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Should Levothyroxine Be Prescribed While Having Subacute Thyroiditis?

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Posted on Mon, 4 Sep 2023
Question: i have a question about subacute thyroiditis. after T4 and TSH have normalized then 2 months later TSH is 5.89 should Levothyroxine 75 mcg be prescribed?
doctor
Answered by Dr. Mirjeta Guni (23 minutes later)
Brief Answer:
About subacute thyroiditis and high TSH:

Detailed Answer:

Hello,

Subacute thyroiditis is often followed by hypothyroidism that may be transitory or permanent.

I usually suggest to my patients to start 50 mcg of levothyroxine if the hypothyroidism symptoms are present and keep monitoring TSH every 2 months, if there will be a tendency to be lower than normal, stop levothyroxine because the thyroid may have recovered.

You need to check also anti-TPO and anti-Tg antibodies to rule out Hashimoto thyroiditis that may have been present before subacute thyroiditis is installed. If they are high, it means that levothyroxine treatment will be long term.

Regards,
Dr. Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni (36 minutes later)
The antibodies have been checked and are not elevated. Also a small nodule was examined and showed no abnormalities. I am concerned that the medication with TSH so low - 5.89 - is unnecessary especially since it was in the normal range mid-May at 4.60. I’m concerned that taking the meds for 6 months may suppress my body’s Natural hormonal levels.
doctor
Answered by Dr. Mirjeta Guni (1 hour later)
Brief Answer:
About hypothyroidism caused by subacute thyroiditis

Detailed Answer:

Hi,

If the antibodies are negative, than it may be a transitory hypothyroidism caused by subacute thyroiditis.

If you do not have symptoms of hypothyroidism (feeling sleepy, weight gain, feeling cold etc.) you may keep monitoring TSH every 2 months and start treatment if there will be a tendency to get higher.

Regards,
Dr. Mirjeta
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Should Levothyroxine Be Prescribed While Having Subacute Thyroiditis?

Brief Answer: About subacute thyroiditis and high TSH: Detailed Answer: Hello, Subacute thyroiditis is often followed by hypothyroidism that may be transitory or permanent. I usually suggest to my patients to start 50 mcg of levothyroxine if the hypothyroidism symptoms are present and keep monitoring TSH every 2 months, if there will be a tendency to be lower than normal, stop levothyroxine because the thyroid may have recovered. You need to check also anti-TPO and anti-Tg antibodies to rule out Hashimoto thyroiditis that may have been present before subacute thyroiditis is installed. If they are high, it means that levothyroxine treatment will be long term. Regards, Dr. Mirjeta