How to normalize TSH levels?

Posted on Wed, 29 Oct 2014 in Thyroid Problem and Hormonal Problems
Question: I had a complete thyroidectomy. In July, my TSH was .7. In September, I was on Cipro for a kidney infection and didn't realize that I should take it 6 hours apart from my Armour thyroid. During a recent physical, my TSH is 46. My endo ordered more tests to verify such a high number, but I feel horrible...tired, muscle weakness, heavy feeling in my neck, clavicle, and throat. What is the usual course of action for a doctor to return my TSH to normal?
Answered by Dr. Saumya Mittal 1 hour later
Brief Answer:
I would start thyroid replacement

Detailed Answer:
I am Dr Mittal.
I have read your query.

The best way to answer your question would be to explain to you the way it works.

Thyroid hormones are secreted as a result of stimulating effect of TSH. When thyroid was producing excess thyroid hormone levels, TSH was low. Now that thyroid levels are gone, TSH is secreted excessively to stimulate thyroid hormones. Thyroid gland has been removed, so body creates more TSH.

The best way to control the symptoms would be to take thyroid medicines. It is regularly prescribed by the doctor to people who had a thyroid surgery

At those levels, I will suggest that you can get a initial dose of 100 mcg and then step up from there. If you can let me know your body weight, last dose, and last test report, I think I will be able to make a better suggestion on the dose of the medicines.

Your symptoms all are suggesting hypothyroidism. Almost text book features.

Best if luck.
Dr Mittal...

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Saumya Mittal 1 hour later
Thank you. I typically take 30 mcg (1/2 of a 60 mcg tablet daily). My last dose of Armour was 60 mcg on October 1 at 8 AM. I weigh 105. My lab results were from 9/24/14:
TSH: 46.8 uIU/mL
Free T4: .76 ng/dL
Free T3: 3/1 PG/ML
Answered by Dr. Saumya Mittal 8 hours later
Brief Answer:
go to 100 mcg

Detailed Answer:
by the calculation, your ideal thyroid needs should settle around 150 mcg.
However, that is a very high dose to get to straight off.
I would suggest stepping up to 100 mcg.
Repeat thyroid profile after 2 months.
If TSH is still low, we can then move to 150 mcg.

I hope that helps.
Dr Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Saumya Mittal


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