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Reports show TSH level is high. Suggest

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Practicing since : 2004
Answered : 319 Questions
Dear Doctor,

You helped us with several queries a couple of weeks ago, and I am writing to you to follow-up. Here's a link to the previous thread: WWW.WWWW.WW
My wife's reports have come, and I've attached that with this query for your kind perusal.

Many thanks,
Posted Mon, 17 Jun 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Om Lakhani 1 hour later

I have gone through the new reports that you have sent. The Anti TPO is negative and the other hormonal tests are also fine. The TSH level is high and suggestive of Subclinical hypothyroidism like I suggested last night, however since the TPO is negative there is no indication for treatment as of now. With Anti TPO negative the risk of progressing to overt hypothyroidism is <2 % per year. However I would advice you to get done a thyroid function test annually.

The other hormonal tests are fine. The Testosterone in this report is normal, so probably the earlier report was false positive.

I think she is doing well and just fine. Just have an annual thyroid check up thats all. For Hyperacidity we generally prescribe Pantoprazole with Lesuride combination to be taken once a day in the morning 30 min before breakfast.

Dr. Om Lakhani.

Above answer was peer-reviewed by
Follow-up: Reports show TSH level is high. Suggest 1 hour later
Dear Doctor,

Over the last 1 year, her TSH level has increased from 3 to more than 7. We are a little worried about it. She is having several symptoms that are suggestive of hypothyroidism (like increased sensitivity to cold, weight gain of 7 kilos in 1 year, severe hair fall, weakness, etc.).

I should also mention that her mother has hypothyroidism, and is under medication for the same.

I should have provided you with this information perhaps earlier, but given this history, would you recommend medication to her at the moment, or is she fine without any medication?

Many thanks for your kind help.

Answered by Dr. Om Lakhani 11 hours later

Given the fact that her Anti TPO is negative at the moment there is no indication per se to start on thyroid medications. What she has is subclinical hypothyroidism and not overt hypothyroidism which means that even though TSH Is high, her thyroid hormones are normal. Hence the symptoms you described as not because of thyroid problem per se.

I understand the fact that her TSH is increased, however even with her increased TSH, her thyroid hormones T3/T4 are still normal, which is a good sign in itself. With her TPO negative her risk of progressing to over hypothyroidism is low.

I would still advice a routine thyroid function testing. If the TSH goes >10 then there night be indication for treatment else no. Remember giving thyroid hormone without indication is not without risk and I wouldn't recommend it !

I will tell you a interesting thing, American academy of clinical endocrinologists say that more people without thyroid problems have symptoms associated with hypothyroidism then people with hypothyroidism !!

So dont worry, as of now there is no requirement for thyroid replacement

Dr. Om Lakhani.
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