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What Causes Elevated TSH Levels?

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Posted on Tue, 14 Apr 2015
Question: I need an Endocrinologist
My Thyroglobulin is 101.3 ng/mL (very high) and my TSH is 45.00 mIU/L ver high also,
what could be the problem?
doctor
Answered by Dr. Binu Parameswaran Pillai (4 hours later)
Brief Answer:
Hypothyroidism

Detailed Answer:
Good day.
Noted your concern.
A high level of TSH suggest uncontrolled hypothyroidism. This is either due to non compliance with medication or due to inadequacy of dosage . Thyroglobulin is a normal protein secreted by thyroid gland and there is no relevance of routine measurement if it. We measure Thyroglobulin in special situations only ( example : Follow up of thyroid cancer). More than that I small keen to know 2 things.
1. FREE T4 level
2. Anti TPO level
3. Anti Thyroglobulin level.

These will be more helpful than a Thyroglobulin level in your situation.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
Thank you for your answer. Do my tests mean that I have Thyroid Cancer or Hashimotos? Should I take a higher dose of Levothyroxine, .25 mg? I cannot tolerate a higher dosage, my heart races and I am getting hyperactive and cannot sleep.
T4 total is 1.1 (low)
T4 free 0.8
T3 uptake 27%
T3 total 73 (low)
Thyroid Peroxidase Antibodies 1 IU/ml
TSI 89 (baseline)
Thank you again, XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (11 hours later)
Brief Answer:
Synthroid preferred

Detailed Answer:
No. You don't have thyroid cancer (you need an ultrasound neck to look for that).
Since your thyroid peroxidase antibody levels are low, Hashimoto's disease is unlikely ( but not impossible). Because, some times, over a period of time, the thyroid peroxidase antibody levels can fall in Hashimotos.

The TSH suggests that you have under corrected hypothyroidism.
Well, most endocrinologists do not prefer Armor thyroid . Most of us prefer Synthroid. You may need to stop Armor and start with a low dose Synthroid first ( start with 25 mcg for one week, then increase to 50 mcg next week, then increase to 75 mcg). Please Recheck TSH after 6 weeks.
Regards
Binu
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Elevated TSH Levels?

Brief Answer: Hypothyroidism Detailed Answer: Good day. Noted your concern. A high level of TSH suggest uncontrolled hypothyroidism. This is either due to non compliance with medication or due to inadequacy of dosage . Thyroglobulin is a normal protein secreted by thyroid gland and there is no relevance of routine measurement if it. We measure Thyroglobulin in special situations only ( example : Follow up of thyroid cancer). More than that I small keen to know 2 things. 1. FREE T4 level 2. Anti TPO level 3. Anti Thyroglobulin level. These will be more helpful than a Thyroglobulin level in your situation. Regards Binu