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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Reason For Increasing TSH Despite Taking Thyronorm?

hello my father is 85 and is on thyronom 50 since last three years. his t3 and t4 are within range of the testing lab. three months ago his tsh was 6.1 which was just outside the lab range of 5.6. after three months its gone up to 11 inspite of his continuing the med. what is the problem nosh
Thu, 27 Mar 2014
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Endocrinologist,  's  Response
Hello,
Good day.
TSH is a hormone produced by the pituitary gland in response to the level of T3 and T4 . TSH also varies for a number of reasons including cold weather, recovering from a fever etc. Noted that your Dad's t4 and t3 are in normal range. In Old age, TSH rises for a good reason. Body is trying to slow down the metabolism. There are ample evidence that TSH is slightly on the higher side in old age. That infact has a protective effect. However, if the TSH is in the range of 11, he may need to increase the dose of Thyronorm slightly .

At this age, I wouldn't push up the dose of Thyronorm just based on a single TSH reading, but will repeat the TSH in a good lab ( using a third generation hormone assay like CLIA) . Make sure that you check the TSH in the mornings.
Write to me after you have repeated the TSH value along with a Free T4 (FT4) in empty stomach before taking that day's tablet. Again, please do the test in a good lab.

Regards
Binu
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Reason For Increasing TSH Despite Taking Thyronorm?

Hello, Good day. TSH is a hormone produced by the pituitary gland in response to the level of T3 and T4 . TSH also varies for a number of reasons including cold weather, recovering from a fever etc. Noted that your Dad s t4 and t3 are in normal range. In Old age, TSH rises for a good reason. Body is trying to slow down the metabolism. There are ample evidence that TSH is slightly on the higher side in old age. That infact has a protective effect. However, if the TSH is in the range of 11, he may need to increase the dose of Thyronorm slightly . At this age, I wouldn t push up the dose of Thyronorm just based on a single TSH reading, but will repeat the TSH in a good lab ( using a third generation hormone assay like CLIA) . Make sure that you check the TSH in the mornings. Write to me after you have repeated the TSH value along with a Free T4 (FT4) in empty stomach before taking that day s tablet. Again, please do the test in a good lab. Regards Binu