TSH 2.00 but FT4 is high?
Posted , 5 users are following.
Hello everyone. I am new here and need some guidance please. I have been diagnosed hypothyroidism for 3 years now and newly diagnosed Hashimoto's. My doctor just raised my levothyroxine from 50mcg to 75 mcg because my TSH was high at 6.07 (range 0.27 - 4.2 ) My FT4 at that time was 1.36 (range 0.9 - 1.7 ) I was also having symptoms. I was tested 4 weeks later my labs are TSH 2.1 and FT4 is 1.7. Same lab range as above. My question is why would my FT4 be so high while my TSH is normal. I am still having hypo symptoms with hairloss, aches and pains, cold all the time, and tired all the time. But in the morning and later in the evening I feel speedy and jittery, but still tired... if that makes any sense..lol. According to all I have read.. my TSH still needs to be lower, but I fear if I go lower, my FT4 will continue to raise causing hyper symptoms? I am so confused. Thank you.
1 like, 22 replies
shellyC19 sweetmelissa
Posted
My name is Shelly and I am a nurse in the USA. I have Hashimoto's disease since 1987 when I was 27. I am now 54.
Hashimoto's is an autoimmune disease and it attacks the thyroid gland slowly and it can make it slow to work or not work at all.
Normal TSH (Thyroid Stimulating Hormone) should be between 0.27-4.2 in that range area. When the TSH level is on the higher end it means you are low in Thyroxine and it gets a signal from the Pituitary gland to the thyroid and TSH says make more hormone. Hashi's messes up the gland and things do not work right.
Levothyroxine is T4 and in a normal thyroid it is converted into T3 called Liothyroninne and is the useable hormone in our bodies.
Many of us with Hashimoto's can't convert T4 well enough so it sits in your blood Now you may be converting better at 50mcg and at 75mcg a big jump up, it is not converting well enough into T3. FreeT4 (FT4) is the amount in your blood that is free flowing in your blood stream. You are at 1.7 and not really horrible on that and it does take time to build a new level, about 6 to 8 weeks. Give it a bit of time and let the body get used to 75mcg since it went up to that dose.
It most likely will settle down in you. A problem is the medication does not come in say 60mcg, it comes in 50mcg, then 75mcg so it is a lot and would have been better if you could have gone to 65mcg for a while. You would need to cut pills up to make that dose.
Your TSH may come down more but then your FT4 may also come down a bit as the body gets used to this new dose.
I hope I helped, any questions just ask.
Shelly
sweetmelissa shellyC19
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Widdzy shellyC19
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Regarding the origianl post in this example, the doctor raised the Thyroxine medication from 50 to 75mcg because the TSH was high. Is this the correct direction to go in order to bring the TSH to within range? I've recently had a very low TSH reading and the GP continues to suggest that i decrease my Thyroxine intake. I'm currently on 50mcg and hes even suggested i reduce it to the lowest level. I had a thyroidectomy 5 years ago and am currently awaiting the next change to make me feel better
Regards,
Kevin
shellyC19 Widdzy
Posted
TSH ranges from 0.45 to 4.50 when you are towards the higher end say 4.50 it means you are HYPO or Low in thyroid. It is opposite. So if you were at 0.45 you would have too much or be HYPER.
I know it is confusing. Most doc's like the TSH to be in 1.0 to 3.0 range or in the middle. So if he raised it, your TSH was at the high end of the scale and you need more thyroxine. The med comes in increments like 50mcg and then 75mcg it does not come in 60mcg. To make a in between dose you would have to have a 50mcg and a 10 mcg pill. So doctor's just up it to the next highest one.
Some of us need more thyroxine and some of us need a bit less, so it takes our bodies about 6 to 8 weeks to build a new level and then they draw blood and can tell if the TSH is coming down into the mid range.
It can take some playing around with the doses to get it right for you. Let's hope it does help bring your TSH into the "normal" range.
Any questions, just ask.
Stay well, Shelly
Widdzy shellyC19
Posted
Yep understand the train of thought now. I have a very low TSH whilst on medication (levo 50mcg) and the indication is that my body is still receiving too much thyroxine Hormone. This is where the confusion is because i dont have a thyroid to make the T4, this is only provided from the Meds. My thoughts now are that the Pituitary gland is giving wrong message of TSH. My next action of course is to get my T4 and T3 levels checked which should confirm this - are my thoughts on this correct ? Also i've just started taking B12 supplements as this seemed to identify or have a common thread with some of my symptoms particulalry with Chronic Tinntus - Have you ever come across this symptom before ?
Thanks - Kevin
shellyC19 Widdzy
Posted
Since you had your thyroid removed, did you have the whole gland removed or just part of it?
Your meds have to be absorbed and converted in the liver and intestines. Most of the Synthetic meds like Levo and Cytomel have to be absorbed by your thyroid gland. Infact they were designed for people who had thyroid glands. When you remove the gland other organs need to do the work and it can take longer to get into the bloodstream and work. It will work but it can be tricky to find the right dose for you.
When you had blood drawn on that day you may have had a low end of scale reading, and it could be the med is still building and absorption is slower because you do not have the thyroid. Also did you take a dose before blood work?
B-12 can be low in a lot of us with thyroid problems and it also is important to have it okay because it helps with making new red blood cells and energy and not feeling sleepy. It is important to have all of our minerals and vitamins at proper levels. Many of us are low in Vit. D and it seems to be a linkage to being Hypothyroid. I have not heard of B-12 in linkage to Chronic Tinnitius but if it helps that is great.
We also need to have our potassium, sodium, calcium, magnesium, selenium, ferritin, and iron levels all in good shape. Certain minerals are needed for our thyroid medication to work well.
Stay well,
Shelly
shellyC19 Widdzy
Posted
You should have T3, and T4 levels and TSH checked along with the minerals and vitamins list in my other post.
Shelly
barbara98940 shellyC19
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shellyC19 sweetmelissa
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RE: Hair loss should stop as you get your new level built up in you. Make sure to have your minerals tested. Calcium, potassium, sodium,magnesium and ferritn, iron and Vit D and B-12, also selenium level. take your Levo on an empty stomach and wait an hour before eating. It should take a while for the hair to come back. It took me 6 months. Hang in there and make sure your doctor checks the above minerals and vitamins as many of us with thyroid problems have low Vit D and iron and other minerals.
Shelly
sweetmelissa shellyC19
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shellyC19 sweetmelissa
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Iron is important to helping Thyroxineorking well, and also helps in us making new red blood cells and it helps with hair growth a bit. Taking a good multi-vitamin with iron will help a lot and eating Liver, spinach, leafy green veggies are good sources. Try Gluten free diets can help with antibodies also
Free T3 is important if you are having trouble converting T4 or if T3 level is not stable. It helps diagnose things better.
We tend to have low body temps when we are hypothyroid.
sweetmelissa shellyC19
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LAHs sweetmelissa
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I agree with everything Shelly says. My immediate opinion is that you are not converting T4 to T3. Get your T3 measured as soon as you can.
If your T3 is low, request something like Cytomel (syn. T3) to take with your syn. T4 and if that is difficult (e.g. are you in the UK - where it can be difficult to get) then request Armour Thyroid, an NDT. But first measure your T3, it will tell your which way to go next.
sweetmelissa LAHs
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barbara98940 sweetmelissa
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I found it takes me 12 weeks after an increase or decrease in levothyroxine (aka T4) dose for my symptoms to stabilise and the blood tests to correctly reflect the new dose. When asked to increase or decrease my thyroxine dose I found it better to cut a 25mcg tablet into quarters and increase the dose by a quarter of a tablet every two days. This way I minimised the swings in symptoms.
sweetmelissa barbara98940
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LAHs sweetmelissa
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But you do need to monitor your T3 to know what is going on.
The jitters after coffee is suggesting that you may be at the upper end of the ranges for starters.
LAHs barbara98940
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sweetmelissa LAHs
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barbara98940 LAHs
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