my tsh is at its highest, what can I do? - Thyroid UK

Thyroid UK

138,504 members162,507 posts

my tsh is at its highest, what can I do?

Jgoodwin977 profile image
39 Replies

hello

my tsh is now at its highest 5.19 and keeps increasing. I wanted to know if thyroid cancer causes this and if there’s anything you can do to help bring it down without medication?

my t4/t3 12.5/4 are on the low side, but my thyroid antibodies TPO have at least come down to 36.7.

I have hashimotos and know this causes the tsh to go up, but thought it was strange as I’ve managed to get my antibodies right down almost into remission, so thought that would help improve my tsh if anything?

Many thanks

Written by
Jgoodwin977 profile image
Jgoodwin977
To view profiles and participate in discussions please or .
Read more about...
39 Replies
PurpleNails profile image
PurpleNailsAdministrator

Welcome of forum.

You know have Hashimoto’s. This is where the immune system attacks your thyroid this causes the level that your of thyroid is capable of producing hormone to lower. You need replacement hormone when levels become too low. There no medication which can rectify it.

Low thyroid hormones causes the TSH (thyroid stimulating hormone) which is a pituitary hormone to rise, it’s a signal for the thyroid to work harder.

The antibodies are cleaning up the substances released during the attack. So it doesn’t tell you the extent of damage or how / when it’s occurring. It doesn’t correlate to symptoms or thyroid levels at the time, it just confirmation autoimmune it present. It why doctors say it’s a sign you may become hypothyroid in future.

Are you taking replacement?

TSH above range 2x 3 months apart in criteria for treatment. Low in range FT4 & antibodies supports treatment too.

Function isn’t always affected with thyroid cancer, but there nothing in thyroid function results which would cause dr to consider investing for thyroid cancer.

Jgoodwin977 profile image
Jgoodwin977 in reply to PurpleNails

thank you

I’m not on medication and wondered if there was another way to bring the tsh down?

I have thyroid cancer, but annoyingly they didn’t check my TGAB

I’ve managed to keep my tsh within range with high TPO in the 4 hundreds, but now that I’ve got my antibodies down to 36, my tsh has gone up, so that’s why I wondered if it was the cancer

On a positive, My parathyroid has at least corrected itself

Many thanks

PurpleNails profile image
PurpleNailsAdministrator in reply to Jgoodwin977

Have you recently been diagnosed / treated? Please add some history to your bio / profile.

Usually thyroid cancer is treated with full thyroidectomy & often radioactive iodine in addition.

In which case it’s essential to take replacement hormone as there is no remaining thyroid.

Thyroid function (TSH, FT4 & FT3) relates to function only. TPO & TG antibodies relate to autoimmune. When monitoring for cancer it’s Thyroglobulin (the protein itself) not the antibodies which need to be tested.

TSH is often kept suppressed, at least in the months following treatment of thyroid cancer. It’s stops residual thyroid cells being stimulated.

Jgoodwin977 profile image
Jgoodwin977 in reply to PurpleNails

I was diagnosed in 2022 and trying the holistic route first.

Yes my Thyroglobulin has been high since 2018, but TGAB was ignored

Thanks for the clarity

annnsandell profile image
annnsandell in reply to Jgoodwin977

Having had thyroid cancer and in remission, I am worried that you feel you can treat it holistically. Have you sought any advice on this? What would normally happen if left untreated is that the cancer would spread firstly to the lymph nodes. Whilst there are different forms of thyroid cancer it is very treatable in the early stages. Other tests like Thyrogloblin will check cancer levels.

With Hashimoto’s Disease, the thyroid is infiltrated by white blood cells and slowly loses its function hence the TSH rise and Levothyroxine is prescribed. A goitre is common as in thyroid cancer. You mention somewhere nodules shrinking, that may be because the antibodies with Hashimoto are under better control. What cancer tests have you had?

Jgoodwin977 profile image
Jgoodwin977 in reply to annnsandell

yes, I’ve had lots of advice and it’s a very slow growing one that I have

I’ve had a biopsy twice, d-dimer and TGAB test

annnsandell profile image
annnsandell in reply to Jgoodwin977

How did you have a biopsy? You probably realise that d-dimer and TGAB are not relevant to Thryroid cancer.

Jgoodwin977 profile image
Jgoodwin977 in reply to annnsandell

it was done with a very large needle and very uncomfortable

They can both be indicators of cancer and have been elevated since the cancer diagnosis, so there is some correlation

What cancer tests do you know of to check?

annnsandell profile image
annnsandell in reply to Jgoodwin977

So a needle biopsy test is the most used first test to indicate the presence of cancer in a goitre. It can also show negative when cancer is present. The only conclusive test is to remove part of the Thyroid and test.

Jgoodwin977 profile image
Jgoodwin977 in reply to annnsandell

yes both of my biopsies were positive unfortunately, so I definitely have it.

I will look into Levothyroxine. Many thanks

greygoose profile image
greygoose

It's not about improving the TSH. TSH is just an indicator of thyroid hormone levels. It doesn't do anything else. It doesn't cause symptoms and doesn't make you ill in anyway.

Same goes for antibodies. TPO and Tg antibodies are just indicators that you have Hashi's. And, once you know that there's no point in testing them again. They fluctuate all the time so the actual level, once over-range, is irrelevant. And, even if they went down to zero - if such a thing were possible - you'd still have Hashi's, and your immune system would still carry on destroying your thyroid.

What is important is your FT3. That is the active thyroid hormone, and if that is too high or too low, it causes symptoms. If you're FT4/3 are low, then you need thyroid hormone replacement (levo is not medication in the usual sense of that word, it is the thyroid hormone T4).

Hashi's does not cause the TSH to rise. Being hypo - i.e. low thyroid hormone levels - causes the TSH to rise. Raise the thyroid hormone levels and the TSH will drop.

There is no direct connection between antibody levels and TSH. And reduced antibodies do not mean that Hashi's is 'in remission'. The antibodies are there to clean up traces of TPO and Tg that leak into the blood during an immune system attack on the thyroid. That is all they do. And given that they have that job to do, is it really desirable to try and reduce their number?

Jgoodwin977 profile image
Jgoodwin977 in reply to greygoose

Thank you for explaining

It’s strange as my t3 has been 4 for a while and tsh has been 2-3, so wondered how it had gone up to 5 if my t3 has remained the same and TPO has gone down. That’s why I thought it could be the thyroid cancer perhaps?

Many thanks

greygoose profile image
greygoose in reply to Jgoodwin977

I don't see why it would be thyroid cancer.

But, as I said, antibodies have nothing to do with thyroid hormone/TSH levels. They don't influence them in any way.

Are the blood draws for your tests always done at the same time of day?

Jgoodwin977 profile image
Jgoodwin977 in reply to greygoose

Yes, I always do them first thing fasted.

I guess the thyroid has just been struggling for so long and now starting to give way then perhaps

It’s a shame as I was making progress. Just don’t get why my tsh has gone up to 5 when my t3 has remained stable at 4 for a while.

Many thanks

greygoose profile image
greygoose in reply to Jgoodwin977

I've just seen above that you say you have thyroid cancer, is that correct? If so, have you not had your thyroid removed? And you're not on any thyroid hormone replacement?

It’s a shame as I was making progress. Just don’t get why my tsh has gone up to 5 when my t3 has remained stable at 4 for a while.

What do you mean by 'progress'? And why is it a shame? Have your symptoms increased? I don't think I'm fully grasping the question, here. It doesn't really matter why your TSH has gone up, it's only a rough guide to thyroid status and has a tendency to fluctuate. But, perhapse your FT4 has dropped, if your FT3 has remained the same.

I was diagnosed in 2022 and trying the holistic route first.

The holistic route? For cancer? That sounds like a very dangerous thing to do.

So, you have cancer, and Hashi's and a TSH of 5. You are hypo and it's going to get worse. You should at least be on thyroid hormone replacement. I honestly cannot believe that a holistic approach, whilst it might be a good thing for some health problems, is the right thing to do in your case. I think you're playing with fire. And there's really not much advice anyone here can give you.

Your TSH needs to be suppressed, At the moment it's stimulating your thyroid and probably making things worse. But, you cannot get your TSH down to zero without thyroid hormone replacement, that is 100% certain. Unless, of course, you have a Hashi's 'hyper' swing, but that would only be temporary. You need thyroid hormone replacement. There's no other way.

Jgoodwin977 profile image
Jgoodwin977 in reply to greygoose

yes, that’s right. I’m taking the holistic approach for now.

Progress as in the tumour had shrunk, antibodies gone down and tsh/t4/t3 stability, with no symptoms other than insomnia and cold hands/feet. My hair stopped falling out, heart palpitations, constipation, dry skin, shaking hands and anxiety all stopped

It’s a shame because I’ve been very careful but blood work has got worse since increasing my protein intake to gain weight. Yes, my t4 was 14 before

Yes, I get hyper swings and want to be tested for graves as my eyes are bigger and find it hard to put on weight. I’m at the lower end of my BMI due to fasting to starve the cancer.

Ok, thanks for clarifying. If you don’t take the prescription, what happens?

Thanks

greygoose profile image
greygoose in reply to Jgoodwin977

With Hashi's levels fluctuate due to the destruction of your thyroid by the immune system. So, therefore, symptoms fluctuate with them. That is how it works.

Weight-loss, and difficulty gaining weight can be hypo symptoms.

want to be tested for graves as my eyes are bigger and find it hard to put on weight.

Hardly likely to have Graves' with a TSH of 5. Plus TRAB can be present with Hashi's, causing a lot of people to be wrongly diagnosed. So, if you do get tested for Graves' make sure it's the TSI that's tested.

Thyroid Eye Disease can also be caused by Hashi's. It doesn't have to be Graves'.

If you don’t take the prescription, what happens?

You mean thyroid hormone replacement? If you don't take it, you just get more and more hypo. TSH will rise, FT4/3 will get lower and lower - although you will have 'hyper' swings from time to time - and the lack of thyroid hormone will affect every part of your body and brain. This, long-term, can lead to problems like liver and kidney failure, heart attack, dementia, to name but a few. And the longer you delay taking it the more irreversible damage that can be done to your body.

I suspect that what you take to be 'progress' is actually the vagaries of Hashi's, and nothing to do with whatever it is your doing. I'm not talking about the cancer, because I know nothing about that. But the symptoms, and antibody count. And as far as I know, nothing you can do can halt the Hashi's eventual destruction of your thyroid, although it might delay it for a while.

Jgoodwin977 profile image
Jgoodwin977 in reply to greygoose

ok, thanks so much for your clarity. I appreciate the information

greygoose profile image
greygoose in reply to Jgoodwin977

You're welcome. :)

SlowDragon profile image
SlowDragonAdministrator

important to test and maintain OPTIMAL vitamin levels too

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

With two test with TSH over 5, high thyroid antibodies and symptoms you could/should be started on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test (and last dose levothyroxine 24 hours before test )

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Jgoodwin977 profile image
Jgoodwin977 in reply to SlowDragon

thanks so much for this

Yes my other victim tests are fine, if anything I overdose but all back in normal range now and not estrogen dominant anymore.

I wanted to try and avoid taking a prescription and do it naturally if possible? The only symptom I have is tiredness, but I put that down to the insomnia.

I get everything checked every 3 months first thing, but a shame I haven’t been able to check pituitary antibodies, dhea, reverse t3 and total t3

Thank you for all the links and guidance, I really appreciate it

SlowDragon profile image
SlowDragonAdministrator in reply to Jgoodwin977

I wanted to try and avoid taking a prescription and do it naturally if possible?

Levothyroxine is not a medication, it’s a replacement thyroid hormone and necessary to start because your own thyroid is failing

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Jgoodwin977 profile image
Jgoodwin977 in reply to SlowDragon

wish i could understand that graph

I thought up to 2.5 was optimal?

How do i work out how much Levothyroxine I need or is it just trial and error?

Thanks

SlowDragon profile image
SlowDragonAdministrator in reply to Jgoodwin977

Most important thing is resolution of symptoms

ALWAYS Test early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

Many, (most?) find, on just levothyroxine, they need Ft4 at least 70% through range and Ft3 at least 60% through range

For many that will result in TSH around or below 1

Many people will have TSH below that

All four vitamins tested and maintain at good levels as well

Jgoodwin977 profile image
Jgoodwin977 in reply to SlowDragon

what do you mean by Ft4 at least 70% through range and Ft3 at least 60% through range?

SlowDragon profile image
SlowDragonAdministrator in reply to Jgoodwin977

When you do blood test

Test early morning and (if/when on levothyroxine last dose 24 hours before test)

Because different labs have different ranges …we then work out results as percentage

Eg

Ft4 13.6 (range 12-22) - Ft4 is low

Free T4 (fT4) 13.6 pmol/L (12 - 22) 16.0%

But

Ft4 13.6 (range 7-17) - Ft4 is average

Free T4 (fT4) 13.6 pmol/L (7 - 17) 66.0%

Percentage calculator

thyroid.chingkerrs.online

Jgoodwin977 profile image
Jgoodwin977 in reply to SlowDragon

oh great thanks for explaining

I’ll fill this out when I get a chance and copy it into the group

Most appreciated

Buddy195 profile image
Buddy195Administrator

Like others, I suggest you look to take medication (Levothyroxine) to address your thyroid levels. Having thyroid levels out of range/ not optimal for me, gave me a raft of adverse symptoms (both mentally and physically).

In addition, regarding your eyes, please get them checked by an ophthalmologist, as your symptoms could be the start of Thyroid Eye Disease. TED is normally associated with Graves, although I and some other members here, have this condition with Hashimotos. Taking a selenium supplement of 200ug daily has been shown to be effective with mild/ moderate cases of TED.

I get hyper swings and want to be tested for graves as my eyes are bigger and find it hard to put on weight. I’m at the lower end of my BMI due to fasting to starve the cancer.

I presented with ‘hyper like’ symptoms including weight loss and tremor; these resolved when optimally medicated. Working on key thyroid vitamins also massively improved my health.

Personally, I would stop fasting, and explore conventional medical options to treat your thyroid cancer.

Jgoodwin977 profile image
Jgoodwin977 in reply to Buddy195

thank you! Yes I’m seeing the eye doctor soon. Many thanks

Delilahmy profile image
Delilahmy

I am a huge fan of natural therapy for cancer …. [ redacted substance ] is one I have found interesting but I would implore you to also look at the normal medical options as they can work very well together. My advice would be to not exclude conventional medical options

Good luck

helvella profile image
helvellaAdministratorThyroid UK in reply to Delilahmy

The substance referred to (now redacted) cannot legally be supplied in the UK and EU and is banned by the FDA in the USA.

Jgoodwin977 profile image
Jgoodwin977 in reply to helvella

yes, I've struggled to get them

FancyPants54 profile image
FancyPants54 in reply to helvella

Why would anyone mess about with cancer? Insane.

Jgoodwin977 profile image
Jgoodwin977 in reply to FancyPants54

it actually works, hence they banned it, as it’s natural so can’t be patented. Unfortunately the health care system is a business and they want to stay in business in the maximum ways

PRJ20 profile image
PRJ20

👋🏽Hi Jgoodwin977 and welcome to the forum - or at least your first posting on the forum since you joined last August. 🙂

I'm sorry, I'm somewhat confused and unable to get a full picture of what's going on here or what your asking/hoping the forum (admin & members) to help and support you with so, please forgive me for starting off with questions. 😔 You state on your Bio, which you also expand on a bit more on a post on the Thyroid Cancer Support forum on HU (from what I have seen a little used worldwide forum, not particular to the UK, which you also posted on yesterday and have now had one comprehensive reply from a member in NZ offering advice and experience similar to above):

Great to be apart of a support group with like minded people going through thyroid problems: hashimotos and PTC thyroid cancer

Although I'm aware the 'P' part of that most likely stands for Papillary (is that correct?), please would you confirm what the TC part stands for? - Thanks.

You also say above, in response to queries by annnsandell who has also had thyroid cancer (in their case successfully treated and in remission following conventional treatment):

yes both of my biopsies were positive unfortunately, so I definitely have it.

Would you also please confirm whether these were [both] from [the] FN biopsies you are referring to and whether you have yet to have the "definitive test" to diagnose thyroid cancer - of "part of the thyroid being removed" and biopsied - that they refer to; whether they were taken/tested at the same time; from different parts/lobes of the thyroid or goitre; and whether the cancer has been typed and staged?????

In response to one of the excellent and comprehensive responses from SlowDragon , you state:

Yes my other victim tests are fine, if anything I overdose but all back in normal range now and not estrogen dominant anymore.

First, are you aware that 'normal range' does not necessarily mean Optimal, particularly with Hashi's when we're talking about any results (be they Vitamins, TFTs or any of the other blood tests that indicate whether the thyroid is adequately supported for relief of symptoms and well being) and specifically for the combination you [now] have of Hashi's and Thyroid Cancer? - i.e. As others on here will attest to, certainly with Hashi's, all the core vitamins we need are frequently below optimal due to a combination of factors viz-a-viz the most common ones being: low stomach acid; leaky gut; [both of which can/do lead to] certain food intolerances and/or other autoimmune disorders such as Pernicious Anaemia (PA) and Coeliac Disease and, hence, why it is often recommended on here that these are tested for and it is often of benefit to cut out gluten and dairy even if these latter tests come back 'negative' or inconclusive. I also know for a fact that the same holds true in approaching the treatment for any form of cancer and, moreover, as you have yourself pointed out "I’m at the lower end of my BMI due to fasting to starve the cancer." (really?) what you have done rather proves that point and I fully agree with greygoose and others who have offered their input that you are essentially playing with fire/going down a dangerous route.

Secondly: so at some point (presumably before or since the thyroid cancer was diagnosed in 2022?) you've had high oestrogen or shown to be oestrogen dominant - Is that correct and would you please confirm at what point (year will do) that was found/diagnosed and how this is being monitored??

Finally, as PurpleNails requested, would you please fill in your Bio with more detail - including any and all blood test results you have with ranges (in brackets) since diagnoses - so that admin and other members on the forum are better placed to guide and support you from an understanding of your individual thyroid journey and timeline.

As an end note of equal importance, I will add that: you are both legally entitled to a print-out of all your results, as well as to on-line access to not only those results but, to your complete primary care record (n.b. any hospital records you need that cannot be seen on your PC record, can be obtained via a Subject Access Request/SAR to the hospital); and I would urge you to get both those printouts and on-line access if you haven't already done so (just ask if you have any further questions re this, maybe on another post).

With apologies, again, for all the questions and really appreciate your answers in clarifying and clearing up any confusion. 🙂🦋

Jgoodwin977 profile image
Jgoodwin977 in reply to PRJ20

I’m also neurodivergent, so apologies if their hasn’t been clarity and thanks for your insight

TC stands for thyroid cancer as its full name.

Ptc is the type of cancer and they said they don’t stage it and is addressed differently. I’ve had no surgery

So if normal range isn’t enough for vitamins, when I overdosed out of normal range, that was actually optimal/sufficient?

Fasting proves what point sorry? I was still supplementing whilst fasting to make sure I was getting my nutrients.

I found a lump in my breast which was benign, so they checked my estrogen at the end of last year which was high, so I took some supplements to help bring it down and found out a few days ago that it’s now back in normal range.

I’ve had so many blood tests, I wouldn’t know where to begin, but I’ve put all my latest thyroid results here. My medical records are extensive and currently have a clinical negligence case, as the doctors gaslit me for so many years, so yes I have a massive pile of medical record.

Let me know if I missed anything and if there’s any specific blood results needed. I don’t know how to use this site well and thought I filled out my profile, let me know exactly what is needed and I’ll put my results from this week in

Many thanks

Poniesrfun profile image
Poniesrfun

When someone says they are treating something “holistically” I take it to mean they are following a healthy diet, exercising, keeping their environment clean, meditating to minimize stress and perhaps practicing some energy balancing modalities - all to improve and maintain their immune system. Not taking some magic bullet elixir claimed to cure cancer. (Many of which are found to contain the drugs you wish to avoid)

An optimized immune system can improve response to cancer - this is now being demonstrated by the immune modulators developed in the past few years, including their use in metastasized thyroid cancers - but these are extremely precise and targeted. If a holistically optimized immune system worked on our thyroid cancers thousands of healthy active people would never get it in the first place.

A healthy immune system which supports low inflammation might help keep auto-immune antibody flares lower. There needs to be a little common sense thrown in. If thyroid hormone levels are low and TSH creeping up and you’re experiencing fatigue you need some replacement hormones. Pretty basic. If your sodium is low you’d get some salt. 🧂 If protein is low you’d increase your choice of protein intake. And if your eyes are causing issues you see an eye doctor

Patti in AZ

PRJ20 profile image
PRJ20 in reply to Poniesrfun

Exactly! 👌🏽💚🦋

Jgoodwin977 profile image
Jgoodwin977 in reply to Poniesrfun

I think you’re simplifying a very complex issue and there’s a bit more to it.

Not sure why you think I’m taking a magic bullet elixir, but my tsh has never been that high before so never been suggested hormone replacement therapy.

I have adhd, so my insomnia could be due to that, which would cause fatigue, so it’s not so black and white. Im hoping I can resolve it as I believe your body is capable of healing itself.

Not sure if you’re aware, but your message doesn’t come across kind or friendly. It actually sounds very condescending, which isn’t helpful. Not sure what the policy is here, but if disrespect is allowed then maybe this isn’t a safe place to be.

You may also like...

I think my cortisol is highest at night. How can I change its cycle?

Whats the highest dosage of Levothyroxine you can be prescribed

moody, etc. I know for a fact I will finally be diagnosed with Hashimotos! Whats the highest dose...

My mum is being ignored by her doctor, TSH 7.5 (0.5-4) and very poorly. What can I do?

finally reaching a TSH of 5.4 (2.2-4.8) and FT4 of 10.4 (12.5-28.5). I'm feeling heaps better on...

TSH has dropped to 0.01- what do I do about it?

IU/mL) THYROGLOBULIN ANTIBODY 24.8 (0.00 - 115.00 IU/mL) THYROID PEROXIDASE ANTIBODIES*83.7...

How can I increase my TSH?

haven’t changed anything. I’m gluten free and have gained 5lbs of fat. How do I get my TSH up so it...