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Cause of fluctuating TSH with normal T3 and T4 values - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Hi, I am 25 years old and I am suffering from Hypothyroid. The TSH count initially was 10.35. I consulted a doctor and was advised to take Thyronorm 75mcg and show him after 2 months. After 2 months, the TSH count reached 0.02. On showing the doctor again, I was asked to decrease the dosage to Thyonorm 50mcg. After 3 months when I checked the TSH count again. It was back to 9.5. I am not sure why there is this fluctuation? What are the harms of this fluctuation? Also, My T3 and T4 counts seem to be normal through out. Could anyone please advice?
Doctor :   Hi
User :   Hi
Doctor :   I am Dr.XXX, here
Doctor :   Let me read your query
User :   Hi, Dr, XXX,
Doctor :   Ok
Doctor :   May I know your age?
User :   I am 26yrs now
Doctor :   Fine, I got it
Doctor :   Were your T3 and T4 levels normal even previously?
User :   yes
Doctor :   like when your TSH was above 10
User :   yes, they were normal even then
Doctor :   Ok
Doctor :   Have you got the free T3 and free T4 levels tested?
User :   I am not sure what is free T3 and free T4?
Doctor :   Ok
Doctor :   So you should get that tested first
Doctor :   if that is low, then it can be commented
User :   is it different from the normal T3 and T4 tests?
Doctor :   Free hormones are the main active hormones
Doctor :   there are 2 components
Doctor :   bound and free
Doctor :   normal levels measure in total
User :   ok
Doctor :   The free levels does influence the TSH levels
Doctor :   also TSH levels can rise up
User :   the bound levels dont?
Doctor :   due to stress, infection and other health problems as well
Doctor :   the bound levels is the reserved part
Doctor :   so if the free part is less, it shall stimulate the body to secrete more TSH
User :   I am currently suffering from cough too. Can it be a reason for the high TSH levels?
Doctor :   Sure, it can alter your TSH levels
Doctor :   meaning increase it
User :   ok
User :   I am get my free T3 and T4 levels tested.
Doctor :   ok
User :   Since the last TSH report, which showed the TSH level as 9.5. I have not been able to show the doctor. But I have started taking 75mcg of Thyronorm that was earlier adviced by doctor
Doctor :   Ok
User :   Was that a correct move to take?
Doctor :   Now dose has to be regulated
Doctor :   along with regular follow ups with the blood test
User :   ok
Doctor :   has the doctor advised for monthly or quarterly thyroid profile?
User :   in 2 months
Doctor :   Ok, that is good enough
Doctor :   to keep your thyroid status updated time to time
User :   I have not been very sincere lately with it.
Doctor :   ok
Doctor :   Atleast once in 3 months, I suggest
Doctor :   if you are not having any symptoms
User :   Doctor I want to know how dangerous is Thyroid?
Doctor :   or if you are feeling better with treatment
Doctor :   it is not dangerous at all
Doctor :   there is no danger in it
Doctor :   but dose regulation is important
Doctor :   thats it
User :   Symptoms: I am gaining weight, I am losing hair, some times I get rashes on the skin
Doctor :   Ok
Doctor :   they are low thyroid features
Doctor :   shall start reducing with thyronorm treatment
User :   i.e. low production of thyroxin right?
Doctor :   yes
User :   Will I lose weight later on?
Doctor :   sure
Doctor :   but diet and exercise are also important
User :   okay. What is adviced as a part of diet?
Doctor :   normal one for weight loss
Doctor :   like restricted calories
User :   ok
Doctor :   lots of fruits and veggies
User :   As a girl, the internet says, thyroid causes problems in pregnancy and reproduction.
Doctor :   Yes, that is if left untreated
Doctor :   if the problem is maintained with correct medicines
User :   okay
Doctor :   then no issues with fertility
User :   ok
Doctor :   Is there any thing else I can help you with?
User :   How does T3 and T4 counts effect? I mean if my T3 and T4 counts are in control, is it a positive sign?
Doctor :   Yes it is
User :   Is there anything in specific that you want me to take care?
Doctor :   Follow up with blood tests and doctor's consultation
Doctor :   Weight control
User :   okay Doctor
User :   Thank you so much for this
User :   It helped me a lot. I was very tense about this disorder
Doctor :   Sure, pleasure helping you
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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