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Thyroid stimulating harmone is little high , T3 and T4 are normal, irregular menstruation problem - Online Doctor Chats

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

General & Family Physician
Practicing since : 2005
Answered : 2584 Questions
Doctor :   Hi
Doctor :   Good evening.
Doctor :   How can I help you?
User :   Hello Doctor.
User :   My wife (26 years old) was asked to undergo a Thyroid blood test
User :   her results shows T3 and T4 as normal. whereas the TSH is 4.9 against 4.2
Doctor :   Ok
User :   so the doctor advised her to take Thyroxine 25
User :   she is taking the tablets(one per day in the night) for the past one month
Doctor :   Ok
User :   her last cycle was on April -17. she has not get her cycle this month yet. Otherwise she used get her cycle on time
Doctor :   Ok
User :   she is worried whether taking the tablet is delaying her cycle.
Doctor :   I shall explain that.
User :   sure
Doctor :   May I know if you and your wife are sexually active?
User :   yes
Doctor :   And are you trying for pregnancy?
User :   no
User :   we have one son (3 yrs old now)
Doctor :   Ok
Doctor :   Let me explain now.
User :   ok
Doctor :   Menstrual irregularities occur due to multiple reasons.
Doctor :   Hypothyroidism is one of the causes of it.
Doctor :   TSH levels at 4.9 is just under limit suggesting that hypothyroidism is under control.
Doctor :   On the contrary to your wife's believe, it is possible that the delay in the period can occur if your wife is not taking the thyroxine tablets regularly.
Doctor :   At this point, I would like to know when was her TSH done lastly?
User :   March-17, 2011
Doctor :   Ok
User :   Actually, her last cycle was Mar-18, 2011
Doctor :   Since it was just a few days back, I do not think either her thyroid problem or the medication that she is on, is the cause for the delay in the period.
User :   Ok Doctor
Doctor :   The current delay in the period might have occured due to hormone disturbances.
Doctor :   such disturbances are expected to occur in times of stress, infections, lack of sleep, reduced nutrition.
Doctor :   Rarely such symptoms can occur due to uterine conditions such as fibroid or ovarian cysts.
Doctor :   since you report this was the first episode,
Doctor :   I expect the symptoms to improve subsequenlty.
Doctor :   It is worth getting urine pregnancy test if you had involved in unprotected sexual intercourse recently - to rule out pregnancy
User :   sure, will do that.
Doctor :   If symptoms persists, then a repeat of TSH levels and gynec examination will be necessary.
Doctor :   Do you follow?
User :   Yes, Doctor
Doctor :   Do you have any other doubts that you want me to clarify?
User :   Thank you very much Doctor. I had one last thing to ask
User :   There is no thyroid history seen at her parent's side. But still she has got. 2 years back we did the same test on advise of a gynec (She was putting on weight after delivery). To ensure the weight gain is not due to Thyroid problem. the results were normal (all T3, T4 and TSH). But the TSH is 4.9 when we tested last month. May I know what could have contributed to this increase in TSH.
Doctor :   Yes, genes can contribute to thyroid dysfunction.
Doctor :   But other local factors such as reduced iodine intake, infections and other autoimmune components can lead to thyroid problems.
Doctor :   In a few women thyroid problems are associated with pregnancy.
Doctor :   It is difficult to prove which of these factor may have caused the thyroid problem.
Doctor :   Tests to see if they are auto immune or not
Doctor :   is to be highly considered.
Doctor :   As they are the most serious condiition.
Doctor :   But looking at your thyroid profile
Doctor :   the need for those tests is doubtful.
User :   Thanks for the explanation Doctor.
User :   She was having pain on her left palm. We initially consulted an ortho. took xray and underwent (ENMG) test to identify whether it is a corporal tunnel syndrome. the test results were normal. so the ortho asked us to take the thyroid blood test. In this regard, is TSH 4.9 really an alarming one?
Doctor :   Endocrinologist prefer to treat any TSH above 3.5
Doctor :   But upto 5.5 is considered under normal limits.
Doctor :   So I would say the TSH levels are not alarming.
Doctor :   * not very alarming.
User :   Ok Doctor. The Thyroid testing lab says upper range is 4.2 but some other labs give a different number as upper range. Is that how a lab marks it
Doctor :   Different laboratory have different range.
Doctor :   But like I mentioned earlier, treatment may have to be started if the values are above 3.5 and when there are symptoms of hypothyroidism.
Doctor :   I am sorry, the normal upper limit is considered as 5
User :   Ok
User :   Ok Doctor. Thanks for your time. It is really helpful.
Doctor :   * I mean i had intially mentioned 5.5.
User :   Yes, got it
Doctor :   some labs considered it as 4.5 while some at 5.
Doctor :   Hope it is clear.
Doctor :   Do you have any other query?
User :   No, Doctor.
User :   thanks once again
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
User :   Bye
Doctor :   Have a nice day!!
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