TSH 6.49 linked? with illness…treat or wait?

[Bearo]

My partner (male, 61) was a bit unwell last year - suffering lots of colds, low energy, feeling cold, slightly raised TSH, I think it was just over 3. Lots of things have been on the low side when full bloods are taken. His vit D was 50 but he supplemented and raised it to 125.

A mark was found on his lung over a year ago and cancer was suspected so in January this year he had a 25% section of lung removed. On examination It wasn’t cancer but Organising Pneumonia. I hadn’t heard of this but it’s not a viral pneumonia. He is now recovering from the op but has indigestion (likely from the anaesthetic) and not much appetite.He has also had a cough since leaving hospital. He is finding recovery very slow and I’m wondering if has caught one of the bugs doing the rounds and also if his struggling thyroid is slowing him down.

His latest blood test, before his op, shows TSH 6.49 and FT4 16 (11-22). Cholesterol is also raised. No TPO, unfortunately, which would have been useful.

I’m assuming that a high TSH could be due to being unwell, on and off, for a year, and that as he recovers it will go down on its own accord. How long should he wait before asking for a retest? A couple of months?

Or am I wrong and he should start Levo?

[SlowDragon Administrator]

What other vitamin supplements is he taking

Low B12 common after anaesthetic

Suggest you get him FULL Thyroid and vitamin testing including thyroid antibodies

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and 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

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...

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

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

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

[greygoose]

FT4: 16 pmol/l (Range 11 - 22) 45.45%

His TSH is high because his FT4 is low, and his FT3 is probably lower. High cholesterol is a sign of low T3. And the high TSH is not the problem, it's the low FT3. And the TSH won't go down until the FT3 goes up.

So, whether or not he should start levo is a matter to be decided by his doctor - a lot of them like the TSH to go over 10 before they will treat. But how does he feel? Does he know if he has Hashi's? Or is that why you wanted the TPOab tested, to find out?

[Bearo in reply to greygoose]

Yes, I thought if TPO had been tested and was positive it would point towards treatment.

The surgery sent him a text informing him that his thyroid was ‘looking tired but producing in-range hormones’ and to have another test in six months. Meanwhile to contact surgery if ‘feeling cold, tired, putting on weight, constipation, losing hair.’ He doesn’t feel well but has put feeling cold down to the cold snap we’ve just had and tiredness to being post-op. He is slowly feeling better rather than feeling worse and worse so probably still in post-op recovery plus maybe a winter virus.

He continues to supplement D but hasn’t been supplementing B12. I’ll remind him.

[greygoose in reply to Bearo]

Well, they say that, but they don't 100% know, do they, because they haven't tested the FT3! That could be below range.

But, if he's feeling better then perhaps best to wait another... well, I personally think six months is too long, but it's all about saving money, isn't it. At least he has the option of contacting the surgery if he starts feeling worse.