Why is my TSH rising when levothyroxine dose increased?

[Jandun]

My TSH appears to be rising even though my dose of levothyroxine has been raised. I've been on levothyroxine for just over 12 months now and actually feel pretty good with no brain fog these days. My TSH has never been sky high and, consequently, I had to fight for treatment. I'm still not officially diagnosed as hypothyroid! I started with a TSH of about 7 to 7.5 and this was considered not to need treatment because I had no thyroid antibodies.

My TSH 6 weeks ago was 5.8 ref 0.2 to 6 with my FT4 13.5 ref 10 to 20 so my doctor raised my dose of levithyroxine from 75mcg to 100mcg. I decided to check what the level was now before my official blood test which was today. I used a Myrios test earlier this week and the results came back as TSH 8.70 ref 0.24 to 4.20 and FT4 16.5 ref 12 to 22. I would like to be forearmed before my doctor rings me for a telephone appointment on Monday and would very much appreciate advice as to why my TSH should have gone up.

[helvella]

Were the blood draws done at the same time of day?

Are you taking any other supplements or medicines? Or any other illness at present?

Rod

[Jandun]

Both bloods done in the morning one at about 7 am at home the other at the hospital at 9pm. I'm on aspirin 75mg, atorvastatin 49mg, bisoprolol 7.5mg, Omeprazole 20mg, ramipril 5mg and I supplement with coenzyme Q10 200mg and later in the day 100mg, vit d3 5,000iu (I was very deficient) folic acid 800 mcg (again deficient) and fish oil 2x 1100mg per day. Phew I think that's it! I had a heart attack two years ago and have a stent. I don't actually have high blood pressure but was prescribed the ramipril and bisoprolol following my heart attack. Apart from that I'm reasonably well

Jane

[Jandun]

Also I don't my levo on the morning of a test or my statin the night before (if I remember).

[helvella]

I am worried that anything I say would be a bit of a stab in the dark, a guess.

So while I am happy point out that several of those medicines have been reported to affect thyroid hormone levels and/or TSH, I don't feel confident in saying "That one is doing it!".

Have a look here:

thyroiduk.healthunlocked.co...

That is not complete or perfect - but it is worth a look.

Rod

[Jandun in reply to helvella]

Thank you Rod. Any help/pointers appreciated.

Jane

[Hidden]

A tsh of over 4 puts you at greater risk of heart problems, according to the society for endocrinology. see their press release from april 2010. endocrinology.org/press/pre...

Have you considered taking Ubiquinol rather than co enzyme Q10? the co enzyme q10 has to convert into ubiquinol....

Maybe you are not managing to convert the T4 into T3? hence the tsh increase?

Have you ever had the free T3 measured?.....

[Jandun in reply to Hidden]

Thank you. I will look at Ubiquinol. I also wondered about conversion and I will get a private test so my t3 is measured. No chance at the doctors!

[NanaV54 in reply to Jandun]

Make sure you ask for Free T3. It's the T3 that's available for your body to use, and not bound to proteins. Low B12 has some of the same symptoms as hypothyroidism and low D3 can affect your thyroid levels and conversion. It could be why your FT4 is so high, especially when your TSH isn't suppressed.... It's not being used to convert it to T3. Your body has to convert T4 to T3, which is the active hormone. You may need T3 supplementation too. If you are taking D3, be sure to add Vit K2 M7 to your D to regulate your calcium levels and protect against calcification of your arteries. Talk to your Dr again, about checking your D levels. I take Armour thyroid, but I live in the states and it's available to me. I have 2 sisters that also take NDT because of conversion issues.