# Sudden drop in TSH? (2.5 months)



## glasstheme

Hi everyone, I was very happy when I found this forum because I'm currently living abroad and I need some help with understanding odd lab results.

Here's the story in short: Female, 25. Diagnosed with Graves and Hashimotos at age 9. No problems since the early teens and in general stable lab results. Currently on 150 micrograms levothyroxine.

A week ago I went to my uni clinic because I had been feeling unusually tired, had joint pain, frequent headaches and enlarged lymph nodes on the neck which had been there for 2 months. The doctor ordered a blood count and also FT4 and TSH levels which annoyed me slightly because I had checked them right before I left home approx 2.5 months earlier and everything had been fine.

Got the results today and it's crazy crazy, in 2.5 months I've gone from a TSH level well within the normal range to 0.069 uIU/mL (with ref.range of 0.270-3.20). The FT4 is now 19.49 pmol/L (ref range 12.0-22.0), this is the same reference range as my hospital at home and when I left home they were at ~14 pmol/L. So they are normal but elevated compared to the last test.

Does anyone have a clue about that would have caused this sudden decrease in TSH? I haven't had any problems with my thyroid for years and years... Any suggestions would be much appreciated

The doctor performing the tests isn't a specialist and he wanted to lower my meds, I'm trying to decide if I should just ignore it until I come home in early January or if I need to find a specialist here. I'm reluctant to follow his advice when he can't even explain properly why this has happened...


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## glasstheme

Hah, fantastic, the first thing I manage to do is to post this in the wrong sub-forum. It was meant to go in the lab results discussion of course... If any mod would like to move the thread it would be great 

(so sorry!)


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## Andros

glasstheme said:


> Hi everyone, I was very happy when I found this forum because I'm currently living abroad and I need some help with understanding odd lab results.
> 
> Here's the story in short: Female, 25. Diagnosed with Graves and Hashimotos at age 9. No problems since the early teens and in general stable lab results. Currently on 150 micrograms levothyroxine.
> 
> A week ago I went to my uni clinic because I had been feeling unusually tired, had joint pain, frequent headaches and enlarged lymph nodes on the neck which had been there for 2 months. The doctor ordered a blood count and also FT4 and TSH levels which annoyed me slightly because I had checked them right before I left home approx 2.5 months earlier and everything had been fine.
> 
> Got the results today and it's crazy crazy, in 2.5 months I've gone from a TSH level well within the normal range to 0.069 uIU/mL (with ref.range of 0.270-3.20). The FT4 is now 19.49 pmol/L (ref range 12.0-22.0), this is the same reference range as my hospital at home and when I left home they were at ~14 pmol/L. So they are normal but elevated compared to the last test.
> 
> Does anyone have a clue about that would have caused this sudden decrease in TSH? I haven't had any problems with my thyroid for years and years... Any suggestions would be much appreciated
> 
> The doctor performing the tests isn't a specialist and he wanted to lower my meds, I'm trying to decide if I should just ignore it until I come home in early January or if I need to find a specialist here. I'm reluctant to follow his advice when he can't even explain properly why this has happened...


Have you lost weight? Are you eating a lot of sushi-type foods w/seaweed? Or other sources of increased iodine?

Enlarged lymph nodes truly dictate an ultra-sound of the thyroid for believe this or not, cancer can cause hyper. Or vice versa. Not sure which comes first, the cart or the horse but you get the picture, I am sure.

Thyroid cancer in patients with hyperthyroidism.
http://www.ncbi.nlm.nih.gov/pubmed/12876418

Graves' and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm

If you have lost a bit of weight, it is likely that you may be a tad bit over medicated also.

Just some things to ponder.


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## glasstheme

Oh...sushi...I have struggled with insane stomach aches and sushi is one of the few things that doesn't kill me so it's possible that I've eaten more seaweed than normal. Would that mean that the levels would go back to normal if I found something else to eat?

As for weight it has been fluctuating more than normal. In this time I've lost approx 4kg and then gained it back (I blame the whole stomach ache thing).

Thank you so much for the answers and links. The doctor wanted to do an ultrasound of the thyroid so I'll make sure to follow up on that next week.


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## Andros

glasstheme said:


> Oh...sushi...I have struggled with insane stomach aches and sushi is one of the few things that doesn't kill me so it's possible that I've eaten more seaweed than normal. Would that mean that the levels would go back to normal if I found something else to eat?
> 
> As for weight it has been fluctuating more than normal. In this time I've lost approx 4kg and then gained it back (I blame the whole stomach ache thing).
> 
> Thank you so much for the answers and links. The doctor wanted to do an ultrasound of the thyroid so I'll make sure to follow up on that next week.


We might have nailed it but get the ultra-sound anyway. Wise doctor; don't lose all confidence in this one if he/she recommended ultra-sound.

Keep in touch. I always like to know outcomes!


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## glasstheme

Andros said:


> We might have nailed it but get the ultra-sound anyway. Wise doctor; don't lose all confidence in this one if he/she recommended ultra-sound.
> 
> Keep in touch. I always like to know outcomes!


I tried googling seaweed and TSH and the hits I get appear to suggest that iodine would increase the TSH levels, or am I getting it wrong?

I will keep you posted, I've been reading a bit and I guess he's actually right in wanting to lower my dose. Maybe I should give him a chance


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## Andros

glasstheme said:


> I tried googling seaweed and TSH and the hits I get appear to suggest that iodine would increase the TSH levels, or am I getting it wrong?
> 
> I will keep you posted, I've been reading a bit and I guess he's actually right in wanting to lower my dose. Maybe I should give him a chance


Recent studies by Dr. Nathan Rose of Johns Hopkins University confirm that iodine does indeed cause autoimmune hyperthyroidism in genetically susceptible individuals.
http://neurotalk.psychcentral.com/thread22962.html

Taking excessive kelp, bladderwrack, or other forms of seaweed can cause hyperthyroidism by overloading the body with iodine.10-12 
http://healthlibrary.epnet.com/GetC...03-7f62-4563-8d47-5fe33da65dd4&chunkiid=39022

What causes hyperthyroidism?
Hyperthyroidism has several causes, including

•Graves' disease
•one or more thyroid nodules
•thyroiditis, or inflammation of the thyroid gland
•ingesting too much iodine:rolleyes:
•overmedicating with synthetic thyroid hormone, which is used to treat underactive thyroid
http://endocrine.niddk.nih.gov/pubs/Hyperthyroidism/

Looks like it can vary in individuals (either or)

Iodine and thyroid activity

Supplements can trigger or worsen thyroid conditions.
Vitamins and Supplements image by Scott Griessel from Fotolia.com IPCS says that excess iodine can trigger or worsen hypothyroidism and hyperthyroidism, the under-production of thyroid hormones or their overproduction. IPCS says that people who have lived with iodine deficiency for many years are more likely to have thyroid reactions to iodine, females are more likely to be affected by excess iodine, and those with thyroid diseases may react strongly to added iodine in food, water or supplements

Read more: Red Marine Algae & Hyperthyroidism | eHow.com http://www.ehow.com/about_6495177_red-marine-algae-hyperthyroidism.html#ixzz1cBU4o2CK

You know your own body so you will have to experiment by stopping the ingestion of seaweed and see what happens.


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## glasstheme

Hi, finally figured out what caused my TSH to drop. Figured an update was appropriate for future people with similar concerns 

I saw a specialist yesterday and her opinion was that an infection had triggered the Graves so my thyroid pushed out the hormones it had stored (also having Hashimotos is a bit lucky since only a small part of my thyroid actually works). She wanted to decrease by Levothyroxine to 125 microgram for 2 days a week and stay at 150 for the remaining five until my levels return to normal. So I will probably feel crappy until things adjust and then I will need to recheck my levels in 8 weeks to make sure the THS doesn't stay suppressed.

She believed that my joint pain wasn't related to the thyroid but instead caused by the infection. Ah such an interesting life...I'm actually considering removing the gland to avoid this in the future but maybe that is a bit drastic


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## Andros

glasstheme said:


> Hi, finally figured out what caused my TSH to drop. Figured an update was appropriate for future people with similar concerns
> 
> I saw a specialist yesterday and her opinion was that an infection had triggered the Graves so my thyroid pushed out the hormones it had stored (also having Hashimotos is a bit lucky since only a small part of my thyroid actually works). She wanted to decrease by Levothyroxine to 125 microgram for 2 days a week and stay at 150 for the remaining five until my levels return to normal. So I will probably feel crappy until things adjust and then I will need to recheck my levels in 8 weeks to make sure the THS doesn't stay suppressed.
> 
> She believed that my joint pain wasn't related to the thyroid but instead caused by the infection. Ah such an interesting life...I'm actually considering removing the gland to avoid this in the future but maybe that is a bit drastic


Good to hear from you!! Where was the infection? Glad you are getting a re-check in 8 weeks.

Did this doctor run your FREE T3 and FREE T4?

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=3

Did you not have the ultra-sound?

How do you feel?


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## glasstheme

She thought it might have been an UTI I had or possibly another infection I didn't notice - she was very vague about it.

After a few weeks I started feeling better and had a bit more energy, now I feel as if it's going downhill again. I'm a bit frustrated because the doctors ordered all these different tests for each other with was then ignored. Apparently I have high eosinophils (and low neutrophils), low blood urea and low calcium - but I have no idea what it means and my lymph nodes on the neck are still enlarged.

Maybe my hospital back home in Sweden will be able to help me in January. If I end up finding answers I'll write here in case anyone in the future has a similar experience (I love the old posts in this forum, they are extremely helpful)


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## Andros

glasstheme said:


> She thought it might have been an UTI I had or possibly another infection I didn't notice - she was very vague about it.
> 
> After a few weeks I started feeling better and had a bit more energy, now I feel as if it's going downhill again. I'm a bit frustrated because the doctors ordered all these different tests for each other with was then ignored. Apparently I have high eosinophils (and low neutrophils), low blood urea and low calcium - but I have no idea what it means and my lymph nodes on the neck are still enlarged.
> 
> Maybe my hospital back home in Sweden will be able to help me in January. If I end up finding answers I'll write here in case anyone in the future has a similar experience (I love the old posts in this forum, they are extremely helpful)


Good to hear from you. Sorry you feel on the decline again.

I am now thinking it might be a very good idea to get these tests listed below and an ultra-sound of the thyroid as well.

TSI (thyroid stimulating immunoglobulin)
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin, http://www.ncbi.nlm.nih.gov/pubmed/1969138 ), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

And I am sure you will be glad to be home. There is no place like it!


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