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Doctor insights on: High Tsh Despite Treatment

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Chronic fatigue? Low TSH high beta globulins, high LFT, nuclear studies normal, all hormones normal. Any suggestions ?

Chronic fatigue? Low TSH high beta globulins, high LFT, nuclear studies normal, all hormones normal. Any suggestions ?

Liver?: What did your doctor say about the high liver enzymes? It sounds to me like you need to be working closely with your doctor to figure out what is going on and what is best to do about it. I wish you the very best. ...Read more

Dr. Quang Nguyen
951 doctors shared insights

Thyroid Stimulating Hormone (Definition)

A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland and tells the thyroid gland to make and release the hormones thyroxine ...Read more


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What's the treatment for someone with high TSH thyroid level?

What's the treatment for someone with high TSH thyroid level?

Thyroid hormone.: Elevated TSH (thyroid stimulating hormone) levels almost always mean that the pituitary gland is unsatisfied with the level of thryoid hormone in the blood (hypothyroidism). It is easily treated with thyroid hormone pill daily, and the TSH level returns to normal. ...Read more

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I have hypothyroid and have been on Synthroid (thyroxine) 112mcg test results are tpo high 173, TSH low 0.126, T4 free normal1.38, is there a need to change meds?

I have hypothyroid and have been on Synthroid (thyroxine) 112mcg  test results are tpo high 173, TSH low 0.126, T4 free normal1.38, is there a need to change meds?

Hypothyroid: Tpo antibodies do not change with treatment. They are indicators of the cause of your hypothyroidism - autoimmune thyroid disease aka grave's disease. Your TSH is slightly suppressed meaning you are getting too much synthroid (thyroxine). Long term side effects of too much synthroid (thyroxine) include an increased predilection for osteoporosis and atrial fibrillation, therefore a slight reduction in dose is warranted. ...Read more

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If thyroglob autoantibodies are high (139) but TSH low (.01) and free T4 and T3 (liothyronine) normal, what is likely diagnosis? Symptom includes recent-onset fatigue

If thyroglob autoantibodies are high (139) but TSH low (.01) and free T4 and T3 (liothyronine) normal, what is likely diagnosis? Symptom includes recent-onset fatigue

Thyroid diagnosis: While one cannot be certain from these data, the most common entity that fits this description is hashimoto's autoimmune thyroiditis. In the early phase, because of the inflammatory reaction in the thyroid gland, more thyroid hormone is released causing the TSH to go low, and sometimes the T4 to go high; after time the inflammation settles down, and the TSH starts to go up, and the T4 goes down. ...Read more

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Very high B12 blood level, low iron, rt side ab pain despite very strict gfdiet for celiac disease, not on vitamins.What could cause high B12 levels?

Very high B12 blood level, low iron, rt side ab pain despite very strict gfdiet for celiac disease, not on vitamins.What could cause high B12 levels?

High B12 and folate (folic acid): Levels are caused by their accumulation and non use in the body. I have seen it related to vitramin b1 deficiency. Worth trying. ...Read more

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Is levothyroxine 25mcg the correct medication for high anti thyroid but normal blood work?

Is levothyroxine 25mcg the correct medication for high anti thyroid but normal blood work?

Unclear question: Your question is unclear. By anti thyroid, do you mean anti-tpo antibodies, which indicates hashimotos thyroiditis? In general, levothyroxine should be given if your ft4 is low, and/or TSH is high. 25 mcg is a very low dose, but the correct dose varies from person to person. You may wish to see an endocrinologist. ...Read more

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Elevated thyroid antibody. But normal thyroid level? Is medicine needed?

Elevated thyroid antibody. But normal thyroid level? Is medicine needed?

Not yet: Anti thyroid antibodies are a sign that your immune system is attacking your thyroid gland. Over time, your gland may fail and them you will require thyroid hormone replacement. Your physician should check your TSH level periodically. When TSH starts to rise, consider medication. Antithyroid antibodies raise your risk of having infertility issues. Make sure your ob/gyn is aware of this. ...Read more

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Dx with multinodular goiter. But T4,free t4,total t3, (liothyronine)tsh, & Tpo ab normal. Tg ab test is high @ 2.3 Iu/ml. range 0-0.9. Would this cause hypo symptoms?

Dx with multinodular goiter. But T4,free t4,total t3, (liothyronine)tsh, & Tpo ab normal. Tg ab test is high @ 2.3 Iu/ml. range 0-0.9. Would this cause hypo symptoms?

Not likely: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, it would have helped to have all the data. From what you presented, you are not hypothyroid, but are at risk for it. Please follow your doctor's advice. ...Read more

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High H&H, high MCV, low MCHC, low RDW, neutropenia, & lymphocytosis all values recurring for a few years. B12 therapy for macrocytosis ineffective. No drugs/alcohol. Do smoke cigarettes. Any ideas?

High H&H, high MCV, low MCHC, low RDW, neutropenia, & lymphocytosis all values recurring for a few years. B12 therapy for macrocytosis ineffective. No drugs/alcohol. Do smoke cigarettes. Any ideas?

Yes: My Opinion Only I suggest you have a bone marrow study. This could represent a "Pre-Leukemic" state...not to scare you JUST an "idea" as you requested. BY NO MEANS AM I MAKING A DIAGNOSIS This situation is UNUSUAL and this is just a thought! Hope this helps you/ Dr Z ...Read more

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I have high tpo, high thyroglobulin and in range TSH and T4 hashi s or graves ?

I have high tpo, high thyroglobulin and in range TSH and T4 hashi s or graves ?

Neither.: If you have normal TSH and T4 you have neither of those diseases yet. You may develop hashimoto's in the future but may not. Progression should be monitored with TSH and possibly ft4. ...Read more

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Blood test TSH 3.40--considered "high" per lab . Has reference range changed lately? Free T4 .9 (normal range) have thyroid nodule, prolactinoma

That TSH: While technically normal is considered by many to be slightly high relative to your age. Discuss it with your rotor. Hypothyroidism can increase prolactin somewhat. If you're taking cabergoline, it needs to be taken twice a week to be effective. ...Read more

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Treatment of high serum cholestrol?

Treatment of high serum cholestrol?

Diet and exercise: If that doesn't get the job done then there are multiple medical options. ...Read more

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Is TSH and tg level indicate to recurrence thyroid cancer or tgab level? After 6 month after tt TSH is .04 and tg .2 but there is tgab should worry?

Is TSH and tg level indicate to recurrence thyroid cancer or tgab level? After 6 month after tt  TSH is .04 and tg .2 but there is tgab should worry?

No Worry: The tg level follows the thyroid cancer but is unreliable if the tgab is elevated. The tgab is only relevant if it is elevated. The TSH is used to follow your thyroid hormone levels and 0.04 is an appropriate level. ...Read more

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Is TSH and tg level indicate to recurrence thyroid cancer or tgab level? After 6 month after tt TSH is .04 and tg .2 but there is tgab should worry?

TgAb: It depends upon what the tgab level is. If the tgab levels are less than 22 iu/ml or 4 iu/ml depending upon which assay your laboratory uses, then there is no concern. If the tgab levels are elevated, the tg (thyroglobulin) test results are unreliable and your doctor may order other tests such as neck ultrasound or nuclear total body iodine scans. The TSH level is where it should be. ...Read more

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TSH is constantly suppressed.FT3 borderline high. FT4 borderline low. Tested 5 times. Thyroid uptake scan = *low 5.3% wo nodules. Please help explain.

TSH is constantly suppressed.FT3 borderline high. FT4 borderline low. Tested 5 times. Thyroid uptake scan = *low 5.3% wo nodules. Please help explain.

Thyroiditis: Why are you having your thyroid tested? what are your symptoms? start from the begining. Medicine is not about scans and numbers. TSH is suppressed by the elevated T3 (liothyronine) as feedback inhibition. I would expect normal to high uptake but it can be low in some cases of Hashimoto's thyroiditis. thyroid scan in Hashimoto's thyroiditis can mimic a wide range of thyroid disorders. Thyroid may be burning out. ...Read more

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Do i need treatment if my TSH 7.69 high normal free T4 and free T3 (liothyronine) and elevated thyroid antibodies?

Yes: Tsh 7.69 with high tpo is not "high normal" but high and indicates hypothyroidism. Having high tpo indicates autoimmune or hashimoto's thyroiditis. I suggest adding selenium zinc b complex and vitamin c and iodine and avoiding gluten for a month and rechecking levels in a month. If no change then you might need thyroid supplementation. ...Read more

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Dr. James Lin Dr. Lin
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My total testostorone is normal, shbg high (depakote) & free t low. A recent test: dihydrotestosterone-very high why? (psa, prostate, other tests ok)

Dr. James Lin Dr. Lin
1 doctor agreed:
My total testostorone is normal, shbg high (depakote) & free t low.  A recent test: dihydrotestosterone-very high why? (psa, prostate, other tests ok)

Okay...?: An isolated high value of a test within the described scenario may not be clinically relevant. In fact, high Dht indicates your bio-active form of testosterone is good, so it's logical not to assert much concern on your daily life. Bottom line is still your energy and ability on how to effectively take on personal and occupational life. If still in doubt, ask doc timely with optional Dht retest. ...Read more

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Have thyroglobulin very high score and thyroperoxidase very high score but normal thyroid function score. High pulse, fatigued, bouts of diarrhea?

Have thyroglobulin very high score and thyroperoxidase very high score but normal thyroid function score. High pulse, fatigued, bouts of diarrhea?

No need to treat: If the thyroid hormone and TSH are normal you can be sure that your symptoms are not thyroid-related. The high antibodies mean that your risk of developing an underactive thyroid in the future is increased so rechecking the T4 and TSH in about a year is not a bad idea ...Read more