Brief Answer: TSH=Thyroid Stimulating Hormone Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this elevated level of thyroid stimulating hormone. TSH is a hormone that stimulates the thyroid gland to produce thyroid hormones which are T3 and T4. When the thyroid cannot respond to this by producing higher levels of T3 and T4, this level would keep rising. This is typical in a case of hypothyroidism. This because higher levels of these hormones are needed to stop TSH from rising. So whenever TSH is high, most likely T4 and T3 would be low. During treatment synthroid would suppress the TSH levels and bring it down to the normal range. If while on synthroid the numbers are still high, it means you are not receiving enough supplements. This would be followed by a clinical assessment to consider increasing the dosae of synthroid to make you feel better. How much synthroid supplement you need can only be determined by how well you feel and what the TSH numbers are. There are patients who need just 25mcg while others need as much as 200mcg. Only monitoring can tell who needs more and who doesn't need more. I think your doctor has done the right thing increasing your dose. If you should not feel a lot better or the TSH stays high, he may consider to increase again. However, if the TSH becomes too low, he may want to reduce it again and look for what works bes for you. In all, only titration would determine what dosage works best for you. I hope this addresses your query fully. If you have more related questions, feel free to ask me and I will gladly address them. I wish you the bes of health and thank you so much for using our services. Dr. Ditah, MD.

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Brief Answer: This shosw that you are not being well treated! Detailed Answer: Hi and thanks for this follow up. A vey low T4 further supports the fact that you are being under treated for there is no reason to continue having very low values like these while on treatment. The reported weight gain is a sign of hypothyroidism, which supports the diagnosis of an under treated hypothyroidism. Talk to your doctor to adjust your drug dosage accordingly. If he is unable or not an endocrinologist, please request for a referral for specialist consult and treatment. I wish you well and keep me posted as you navigate through this process. Unfortunately, I cannot adjust your dosages here but only provide advice for various reasons! Dr. Ditah, MD.

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