my blood tsh blood test in December was 5.1. The most recent test last week increased to 5.7. Is this hypothyroidism? I haven’t been back to my doctor yet but my initial research says that if I have dry skin, get cold easily, fatigued, losing hair, etc then I might have it? Of course, I’m sure every 58 year old with this ohio winter is exhibiting these symptoms!
Anyone have any thoughts if a 5.7 is a candidate for drugs or other treatment or do I just need to wait for summer (if it ever comes)
My understanding* is that if you are sustaining above 4.0 then you are a candidate for levothyroxine to bring it down, and they may want to do an ultrasound and look for nodules. An underperforming thyroid is pretty common but they will want to ensure it isn’t anything more serious. I assume that you have an appointment scheduled with at least your GP, but a trip to an endocrinologist seems in order.
*:NOT A DOCTOR!!!
Are they just measuring your TSH? Or have you had T4, T3, Free T4, Free T3, Reverse T3, and antibodies tests done? Those are probably the next tests an endocrinologist would order, along with an ultrasound.
(speaking from someone who has been on levothyroxine for 20+ years)
Also, many GPs are not aware of new standard norms for TSH, and still go by old numbers in deciding whether to treat or not. Even within the new norms, two people may feel differently at the same number. It’s about what number you feel better at, too.
You’re not within the range of normal, which I believe is 1 - 4. Your results are getting worse, not better. If you are feeling symptoms, and you for sure are, you will be a candidate for meds. I’ve been on them for 18 years. I have found I need to take synthroid, not the generic. You never feel as normal as you would with a normal thyroid. I’m surprised your doctor hasn’t called you already. Schedule the appointment and see what the dr says. It’s not something you just snap out of and waiting really isn’t gaining you anything.
H has been on Synthroid (not generic) for several years now, after a virus left him with low thyroid levels. It has helped somewhat, but he’s still often tired.
BTW… when I developed nodules on my thyroid 20+ years ago, my TSH was fine, and I didn’t have any symptoms of hypo or hyperthyroidism. You don’t necessarily need to be experiencing symptoms to need the medication.
There are so many variables in deciding what to do - that’s why it’s important to have that initial evaluation/consultation with an endocrinologist. Once you get things stabilized and managed, then you can go back to having your primacy doc follow you from year to year. If you reach a point that it’s not easy to stabilize/manage, then you can go back to the endocrinologist for fine-tuning when needed. I went many, many years when I just had my levels checked at my annual physicals, and they were fine.
ohio:
That’s borderline high. Depending on your lab, the “normal range” is 1.0 to 4.0 or 4.5.
Symptoms that were, in retrospect, obvious to me were crazy dry itchy cracking hands and feet – beyond the normal winter hand lotion stuff. Feeling cold all the time. And thinning eyebrows. I just chalked it up to getting old, but the change when I started on the supplemental thyroid (my first TSH was 23.1) was immediate and easily noticeable Now, I can kind of judge whether my levels are good or not based on the degree of dryness in winter.
It’s super easy and super cheap to treat. Just a matter of dialing in the right dose of Levothyroxine. The doc will want to start out on the low side and test again after 6 months. It took me a couple of cycles of that over a couple of years to get up to a stable dose. Once you get it dialed in, it’s just an annual test. One pill per day, preferably on an empty stomach. So right before bed or in the middle of the night. It’s on WalMart’s $4 a month or $10 for 90 day supply deal. I just mail order 90 days for $10 and it shows up in my mailbox. Cheaper than the insurance co-pay. There are no side effects of the medicine (unless you were to overdose).
At 5.1, your doc might not start you on the Levothyroxine unless you also complained of symptoms. My doc said that he doesn’t like to just chase the numbers. Once you are in the ballpark, it’s more symptom related.
Idad
I guess what has me concerned is that it increased from 5,1 to 5.7. He had me test again because he thought I might not have been properly hydrated. In addition to the old guy/winter symptoms I feel “wired” as of late? Don’t know if it is a response to the lab results or not? I’m not gaining weight (a supposed symptom) but as you know I’m working out 2 hours a day and watch what I eat, so I originally thought the first test was bogus.
Actually, any number above 1 usually has me feeling symptoms. I’m very sensitive to it, in fact my dosage is quite high, but when I was diagnosed my first tsh was crazy high and I could barely get off the couch.
I lost 90 lbs with a TSH of 23!
I’m amazed to say my first TSH was 179. Really. The endo I was seeing at the time said, “Your TSH is extremely elevated.”
It took months until I started feeling normal again.
The higher your TSH, the more likely you are to have symptoms of hypothyroidism. Doctors didn’t used to treat people until the TSH got to around 15, but lots of people have symptoms and feel better with thyroid hormone treatment even with normal thyroid hormone levels and TSH in the 5 range. (TSH is really a screening test - it measures the brain’s response to thyroid hormone levels.). Did your doctor check a free T4 level? To predict whether your TSH is likely to continue to go up, your doctor could check a TPO antibody level. If it’s high, it predicts your thyroid function will decline over time.
I have been on levothyroxine or synthroid for almost 30 years. I see an endocrinologist annually. He actually orders less tests than my primary did. Only TSH necessary in his opinion. Every couple of years or so he does an ultrasound of my shrunken old thyroid.
MD here.
Your doctor will start you on synthroid. Also will be good to order free T4, T3, Thyroid peroxidase (TPO), and Thyroid stimulating antibodies (TSI). The thyroid peroxidase (TPO) will test for Hashimoto’s Thyroiditis.
I feel my best around 1.9. Maybe your doc could put u on 75 or 88 levothyroxine to seehow u feel on the drug and if He/she can get u to 3.0 to see how u feel.
My doc did the more complete panel of tests after the initial screening, to rule out some of the more acute causes of low thyroid. Once it appeared to be simply low thyroid function, it’s just been the TSH test once a year to keep the dosage dialed in. So far, it’ll stabilize for a couple of years, then need a one-step increase in dose for another couple of years.
You need to know both the TSH and the thyroid hormone levels (check with your physician for the currently preferred tests) long term. Frequency depends- at least once per year. Numbers can be in the normal range but trending away from norms, leading to rechecking sooner. The specific number also depends on the lab’s norms- a range for normal comes with test results. TSH and, say, free T4, can be both going in the same direction or in opposite directions. How they relate matters. If your TSH is rising and your thyroid hormone level is falling you likely need more thyroid hormone. If both are low or high that’s different. Once diagnosed easy to keep track of (physician here, btw but personal experiences, not my specialty). Fortunately this is an easy disorder to treat- and with no extra side effects since it is hormone replacement therapy.
Testing for Hashimoto’s/autoimmune disease can now easily be done. But, like every lab test, it does cost money. Those being treated for hypothyroidism for a long time do not need to get that test as it won’t make any difference in treatment or prognosis.
Anyone else from the Goiter Belt and get chocolate flavored iodine pills with their snack break milk in elementary school circa 1960? Iodized salt made a difference for those of us far from the salty waters.
An interesting anecdote for those sharing their dosage. What it took to finally get me into a good zone - I take 88 mg., Monday, Wednesday, Friday and Saturday. That schedule is what worked for me… like I said, a lot of it is trial and error, and two people with the same number can feel very different.
I had a similar schedule as @teriwtt for a couple of years – I took one dosage three days a week and another dosage four days a week. (It confused the hell out of Express Scripts.) A good endo will really fine-tune the dosage so you stay in the right values and feel good.
This thread is very timely for me as I was just started on 50 mcg of Synthroid two weeks ago after two TSH tests that were borderline - 2014 was 4.4 and 2015 was 4.2. 2015 T4 Free was 0.94. I have a few of the typical symptoms, especially that I am ridiculously cold all the time (and I live in CA). So far I don’t feel any big improvement in energy or anything else although perhaps I am warmer. Or maybe that is global warming. I do feel very anxious and I am sleeping less. My internist thought it was a good idea especially as my LDL was creeping up despite normal weight, lots of exercise and super healthy eating almost vegetarian. She also said that most doctors now think TSH should be under 2 not under 4.5. I will be very interested to see the 6 week blood tests.