# TSH drop and pattern?



## Endo20 (Nov 16, 2014)

Well...I got my new TSH level that my doctor ordered and it made me more curious after seeing a few past results from Quest. I obtained past medical records from my pediatrician and I was surprised to see the nose dive.

Quick background: I'm 20 (male). My family has a history of Thyroid issues (usually overactive). I went to my primary and they did some blood work but said to see an endocrinologist. He did 2 sets of lab work. I got all 3 lab results back and he sent me for a new TSH sample.

All tests were done fasting.

1st Round: 
TSH - 1.00
T4, Free - 1.3 
TSH W/ REFL Free T4 TSH - 1.00
T3 Uptake - 33 
T3, Total 83

2nd Round (2 weeks after 1st round): 
TSH - 1.9
T4, Free - 1.5

3rd Round (4-5 weeks after 1st round): 
Thyroid peroxidase ab <1 range <9 IU/mL
Thyroglobulin Antibodies <1 range < or = 1 IU/mL
TSI 24 and the range is <140% baseline
TBII <5.0 rangeis <=16%

4th Round (Last Week) 
TSH - 0.84

Historical TSH labs: 
October 2011 - 3.15 
May 2013 - 5.11

It would appear that my TSH was on a climb for many years(I never really felt symptomatic when it was high) and now it tumbled down to 0.84. I'm not sure if the tumble has lead me to feeling horrible. Is there a reason for thyroids to go completely opposite of each other in a pretty short time? What thyroid test am I missing? I asked about an ultrasound and he said it wasn't needed but that was before the TSH level was back. Now I'm not sure what this all means.


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## Andros (Aug 26, 2009)

Yes; the antibodies do that as they attack the receptor sites. You have them and I believe you are slowly progressing to hyperthyroid.

Have you had an ultra-sound or RAIU (radioactive uptake) of your thyroid. If not, it is strongly recommended that you do so.


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## jenny v (May 6, 2012)

Also, please post ranges for each of those labs. It can be hard to tell much without the ranges.


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## Endo20 (Nov 16, 2014)

Here are the ranges for each lab. One of my doctors said it appeared that my thyroid was a bit on the larger size but still within range. I'll be seeing my endocrinologist in about 2 weeks.

TSH Range : 0.4 - 4.5

T4, Free Range : 0.8 - 1.8

TSH W/ REFL Free T4 TSH : 0.40 - 4.50
T3 Uptake Range : 22 - 35 Percent 
T3, Total Range : 76 - 181


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## Lovlkn (Dec 20, 2009)

Endo20

Are you having any symptoms?

Your Thyroid hormones look low while your TSH is bouncing around. So while you have TSI antibodies your are actually more on the hypo side than the hyper side at this time - despite your TSH readings which can lag up to 6 weeks and are for diagnostic screening purpose only.

Att his point - I see your situation as a wait and see what it turns into, unless you begin having symptoms and even then you will likely be treated for hypo not hyper at this point in your lab history.

We all firmly believe on treating based on Free T-3 (or total in your case) and Free T-4 labs rather than by TSH.


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## Endo20 (Nov 16, 2014)

Unfortunately my symptoms are somewhat common across thyroid, adrenal, etc. My blood pressure is sometimes on the low side and/or elevated pulse at times. For example: 83/60 and pulse at 80. Another time its 95/52 with 59 pulse. At other times 105/75 with 124 pulse. Some readings occur after standing, lying down, or doing nothing at all. So it is quite strange at times. At times this leads to a sense of dizziness or a floating/detached sensation. It also causes a flushed/rush feeling in the head. Most of the times I'm cold throughout the day and evening (especially the hands) but a few times in the night I'll wake up sweating (never any fever). Lately I've been experiencing strange sleep cycles (sleeping 9+ hours or as little as 3 hours). I get a bit of a nauseous feeling after eating/drinking some things (never had this before). Beyond this I usually get pain in my back and leg. My cortisol levels are elevated on little sleep and low after 8+ hours of sleep. These erratic symptoms come and go multiple times throughout the day which makes it difficult to feel comfortable. I called my endo earlier today and they said everything looks good and that they don't see this as an endo issue but that they want a scan of the adrenal glands to be safe. I guess the appointment is worthless in 2 weeks.


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