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Dr. Andrew Rynne

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What does elevated TSH level indicate?

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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 2687 Questions

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Posted on Mon, 11 Aug 2014 in General Health
Question: Hi,
detailed medical reports of my mother are attached below.Kindly examine and advise if tests are normal or any specific consultation/re-test should be done
I have 2 questions-
1). I notice TSH levels are high. does this indicate subclinical hypothryoidism. what can be done to make sure this doesnt advance further.
2) what about the triglycerides and alkaline phosphate values and heamogram results. should we be concerned about any of these.
i would request you to give comments about each and every test point by point.
thanks in advance
doctor
Answered by Dr. Prasad 18 hours later
Brief Answer:
May I know your current symptoms...

Detailed Answer:
Hi,

I went through the reports attached. Findings need to be clinically correlated for better interpretation, therefore I wish to know the symptoms you had before undergoing tests. What your current weight and height are? Do you have symptoms suggestive of hypothyroidism.

Specific answers to your question, based on the details provided are:
1. Yes, a high TSH value with no clinical symptoms is suggestive of subclinical hypothyroidism. I ask for free T3 and free T4 test. If needed an endocrinologist review is needed before we start thyroid supplements.
2. Without understanding the current thyroid state it is difficult to comment on the prognosis of thyroid. However on most occasions, hypothyroid disorder is a persistent condition. Medicines are prescribed for long run.

2. Your triglyceride value is high. Perhaps it may be related to your body mass index. Fibrates +/- statin drugs should be considered. Life style change is important too.

3. ALP value at this point is not concerning. It should be followed up.

4. Hemogram shows insignificant findings. ESR of 70 is non specific. It needs to be clinically correlated before we ignore it. Discuss with your treating physician.

Hope I answered all your questions.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 49 minutes later
Hi thanks for your reply.

Can you pls clarify on additional tests

Should we get the free T3 and T4 tests done before visiting endocrinologist?

What do you mean by ALP value should be followed up?

Thanks.
doctor
Answered by Dr. Prasad 14 hours later
Brief Answer:
Test required before starting treatment...

Detailed Answer:
Hi,

1. Visiting a doctor / endocrinologist before further tests is a better option. She may need other tests such as anti TPO antibiody test based on clinical evaluation. All the test can be performed along with free T3 and T4 value simultaneously.

2. ALP rise is associated with bone disorder as well as liver. It is also seen elevated in some people with hypothyroidism. Without a detailed medical history and clinical examination finding, I am unable to comment about this elevation. However ALP number is not alarmingly high. You can discuss with the treating doctor about it. Presuming its related to thyroid disturbance, the value may change with thyroid treatment. Your doctor can retest it after treatment.

Hope I make sense now. Let me know if you still need clarity.

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