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Weight gain, fatigue and increased appetite. TSH level is 1.50. What does it mean?

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Internal Medicine Specialist
Practicing since : 1980
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I have had many symptoms of a thyroid issue for 3 months now: excessive weight gain (10 lbs per month), fatigue, body aches, dull headache, increased appetite, my menstrual cycle has been "weird" (2 days a month now of spotting), feeling cold, irritable/more emotional. MY TSH came back at 1.50 and my Free T4 was .9 What does that mean?
Posted Sat, 30 Nov 2013 in Headache and Migraines
Answered by Dr. Rakesh Karanwal 1 hour later
Brief Answer: It will take 3-4 months time improvement begins Detailed Answer: Hi XXXXXXX Thanks for your query. Firstly, all problems- except for increased appetite- are typical features of Hypothyroidism, that is, thyroid gland is producing inadequate amount of the hormone called Thyroxin. I presume that you are on regular Synthroid (thyroxin hormone). Further, may I inform you that Thyroid hormone is one of the slowest acting hormone. It takes 3-4 months to see its effects, AFTER the TSH level reaches near-target level. The target of TSH is to bring it down and maintain it to 1.0 or less. Hence, as your TSH level has already come done to 1.5, you will start feeling better (onset of weight loss, normalization of periods, reduction in fatigue, body aches and hair fall, only AFTER 3-4 months from now. So, you have NO OPTION but to be patient! In my medical practice since 33 years, I follow a slightly different regime : I keep on increasing the dose of Synthroid till TSH level comes down to less than 0.1 and maintain the dose of Synthroid till such time the patient is free from all symptoms and feels absolutely normal. Thereafter, I start reducing the dose of Synthroid gradually, letting TSH rise to between 1-2 and maintain it at that level. Secondly, regarding your headaches which- along with irritability and emotional upsets- point towards tension headache/migraine. I therefore recommend that a regular course of a combination of anti-depressants with anti-anxiety and beta-blockers, will not only relieve you of headaches, irritability and mood swings, but also cure your headaches completely. You may therefore discuss my opinion/recommendation with your treating doctor, who- I am sure- will totally agree with me and, thereby prescribe the advised drugs in appropriate doses. Lastly, rapid weight increase with increased appetite may indicate yet-undiagnosed diabetes. Blood sugar levels will rule out or confirm early diabetes, as the case may be. Hope you find my response helpful and informative. I will be only too happy to help you in case you have further queries, if any. Dr. Rakesh Karanwal
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Follow-up: Weight gain, fatigue and increased appetite. TSH level is 1.50. What does it mean? 4 hours later
Thanks but I wasnt diagnosed with hypothyroidism. I just got those blood tests done and wanted to see if a free t4 level of .9 and tsh of 1.5 could mean hypothyroidism. I have had these symptoms for 3 no this and want yo alleviate such.
Answered by Dr. Rakesh Karanwal 8 hours later
Brief Answer: Thyroid hormones report is normal Detailed Answer: Hi XXXXXXX Nice hearing from you again. I have now understood what you meant. * Firstly, T4 and TSH levels are within normal range. Hence, the possibility of hypothyroidism has been excluded for the time being. I advise you to kindly have these tests repeated after 3 months. * In the light of your clarification, there are just two conditions which fit your symptoms :- 1. Diabetes 2. Polycystic Ovarian Syndrome - characterized by hair loss, weight gain, fatigue, menstrual irregularities, body aches, mood swings and male type hair pattern, to name a few. 3. Rare causes include tumors of ovaries or adrenal glands (located on top of the kidneys. Please consult your doctor, discuss my opinion with him and am sure that he will agree with my opinion. He will order blood sugar profile, ultrasound/CT of uterus, ovaries and adrenal glands; female hormones' levels, blood Insulin levels and other relevant investigations. Based on the tests' findings, he will reach to a diagnosis and start appropriate treatment. Please do take treatment for mood disorders, as already advised. Hope you find my response helpful and informative. I will be happy to answer further clarifications, if any. In that event, I will request you to as many details as possible, even those which you feel are unrelated to your present condition. Fond regards, Dr. Rakesh Karanwal
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