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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest remedy for tiredness, weight gain and constipation

Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1418 Questions

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Posted on Mon, 12 Oct 2015 in Thyroid Problem and Hormonal Problems
Question: My tsh level is 5.8 and has previously been 9. My doctor says he won't put me on anything as my t4 reading is in normal range (13) however I'm ridiculously tired, gained 1.5 stone in 1 month and am very constipated. I'm 20 years old and although it's young, I've been known to have a high matabolism. I would like a second opinion on this? My family also has a family history of thyroid problems. My mum has graves and her sister (my auntie) has hashimotos.
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Answered by Dr. Binu Parameswaran Pillai 44 minutes later
Brief Answer:
Sub Clinical Hypothyroidism

Detailed Answer:
Good day,
Noted your concern. Your T4 is normal and TSH is high. This is called as subclinical hypothyroidism.

In pregnancy, for sure, we would treat this condition and like to keep TSH with in trimester specific cut offs ( between 0.1 to 2.5 in first trimester).

Outside the pregnancy setting, in subclinical hypothyroidism, there is no clear cut guidelines regarding treatment. Most endocrinologists would opt to treat if the TSH is above 10. Otherwise, many prefer to observe.

However, generally, many endocrinologists would treat a TSH value of above 4.5 and below 10 if one or more of the following are present.

1) Infertility.
2) Presence of goiter.
3) An elevated Anti TPO antibody.
4) Abnormal cholesterol profile
5) Metabolic syndrome.

Since you are tired, I would suggest to get a Free T4 ( Ft4) , Anti TPO antibody, lipid profile and an 8 AM serum cortisol done. This will guide us further if treatment is warranted or not.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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