4 Thyrotoxicosis. I was treated for 18 months on Carbimazole which worked and things were stable they said there would be one of three outcomes. I could go hyper again and they would remove the gland, it would stay stable or it could go low and I would need to take thyroxine and it did go low after 18 months of stability. I will try and repeat bloods after the stomach ulcer is sorted and include T3 levels everything else HB and ferritin were fine just the dropping vitamin D levels and significant rise in TSH levels despite being on treatment for both already.

[Lalatoot]

I agree with you that the absorption of the thyroxine is being blocked by your stomach problems.Are you sure that you have too much stomach acid? Too little stomach acid causes very similar symptoms with reflux. If the esomeprazole is not helping it may be that your stomach acid is too low not high.

[rillo1472 in reply to Lalatoot]

Thanks LalatootI have several areas of erosion in the stomach and a small gastric ulcer I had a grade C oesophagitis back in 2019 so had a hiatus hernia repair but it has returned and have never been able to stop the esomeprazole as I am in pain without it. The raised TSH leaves me with very slow transit of food and prolonged exposure to acid trying to digest it. Metabolism is so slow From eating to elimination everything is painful and slow.