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What Causes Elevated TSH Levels While On Sprintec?
Question: My wife was taking Sprintec (birth control) for the last 3 weeks. During this time, she was given a TSH blood test in the course of a normal physical exam. Her TSH level was much higher than it had been in tests taken 1 and 2 years ago. I have read that birth control pills may cause higher TSH levels. Assuming this is true (is it?), how long should she be off the pill in order to re-take her TSH test for a more accurate measure?
Brief Answer:
I would recommend to check the TSH 2 months later.
Detailed Answer:
Hello,
Thank you for asking on HCM!
Yes, it is confirmed that estrogens may raise the TSH level.
The TSH needs about 6-8 weeks to get normalized when you change the dose or remove the cause that may affect it.
So I would recommend to check it 2 months after stopping the birth control.
Hope the information will help.
Kind Regards,
Dr.Mirjeta
I would recommend to check the TSH 2 months later.
Detailed Answer:
Hello,
Thank you for asking on HCM!
Yes, it is confirmed that estrogens may raise the TSH level.
The TSH needs about 6-8 weeks to get normalized when you change the dose or remove the cause that may affect it.
So I would recommend to check it 2 months after stopping the birth control.
Hope the information will help.
Kind Regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thanks. Her doctor ordered another TSH test this morning, but she took her last pill 36 hours before her blood was drawn. Do you think this short time will make any difference in her TSH level?
Perhaps importantly, we are about to do IVF and she's been on birth control just for a few weeks just in the beginning in order to time her period, etc. Her doctor specifically stated that "the birth control has no effect on TSH", which is inconsistent both with what you said and other things I've read. He then prescribed for her "levothyroxine 50 mcg tablets". I'm concerned about (1) her taking a medication that she may not actually need, but (2) whether she does need it now, regardless of the cause, to increase the likelihood of successful IVF.
Last, if you have any thoughts on what to say to her doctor, we're open to hearing them.
Please advise.
Thanks!
XXXXXXX
Perhaps importantly, we are about to do IVF and she's been on birth control just for a few weeks just in the beginning in order to time her period, etc. Her doctor specifically stated that "the birth control has no effect on TSH", which is inconsistent both with what you said and other things I've read. He then prescribed for her "levothyroxine 50 mcg tablets". I'm concerned about (1) her taking a medication that she may not actually need, but (2) whether she does need it now, regardless of the cause, to increase the likelihood of successful IVF.
Last, if you have any thoughts on what to say to her doctor, we're open to hearing them.
Please advise.
Thanks!
XXXXXXX
Brief Answer:
The strategy I propose;
Detailed Answer:
Welcome back!
Before starting an IVF procedure, the TSH level should be below 2.5 mUi/ml. This is very important.
I think that the TSH is checked too early. To judge about the cause that has raised the TSH, you should check also the antibodies (Anti TPO and antiTg) that cause Hashimoto thyroiditis and if they are high, Levothyroxine should be started and the dose corrected 2 months later when the estrogen effect is diminished.
So, if the TSH is slightly elevated and the antibodies mentioned above are negative I would suggest not to start the IVF procedure but to recheck the TSH after 2 months.
If the TSH is high and the antibodies are above the normal ranges it means that she has primary hypothyroidism caused by an autoimmune process and treatment should be started. Two months later the dose needs to get reduced probably as the effect of estrogen is reduced. Once you have confirmed that the TSH is below 2.5 you should try IVF.
Hope I have been clear now, feel free to discuss.
Wish you good health!
Regards,
Dr.Mirjeta
The strategy I propose;
Detailed Answer:
Welcome back!
Before starting an IVF procedure, the TSH level should be below 2.5 mUi/ml. This is very important.
I think that the TSH is checked too early. To judge about the cause that has raised the TSH, you should check also the antibodies (Anti TPO and antiTg) that cause Hashimoto thyroiditis and if they are high, Levothyroxine should be started and the dose corrected 2 months later when the estrogen effect is diminished.
So, if the TSH is slightly elevated and the antibodies mentioned above are negative I would suggest not to start the IVF procedure but to recheck the TSH after 2 months.
If the TSH is high and the antibodies are above the normal ranges it means that she has primary hypothyroidism caused by an autoimmune process and treatment should be started. Two months later the dose needs to get reduced probably as the effect of estrogen is reduced. Once you have confirmed that the TSH is below 2.5 you should try IVF.
Hope I have been clear now, feel free to discuss.
Wish you good health!
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
See below;
Detailed Answer:
Hi,
If Hashimoto thyroiditis is excluded as the cause of the high TSH, than the birth control pills should have caused it.
TSH level 7.0 does not cause serious side effects to the wife's general health but it may be the cause of infertility, spontaneous abortion or may affect the fetus development. That is why is not recommended to plan a pregnancy as far as TSH level is high.
Will be a pleasure to answer further queries.
Best wishes,
Dr.Mirjeta
See below;
Detailed Answer:
Hi,
If Hashimoto thyroiditis is excluded as the cause of the high TSH, than the birth control pills should have caused it.
TSH level 7.0 does not cause serious side effects to the wife's general health but it may be the cause of infertility, spontaneous abortion or may affect the fetus development. That is why is not recommended to plan a pregnancy as far as TSH level is high.
Will be a pleasure to answer further queries.
Best wishes,
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. Yogesh D
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