Tsh 74.3 help!

[Angie10116]

After being in 75mg of Levo for 4 weeks, ( please read my last post) , my tsh went from 36.06 to 74.3… how is that even possible. For reference please look at the pic attached. I’ve started a few vitamins since then, magnesium, omega three, B12, D, selenium. But I don’t understand why my TSH would go up so drastically whilst I’m on medication, I am just looking for some guidance to be honest because I’m very lost. since around three weeks ago, which is when I started the vitamins, my brain fog has lifted a little and I feel a lot more myself. However I’m still experiencing brain fog, coldness, really bad headaches, and a lot of fatigue

[mistydog]

Thyroid doesn't necessarily follow a downward trajectory. Were both tests taken early morning and fasting, just drinking water?

You could be experiencing a thyroid flare, in any event you need more thyroid hormone.

[Angie10116 in reply to mistydog]

Yes early morning. Is a flare up dangerous? Or is all I can do is take more meds?

[mistydog in reply to Angie10116]

Well it's not great, it can be if you have a thyroid storm. But I'm not an expert it. Taking more meds should help, I meant to say before that you are probably under medicated but you need to increase slowly and keep testing every û-8 weeks

[Angie10116 in reply to mistydog]

I’m pretty sure thyroid storm is when you’re over medicated or have too much thyroid hormone, so thankfully not my case as mines too low. But yeah I’ll up my dose, thanks for your advise!

[PurpleNails Administrator]

Has your FT4 & FT3 improved?

You were previously hyper with Graves, so it very likely your TSH will appear lower than it should as it shows a delayed response to thyroid levels. It could remain low & discordant. The technical term being hypothalamus–pituitary–thyroid (HPT) axis down regulation.

While the TSH catches up with levels your low levels need to be treated. By assessing the FT4 & FT3. The TSH might respond further down the line but it could always appear lower than it should.

It’s also possible antibodies are interfering with the test process causing a faulty TSH results, which is why it is high.

Very high thyroid levels risks a thyroid storm, I don’t view this being a possibility now you have had definitive treatment, extremely low levels left untreated can ultimately cause myxedema coma which is rare and should not be a concern if you remain on medication.

Slowly building up to the right level of medication to resolve symptoms is your goal. The doctor may view levels sufficient when TSH in range but you need your FT4 & FT3 in upper part of range.

Increase dose by 25mcg daily and retest in 6 weeks. Some tolerate faster increments but once higher in range allow 6 weeks as this will show how a level settles on a current dose.

[Angie10116 in reply to PurpleNails]

Thank you. Yes my Ft4 has improved. It’s now 11.9 ( range 11.00-25.00). So technically I’m in range but my tsh has gone up which is very strange. I’ve increased from 75mg to 100mg and we’ll see what happens. I know that the accord brand had a problem a few weeks ago, where their tablets crumbled. I believe that I had those ones, but I doubt that it would cause a high tsh? I just don’t understand why my T4 and t3 improved but my tsh went up

[PurpleNails Administrator in reply to Angie10116]

The TSH is playing catch-up. Its indirectly affected by medication in that the replacement hormone is increasing the levels in your system. The feedback loop senses the levels and the pituitary signal the thyroid. The TSH thyroid stimulating hormone, being a pituitary hormone is signalling the thyroid to produce new hormone. The Axis is down regulated and having no thyroid to stimulating it isn’t going to produce hormone. The TSH in many with under range levels would have higher result or test maximum > levels.

[Angie10116 in reply to PurpleNails]

Thank you for explaining that for me. So even though the tsh is high, I believe that I’m moving in the right direction

[PurpleNails Administrator in reply to Angie10116]

As FT4 & FT3 Is improving yes. Think of the TSH as now broken and go by FT4 & FT3.

[Angie10116 in reply to PurpleNails]

Lovely thank you!

[helvella Administrator Thyroid UK in reply to PurpleNails]

I very much agree that interference is a strong possibilty.

It needs to be taken up by the lab and a repeat test done at a lab which uses a different technology for testing.

[Angie10116 in reply to helvella]

Thank you. My doctor decided to move me up to 100mg for now