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Taking synthroid for hypothyroidism. Getting headache. Should I consult endocrinologist?

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
I have a TSH of .08. This has been low for about a year. My T4 and T3 levels are within normal range, the last blood work showed on the higher end but, still normal. I am on synthroid for hypothyroidism. I had an MRI done a couple years ago and it showed no tumors on the pituitary gland. My doctor wants me to see an Endocrinologist. If I had an idea of why I should do that , maybe I would. I get headaches but nothing I can't live with.
Posted Sun, 31 Mar 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Rahul Tawde 9 hours later
Thanks for writing in. Your TSH could be supressed because of slight overdosage of synthroid. The fact that your t4 and t3 were in the higher end supports this. TSH is a more sensitive index of thyroid status and changes ling before t3 and t4 change. So in early hypothyroidism only TSH is elevated while T3 and t4 are still normal. Similarly in hyperthyroidism and thyroxine overdosage TSh gets suppressed before t3 and t4 are elevated. So first thing to do is to reduce the synthroid dosage and repeat thyroid profile after 4-6 weeks. Im sure TSh would then drift towards normal. In primary hypothyroidism dosage adjustment is based primarily on TSH and since your TSH is suppressed it is necessary that you reduce the dose - the simplest thing is to take the same dose that you are on for six days a week from monday to saturday instaed of all days. Repeat the test after 6 weeks if TSH is still suppressed further dosage reduction may be needed.
Hope this helps
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Follow-up: Taking synthroid for hypothyroidism. Getting headache. Should I consult endocrinologist? 15 hours later
Dr XXXXXXX First thank you for explaining this too me. This makes allot of sense because when I was first diagnosed about 13 or 14 years ago with hypothyroidism my blood work was normal and then a year later there was pretty much no function to my thyroid. I am a little confused. Are you saying that there may be a possibility of me now becoming hyperthyroid. What should I look for in symptoms? Can you be hypo and hyper at the same time? XXXXXXX
Answered by Dr. Rahul Tawde 5 hours later
No no. I meant thyroxine over replacement causing high thyroxine levels in blood and hence causing symptoms similar to hyperthyroidism. You cant be hypo and hyper at same time. But if a hypothyroid patient is overtreated they can have symptoms of hyperthyroidism like weakness, anxoety, palpittion, tremors, weight loss etc. TSH will also get suppressed. These are transitory and once thyroxine dosage is reduced TSH will come back to normal and symptoms will redolve. But that patient will always require some thyroxine to maintain normal thyroid status.
Hope this helps.
Above answer was peer-reviewed by
Follow-up: Taking synthroid for hypothyroidism. Getting headache. Should I consult endocrinologist? 18 hours later
Thank you so much for your help. If you decide you need a change, we don't have an Endocrinologist in our area... I am sure you would be kept very busy. XXXXXXX
Answered by Dr. Rahul Tawde 8 hours later
Thanks. No issues. Im always ready to help you.
Above answer was peer-reviewed by
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