Do my results align with typical hypothyroidism?

[borahae]

Hi! I am currently on a dosage of 50mg levo 4 times a week for the past 6 months.

I recently got my results

TSH: 10 (0.5 - 4)

FT4: 15 (10 - 20)

FT3: 5.9 (3.5 - 6)

My previous results 6 months ago

TSH: 5.1

FT4: 18

FT3: 6.1

I think I need to perhaps start taking them everyday instead of skipping. Although I don't really feel any different since 6 months ago. Is it also normal to have no symptoms despite tsh increase?

Also I'm wondering if my results are due to hypothyroidism. I ask this because the results from 6 months ago were weird in that ALL my levels increased. This time however, both my FT4 and FT3 have decreased while my TSH rose.

[radd]

borahae,

No, as typically TSH increases as thyroid hormones decrease.

Sometimes when subclinical or even early days of medicating the pituitary gland may continue to push out a delayed response of TSH even after thyroid hormones have reached a good level but you have been medicating a while.

And TSH seems to have risen further since you have been medicating. Have you had any investigations into pituitary dysregulation issues? What does your doctor say about your raised TSH?

You definitely don't need a Levo dose raise with those high levels of thyroid hormone. Raising further could raise your anxiety issues further. Sorry to read about your anxiety. Hormone misbalance can be a huge contributor towards anxiety & low mood.

[borahae in reply to radd]

Hi! Thank you for replying. I'm kind of unsure what you mean. You said as TSH increase thyroid hormones decrease. Isn't that true about my results? My TSH went up and my FT4 and FT3 went down.

I heard from others here that taking medication 4x a week doesnt necessarily help. also ive been skipping doses and sometimes go 4 days without taking the medication. i was assuming that is the reason why my tsh has gone up.

My doctor hasn't brought up any pituitary issues as I was considered subclinical hypothyroid the last time I saw them. Now they want to increase my dosage and see my lab results in a months time.

[radd in reply to borahae]

borahae,

Your TSH has gone from 5.1 to 10 and this is a big jump.

Whereas your thyroid hormones have only altered slightly and thyroid hormones are never static anyway so there will always be some variation with each test. But this variation doesn't match that of your TSH. Sometimes people do function well with a higher TSH but it is not usual when medicating.

Levo has a long half life so in theory you could dose a whole weeks worth on one go. However, it is considered more sympathetic to the adrenal glands to medicate a more consistent daily dose. This erratic dosing could be another contributor to your anxiety.

If you have been missing doses, that could contribute to raising the TSH but in theory should also decrease thyroid hormones and they are still a very good level.

If your doctor is suggesting a dose raise he is being mistakenly guided by the TSH because your thyroid hormone results are adequate. In fact FT3 was over-range 6 months ago and is still top of range now.

Have you had cortisol tested?

[borahae in reply to radd]

Hi! Thank you for clarifying and no I have not had my cortisol tested. How does this affect my thyroid? Sorry I haven't researched much about it.

I guess I was hoping it is just hypothyroidism because my health anxiety is making me believe that it could be a pituitary tumour instead and that's really scary . Also my doctor and the ent I had last year weren't really good so I don't know what to do from here.

[radd in reply to borahae]

borahae,

Ask your doctor why she wants you to take further meds when FT3 is already top of range?

Also ask your doctor for another referral into investigations as to why your TSH is going up when you are adequately medicated.

Adrenal stress hormones support low thyroid hormone & cortisol levels raise. Consistently raised cortisol levels can interfere with the workings of good thyroid function. The HPA axis (hypothalamus, pituitary, adrenals) is our endocrine/central nervous system team working together to control our stress responses by negative feedback loops.

Also joined in is the HPT axis (hypothalamus, pituitary, thyroid) which also works on feedback loops. No hormone works in isolation and any imbalances will be felt somewhere further up the line. Cortisol issues are notorious for inciting anxiety. Also inadequate iron levels with high thyroid hormone levels.