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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is Your Opinion About Increasing Synthroid If Having Elevated Levels Of TSH And Normal Free T4?

I had a total thyroidectomy 1 year ago. My levels have consistently had an elevated TSH latest of 26 and normal Free T4 of 1.7. My doctor has been decreasing my dose of Synthroid but I think it should be increased. He says no because thefree T4 if gets elvated could cause problems. Please advise.
Tue, 22 Jul 2014
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Endocrinologist 's  Response
Hello thanks for contacting health care magic.
Going through your history I find that you are having primary hypothyroidism post thyroidectomy. which is diagnosed by elevated TSH. T4 may be normal or below normal range. Treatment is usually started when TSH is more than 10. And target TSH while on treatment is 0.5-3.0. In your case it is 26. That means your pituitary gland is over functioning (over exerting) in order to keep T4 in normal range. Which it is very well doing that is why your T4 is in normal range. And that also mean your pituitary is overburdened to keep it in normal range. Please take your medicine regularly and in proper dose as uncontrolled hypothyroidism is associated with ill effects. Not to frighten you but need to say ill effects like premature atherosclerosis leading to coronary artery disease(heart disease).
Bye Take care have a good day
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What Is Your Opinion About Increasing Synthroid If Having Elevated Levels Of TSH And Normal Free T4?

Hello thanks for contacting health care magic. Going through your history I find that you are having primary hypothyroidism post thyroidectomy. which is diagnosed by elevated TSH. T4 may be normal or below normal range. Treatment is usually started when TSH is more than 10. And target TSH while on treatment is 0.5-3.0. In your case it is 26. That means your pituitary gland is over functioning (over exerting) in order to keep T4 in normal range. Which it is very well doing that is why your T4 is in normal range. And that also mean your pituitary is overburdened to keep it in normal range. Please take your medicine regularly and in proper dose as uncontrolled hypothyroidism is associated with ill effects. Not to frighten you but need to say ill effects like premature atherosclerosis leading to coronary artery disease(heart disease). Bye Take care have a good day