Hypothyroidism Tests: A Measure Of Treatment Success
Hypothyroidism is treated with daily medication. Taking synthetic thyroid hormone medication can bring your T4 and TSH levels back to their normal ranges. Once youre on the right dose, your symptoms should subside.
When you first start taking medication, your doctor will need to monitor your blood to fine-tune the dosage. Initially you will need to be tested more frequently, Doria-Medina says. A person who is newly diagnosed and taking medication for hypothyroidism should be tested every six weeks until the dosage is just right.
The dose you start with is your doctors educated guess about whats best for you most likely the lowest dose possible to avoid side effects, which can include a rapid heartbeat and restlessness.
Medication for hypothyroidism is slow acting, and it can take several weeks for your body to adjust. If your TSH is still high and your symptoms havent subsided after 6 to 10 weeks, your doctor will likely increase the dose, and youll need your blood tested again after another 6 to 10 weeks.
This Is Super Important To Understand
Before I get into the cause of High TSH, there is something I want you know and I think this is SUPER IMPORTANT that you understand this because no one else is talking about this. So, I want you to pay very close attention to what Im about to tell you
#1 It is absolutely critical that you have a complete thyroid panel. You can visit it my website for more information on what this consists of. But if you have that done, thats only step one. While having a complete Thyroid panel is essential to addressing the Root Cause of Thyroid disease, many people mistakenly think and believe that by having a complete thyroid test they will have ALL the answers as to why they are gaining weight or why they are losing their hair or why they are fatigued all the time, but there is much more to this.
If You Suspect That A Medication Is Causing Your High Tsh
If you suspect that a medication is contributing to your high TSH and low thyroid function, I encourage you to do two things.
- Watch my video that explains medications that alter thyroid levels leading to symptoms of being Thyroid overmedicated
- Have a serious conversation with your endocrinologist or your prescribing doctor regarding these drugs and the effects they are having on your thyroid levels.
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The Symptoms Of High Tsh
While experiencing symptoms of high TSH and hypothyroidism is common, many patientsand even cliniciansoften fail to attribute those symptoms to a thyroid disorder. This is largely because they are typically also symptoms of other medical conditions as well as non-pathological physical or emotional states. As the American Thyroid Association Task Force on Thyroid Hormone Replacement noted in 2014, The symptoms often have an insidious onset and overlap significantly between patients with thyroid disease and those without. Many signs and symptoms of thyroid dysfunction are neither sensitive nor specific. In other words, you can have hypothyroidism and have the exact same symptoms of someone without it. Thats why it is important to look at the cumulative symptoms.
The most common symptoms of high TSH andhypothyroidism include:
- Feeling tired/worn out
- Hair loss
Unfortunately, as previously noted, thesesymptoms are often difficult to identify as thyroid-related. To use the wordsof the task force, they are not always sensitive nor specific. Thereare, however, a number of symptoms that may more urgently point tohypothyroidism, including:
- Slowed heart rate
- Puffiness in ankles
- Delayed ankle reflexes
Whos At Risk For Hyperthyroidism
According to the National Institute of Health , hyperthyroidism affects approximately 1.2% of the population in the US. Although it occurs in both men and women, its up to 10 times more likely in females.
Youre at higher risk for hyperthyroidism if you:
- Have a family history of thyroid disease
- Have pernicious anemia
- Have primary adrenal insufficiency, also known as Addisons disease
- Consume an iodine-rich diet or medications containing iodine
- Are over the age of 60
- Were pregnant within the past 6 months
- Had thyroid surgery or a thyroid problem such as a goiter also known as a swollen thyroid gland
What are hyperthyroidism symptoms?
Though an overactive thyroid brings on a constellation of high thyroid symptoms , some of them dont seem obviously linked to the condition . Heres what to look for.
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High Tsh Means Low Thyroid Activity
To begin, lets explain a bit of confusing nomenclature. It would seem logical to assume that high TSH means that you might have hyperthyroidism, an overabundance of thyroid hormones. But in fact, the opposite is true.
TSH is produced by the pituitary gland. When thethyroid is functioning normally, the pituitary produces a normal amount. Butwhen the thyroid is underperforming, it starts to produce more and more, hopingto kick the thyroid into gear. While this could indeed elevate thyroid hormoneproduction in a person with a healthy thyroid, it doesnt fix a malfunctioningthyroid. It isnt like trying to jump a stalled carits more like turning thekey again and again.
Thyroid underactivity is common according to the National Institute of Diabetes and Digestive and Kidney Diseases, nearly 5% of Americans over the age of 12 have hypothyroidism. And while this can strike anyone, you are at a higher risk for it if you are in one or more of these groups:
- People who have given birth in the last 6 months
- People who have a history of thyroid disease in their family
- People with autoimmune diseases
Thats why when you are experiencing the symptoms of high TSH, it is important to see a medical professional. You can often avoid serious, long-term health complications by getting the right thyroid function tests and starting treatment as soon as possible.
Questions To Ask Your Doctor
- What is the cause of my hyperthyroidism?
- Do I have Graves disease?
- What types of food and medicine contain high levels of iodine?
- What is the best treatment?
- Will I need to take medicine? If so, for how long and what are the side effects?
- Will I need surgery? If so, what are the benefits and risks?
- Are there any lifestyle changes I can make to relieve my symptoms?
- Am I at risk for related health problems?
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What Should My Tsh Number Be For My Thyroid
Today were going to talk about the TSH test and its results. TSH stands for Thyroid Stimulating Hormone a standard blood test will produce a number of how well your thyroid is performing. Normal range for an adult is typically considered to be between .4 and 4.0 however, in my practice I would say ideal is between 0.5 and 1.5.
In addition, TSH tests are used to help diagnose a condition called subclinical hypothyroidism, which usually causes no outward signs or symptoms. In this condition, you have normal blood levels of triiodothyronine and thyroxine, but higher than normal levels of TSH.
TSH is often the first test doctors use to determine whether you have too little or too much thyroid hormones. High TSH is often linked to an underactive thyroid or hypothyroidism. Read on to learn about the causes, symptoms, and health effects of high TSH levels.
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Thyroid : Hypothyroidism And Hyperthyroidism
More than 20 million Americans have thyroid disease, but 60% dont know it. A Michigan Medicine endocrinologist discusses whos at risk, signs to look for and how to seek treatment.
Theres a small, butterfly shaped gland in your lower neck, the thyroid, that secretes hormones and affects almost every organ in the body, regulating metabolic processes and controlling body temperature.
When the thyroid doesnt produce a normal hormone level, either not enough or too much, thyroid disease occurs. And according to Michigan Medicine endocrinologist its actually more common than heart disease or diabetes.
An estimated 20 million Americans have some form of thyroid disease, but up to 60% of those that have it are unaware of the condition, according to the American Thyroid Association, with autoimmune diseases like Hashimotos disease and Graves disease among the most common culprits of hypothyroidism and hyperthyroidism, respectively.
If the thyroid hormone levels are too low, referred to as hypothyroidism or underactive thyroid, the brains pituitary gland will produce more thyroid stimulating hormone . TSH prompts the thyroid to make more thyroid hormones in response to low levels.
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How Does Thyroid Disease Affect Pregnancy
Pregnancy-related hormones raise the level of thyroid hormones in the blood. Thyroid hormones are necessary for the baby’s brain development while in the womb.
It can be harder to diagnose thyroid problems during pregnancy because of the change in hormone levels that normally happen during pregnancy. But it is especially important to check for problems before getting pregnant and during pregnancy. Uncontrolled hyperthyroidism and hypothyroidism can cause problems for both mother and baby.
Hyperthyroidism that is not treated with medicine during pregnancy can cause:
- Premature birth
- a serious condition starting after 20 weeks of pregnancy. Preeclampsia causes high blood pressure and problems with the kidneys and other organs. The only cure for preeclampsia is childbirth.
- Thyroid storm
- Fast heart rate in the newborn, which can lead to heart failure, poor weight gain, or an enlarged thyroid that can make it hard to breathe
- Low birth weight
What Is Thyroid Medication
Thyroid Hormone Treatment Levothyroxine is thestandard of care in thyroid hormone replacement therapy and treatment of hypothyroidism. Levothyroxine is equivalent to the T4 form of naturally occurring thyroid hormone and is available in generic and brand name forms.
How do I take levothyroxine? To optimize absorption of your thyroid medication, it should be taken with water at a regular time each day. Multiple medications and supplements decrease absorption of thyroid hormone and should be taken 3-4 hours apart, including calcium and iron supplements, proton pump inhibitors, soy, and multivitamins with minerals. Because of the way levothyroxine is metabolized by the body, your doctor may ask you to take an extra pill or skip a pill on some days of the week. This helps us to fine tune your medication dose for your body and should be guided by an endocrinologist.
For patients with celiac disease or gluten sensitivity, a gluten free formulation of levothyroxine is available.
Some individuals may have genetic variant that affects how the body converts T4 to T3 and these individuals may benefit from the addition of a small dose of triiodothyronine.
Liothyronine is replacement T3 thyroid hormone. This medication has a short half-life and is taken twice per day or in combination with levothyroxine. Liothyronine alone is not used for treatment of hypothyroidism long term.
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Causes Symptoms Diagnosis Treatments And Support
Endless energy, unexplained weight lossthe initial symptoms of an overactive thyroid are often seen as good symptoms. Thats why hyperthyroidism is one of the most underdiagnosed endocrine conditions. But if left unchecked, it can lead to serious complications. Were here to empower you with clear answers to all your hyperthyroid questions.
What is hyperthyroidism?
Hyperthyroidism is the abnormal function of your thyroid gland, an organ located in the front of your neck that releases hormones to regulate your bodys use of energy. In other words, if you have high thyroid levels, it means that your thyroid gland is overactive and makes more thyroid hormones than your body needs, which causes hyperthyroidism.
The hormones produced by your thyroid gland are thyroxine and triiodothyronine , and they play an important role in the way your entire body functions. For this reason, when there is an imbalance, such as high T4, it can have far-reaching effects on almost every aspect of your health.
Infographic by Lauren Hunter
- body temperature
How T3 And T4 Affect Tsh Levels
The amount of T3 and T4 in blood serum directly affects levels of TSH that the pituitary gland produces.
The journal Endocrinology says that there is a negative feedback loop that signals to the pituitary gland to produce more or less TSH. If there are low T4 and T3 in the blood, more thyroid-stimulating hormone is produced to boost T4 levels. This is why an underactive thyroid gland is associated with TSH levels above the normal reference range.5
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Other Medications And Herbs
Some herbal supplements and medications can have an impact on thyroid hormone levels, either by competing with the body’s thyroid hormone activity, amplifying the effects of thyroid hormones, or altering medication absorption and activity.
- Medications: Starting or stopping prescription drugs that you are taking for another condition besides your thyroid disease can affect your thyroid levels and your symptoms in a number of different ways. Some medications that may affect thyroid levels include certain cholesterol-lowering drugs, corticosteroids, growth hormone, lithium, and amiodarone.
- Herbs: The Ayurvedic herb guggul, supplements such as tyrosine, products like kelp that contain iodine, and bladderwrack supplements are some of the naturopathic remedies that are known to increase or decrease thyroid function, alter test results, and produce a variety of thyroid related symptoms.
It is best to ask your pharmacist and doctor about potential interactions.
In People With Thyroid Disease
In people being treated for hypothyroidism, a low TSH level may mean:
- Overmedication with thyroid hormone replacement
- Interactions that cause increased absorption or activity despite an optimal dose of medication
- Central hypothyroidism
In people being treated for hyperthyroidism, a low TSH level usually means that further treatment is needed to reduce thyroid hormone levels.
It could also mean that a person must continue to be monitored to make sure thyroid hormone levels return to normal. This is often the case for people who have temporary thyroiditis related to pregnancy or chemotherapy treatment.
Treatment may need to be more aggressive
Medication may not be absorbing enough
Treatment may be more aggressive than needed
Medication may be absorbing too much
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What You Can Do To Improve Symptoms
Eating a proper diet, with a focus on calcium and sodium, is important, especially in preventing hyperthyroidism. Work with your doctor to create healthy guidelines for your diet, nutritional supplements, and exercise.
Hyperthyroidism can also cause your bones to become weak and thin, which can lead to osteoporosis. Taking vitamin D and calcium supplements during and after treatment can help strengthen your bones. Your doctor can tell you how much vitamin D and calcium to take each day. Learn more about the health benefits of vitamin D.
What Are T4 And Ft4
Thyroxine is referred to as T4 and is the main hormone that the thyroid secretes. When T4 in the blood binds to proteins, it becomes T3. Doctors say that blood tests to check if T4 levels are in the normal range are done to test thyroid function. Often, a T4 test is done together with checking for high TSH if a person shows symptoms of hypothyroidism.4
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What Causes An Overactive Thyroid Gland
The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the body’s growth and metabolism. These hormones are called thyroxine and triiodothyronine.
They affect processes such as heart rate and body temperature, and help convert food into energy to keep the body going.
In hyperthyroidism, the thyroid gland produces too much thyroxine or triiodothyronine, which speeds up the body’s metabolism.
There are several possible underlying causes, the most common being Graves’ disease, in which the body’s immune system targets the thyroid gland and causes it to produce too much of the thyroid hormones.
What Is The Normal Range Of Tsh
There are a range of levels that your TSH levels can be. Learning what these levels mean will help you work with your doctor to address your condition adequately.
- Normal TSH – Adults should have TSH hormone levels that range from 0.4-4.2 mU/L. This indicates that the signals from your pituitary gland match the activity of your thyroid gland. Your doctor will use this hormone level alongside the other signals and side affects you may be showing to determine if there is an underlying health issue at hand.
- Low TSH – Low TSH levels can be a sign that you are dealing with an overactive thyroid gland from conditions such as goiter, noncancerous tumors or Graves’s disease. The thyroid may also become overactive during the first trimester of pregnancy. If you are already being treated for thyroid issues, you may develop low TSH levels if you are taking too much thyroid medication. If you are not showing signs of overactive thyroid, you may have damaged the pituitary gland, causing it to produce less TSH.
- High TSH – High levels of TSH are typically caused by an underactive thyroid or hypothyroidism. This is typically caused by Hashimoto’s thyroiditis. If you are already being treated for a thyroid disorder this can be a sign that you need to increase your medication. In rare cases, you may be showing high than normal TSH levels because you have developed a tumor that is causing the pituitary gland to over-produce TSH.
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How Are Thyroid Nodules Treated
Treatment depends on the type of nodule or nodules that you have. Treatments include:
- Watchful waiting. If your nodule is not cancerous, your doctor may decide to just watch your condition. You will get regular physical exams, blood tests, and perhaps thyroid ultrasound tests. If your nodule does not change, you may not need further treatment.
- Surgery. Surgery may be necessary to take out nodules that may be cancerous or large nodules that cause problems breathing or swallowing.
- Radioiodine. This type of treatment is helpful if you have nodules that make too much thyroid hormone. Radioiodine causes nodules to shrink and make smaller amounts of thyroid hormone.