# Increasing TSH levels



## llhg71

I completed the I-131 treatment for papillary cancer 10/2011. I have been on the same synthroid level of 112 since 02/2012. I use name brand medication and pick it up each month from the same pharmacy and I use the same lab. I noticed that my TSH levels have slowly been increasing. What do you think would cause this? I have listed the labs below that I have access to. They have completed thyroglobulin test, but I dont' have them right now.

05/29/12
Your Value Standard Range Units 
TSH 0.77 0.42 - 5.47 UIU/ML 
FT4 0.85 0.61 - 1.12 NG/DL

07/18/12
TSH 0.82 0.42 - 5.47 UIU/ML 
FT4 0.95 0.61 - 1.12 NG/DL

11/2/12
TSH 1.03 0.42 - 5.47 UIU/ML 
FT4 0.93 0.61 - 1.12 NG/DL


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## Octavia

I would say the cause is that your dose is not quite high enough. Looks like it's very close, though, as your TSH increases have been slow and small. Given that you had papillary cancer, you really need to keep that TSH close to zero, so you need a small bump in Synthroid...maybe alternating doses of 112 mcg and 125 mcg, or switch to 125 every day.

What does your doc say?


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## llhg71

I haven't been in to physically see him since August I think. He didn't say anything at that time. I have an appointment with him on Monday.


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## Andros

llhg71 said:


> I completed the I-131 treatment for papillary cancer 10/2011. I have been on the same synthroid level of 112 since 02/2012. I use name brand medication and pick it up each month from the same pharmacy and I use the same lab. I noticed that my TSH levels have slowly been increasing. What do you think would cause this? I have listed the labs below that I have access to. They have completed thyroglobulin test, but I dont' have them right now.
> 
> 05/29/12
> Your Value Standard Range Units
> TSH 0.77 0.42 - 5.47 UIU/ML
> FT4 0.85 0.61 - 1.12 NG/DL
> 
> 07/18/12
> TSH 0.82 0.42 - 5.47 UIU/ML
> FT4 0.95 0.61 - 1.12 NG/DL
> 
> 11/2/12
> TSH 1.03 0.42 - 5.47 UIU/ML
> FT4 0.93 0.61 - 1.12 NG/DL


It is my opinion that you need a bump up on your Synthroid. And it would be a good idea to get a FREE T3 test. Your FT3 most likely would be best at about 75% of the range provided by your lab. Your FT4 is actually high in the range which could indicate that you are not converting and may do better on dessicated thyroid or the addition of Cytomel (T3) to your regimen.

There is no way to tell unless you get that FT3 test.

Most of us w/o a thyroid do not convert well; most, not all!

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

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.

And your TSH should be suppressed since you did have cancer. By all means. Your doctor should not be allowing this.


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## Abcdefg

I think different doctors have differing opinions on suppression. My Rad Onc says we only need to be <1. Whereas my GP wants it under .5. I'm going with the GP's opinion, mostly because I feel better with my tsh lower.

And yes, a dose increase will likely help you :0


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## joplin1975

There are guidelines (at least in the US) for proper suppression.

My surgeon wants me between 0.1-0.3.


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## Lovlkn

Andros said:


> It is my opinion that you need a bump up on your Synthroid. And it would be a good idea to get a FREE T3 test. Your FT3 most likely would be best at about 75% of the range provided by your lab. Your FT4 is actually high in the range which could indicate that you are not converting and may do better on dessicated thyroid or the addition of Cytomel (T3) to your regimen.
> 
> There is no way to tell unless you get that FT3 test.
> 
> Most of us w/o a thyroid do not convert well; most, not all!
> 
> 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.
> 
> And your TSH should be suppressed since you did have cancer. By all means. Your doctor should not be allowing this.


Ditto what Andros said.

How do you feel?

Your FT-4 is in mid range - you likely need a bump up OR you could try adding a small dose of Cytomel which will likely obtain the small FT-4 bump up. You really need FT-4 and F-3 run in addition to your TSH to properly adjust your meds.

My TSH did not suppress until I added Cytomel. I also felt fatigued until I added Cytomel - I have no reason to suppress my TSH but the best replacement combo and my lingering antibodies suppress it.

Without a FT-3 test you will not be dosed properly - aim for mid range on both and tweak afterward depending on how you feel and your TSH since they are trying to suppress your TSH


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## llhg71

I'm feeling fine. My most current TSH level as of last week is: TSH 0.72 0.42 - 5.47 UIU/ML. I don't have the other labs handy. So it seems that my TSH decided to decrease. But now I might as well throw everything out the window. My endo is scheduling me for the thyrogen injections and a scan. :sad0049:

Did anyone have an trouble with the injections? Do you have to go into hibernation for a while after the scan?


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## joplin1975

I didn't have any real trouble with the injections. The first one was a little ouchie-ish and I did get a lump in my butt from that shot, but the second was uneventful. I also got a bunch of chin acne...not idea if it was related to the shot or not, but it was there.

I only did the isolation after my therapy-level dose. After the second scan (which found nothing), I returned to normal activity.


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