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Dr. Andrew Rynne

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What causes abnormal TSH levels despite taking Synthroid?

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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Thu, 10 Sep 2015 in Thyroid Problem and Hormonal Problems
Question: What would atribute a Tsh of abnormal range 0000 be continous for almost 9 moths, My Sybthroid has been decreased four times with nochange down to 25 mg
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Answered by Dr. Shehzad Topiwala 46 minutes later
Brief Answer:
Thyroid

Detailed Answer:
I follow what you are saying.

Thyroid management can be complex and is best handled by a trained endocrinologist in person.

When I see someone in my practice with similar laboratory results, I order the following tests in addition to a thorough physical examination:

CBC
CMP
TSH
Free T4
Total T3
T3 resin uptake
anti TPO antibodies
anti Thyroglobulin antibodies
Prolactin
FSH
LH
8 am serum cortisol

It is possible that on that basis of findings on physical examination I may order fewer tests or more tests.

There is an uncommon condition called Central or Secondary Hypothyroidism that needs to be ruled out.

Moreover, there are certain types of medications that tend to lower the TSH such as steroids and opioids.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala 26 minutes later
Would you consider hunchimoto disase that may be affecting the thyroind galnd?
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Answered by Dr. Shehzad Topiwala 3 hours later
Brief Answer:
Follow up

Detailed Answer:
You are probably referring to Hashimoto's disease.

Yes it is one of the most commonest causes for a permanently under-active thyroid, necessitating lifelong treatment with levo thyroxine (of which Synthroid is one brand name medication).

The two antibody tests mentioned above are helpful is diagnosing this condition. Other indications as to whether it is present come from physical examination.

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