# My TSH is suddenly high - symptoms?



## Ellina (Dec 31, 2016)

Hi all,

Just registered. I have been diagnosed with Hashimoto's 10 years ago, when I was 27.

I never had any major problems, have always been able to work and live a very active life (exercise, travelling, social etc).

That said, there are some consistent symptoms and little nuisances that never really go away:

feeling cold really easily (especially when sitting for a long time), cold hands, cold feet, struggling to get up in the morning (always been a night owl but it has gotten worse and even after 8 hours of sleep I am dead tired in the morning).

My stomach is also always bloated. I have tried dietary changes this year. No gluten, no milk, no dairy. But nothing changed.

No matter what I eat really, it is bloated and hard. I have been seeing a health practioner who put me on probiotics. They do me no harm, but the bloated stomach is still there.

And what bothers me most: I am generally moody (but that might be just my temper), but ever since the Hashi, I also have periods of really low mood. I don't know if I call it depression, since I am able to function, I feel more sad than numb etc. But I feel generally sad and weak and tearful during these times. I used to always blame my current life stressors for these perdiods, but I do think it has something to do with the thyroid. Sometimes my TSH was really low so I reduced the dose.

Now I have been feeling increasingly bad for a few months. I reduced my LT dose in summer but I fear I might have slowly slipped into going hypo.

My lab from October was:

TSH: 1,40 (0,27-4,20)
ft3 2,66 (1,90 - 5,10)
ft4 1,50 (0,90-1,70)

And now, 8 days ago, my TSH was at 5,61. The highest it has ever been since my diagnosis (it was also just above 5 back then).

I know why this could be. I accidentally used some old LT 75 tablets and even broke a quarter of them off because I thought it was 125 and my dose should be 100.

So my own stupidity.

My doctor is only ever looking at the TSH and ocassionally I ask to check the ft3 and ft4, but I feel I might have never really found my "feel good" dose.

Long story short. I'd love to get some feedback here. Maybe someone can give me an opinion:

- Could it be that the symptoms I described above really are to do with not having the perfect dosage yet / are thyroid related?

- I will get the results of ft3 and ft4 next week to see if the high TSH corresponds with low fts. I actually hope me feeling so bad right now will have something to do with this

- I am taking 125 now (which was a dose I had been taking for quite a long time before reducing to 100) again. How long does it take on average until I will feel effects? I can't remember really and I read anything from 1 week to 6 weeks,

Thanks for reading. I know it is quite the novel, but I have so many question marks right now.


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## Lovlkn (Dec 20, 2009)

> My lab from October was:
> 
> TSH: 1,40 (0,27-4,20)
> ft3 2,66 (1,90 - 5,10)
> ft4 1,50 (0,90-1,70)


Are you having labs drawn at the same time each day they are drawn and the exact time apart from your last Levothyroxine dose? When do you take your levothyroxine dose in relation to your lab draw?

You may benefit from a low dose of Cytomel, maybe 5mcg broken in 1/2 and split 6 hours apart. If you do add the Cytomel you will likely need to reduce your levothyroxine to 100mcg as FT-4 tends to raise when FT-3 does.


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## Ellina (Dec 31, 2016)

Hi Lovlkn,

Thanks for replying.

I always get the blood drawn in the morning AND I always take my dose of LT before.

I have heard now that this is not ideal to go since ft3 and ft4 show a peak. TSH wouldn't be increased, is what my doctor says (and hence she tells me to take it as normal in the AM before the lab). But like I said, she is the typ that will check if TSH is in the range of 1 or 2 and that's it.

The thing with Cytomel:

I have tried it before, it was in 2010 when I also figured I could benefit from a boost and read good things about it. I went to a doctor who was known for describing it (I lived somehwere else as well) and took
10μg for about a year. I never noticed any improvement really. I don't remember if I had the constant bloating already back then though. But I was still feeling cold and also mentally not really great.

Granted, it was a tough time for me and I had some external factors certainly playing a role. But in the summer of 2011, I was feeling really really crappy. Really nervous and sad, and my lab showed I was hyperthyroid. ft3 and ft4 were out of the normal range. I don't have the lab stats with me here now, but my (new) doctor told me to either reduce LT and Cytomel, or just omit Cytomel.

I really am a bit scared of Cytomel now and also disillusioned because I never felt an improvement while on it.

All in all, I am a bit desperate because I think that maybe it isn't the Hashi/the dose that is giving me problems. Then again, the symptoms I have must have something to do with it, right?


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## visc (Feb 22, 2014)

24 male with Hashi for 3 years now and i'm in the same situation. Struggling to find a feel good dose.

I was fine on 100mcg Synthroid, now i'm starting to slow down.. I'm waiting for blood work to come, I expect my TSH to be above 1.9 which usually means I need more Synthroid.

If it's below 1.5 then I'm going to talk to my doctor about it. The likelihood it's something other than thyroid is pretty low, but it's always good to raise the issue..

I'm sorry you're going through this!

Hugs and Good luck,

visc


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## Ellina (Dec 31, 2016)

Hi Visc,

Thank you!

I hope you will find our feel good dose as well.

I never took it all that seriously that there should be an optimal dose that I should try to find. As long as I felt mentally ok, I thought "ok, move on, don't focus on Hashis".

But in the meantime, I am pretty sure my symptoms have something to do with it and could get better with a correct dose.

I will find out what my ft3 and ft4 were because my doctor ordered for them to be checked afterwards, from the same blood that had the TSH of 5,61.


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## Lovlkn (Dec 20, 2009)

> That said, there are some consistent symptoms and little nuisances that never really go away:
> 
> feeling cold really easily (especially when sitting for a long time), cold hands, cold feet, struggling to get up in the morning (always been a night owl but it has gotten worse and even after 8 hours of sleep I am dead tired in the morning).
> 
> My stomach is also always bloated.


All very classic hypo symptoms.

The only thing off in your lab's is your FT-3, which is below 1/2 range. Most here state feeling best falling somewhere between 1/2-3/4 of the range.

Asking for your labs and keeping a tracking sheet of lab, doses and how you feel is the best way to dial in your replacement medication doses.

If you did not "feel" the Cytomel then you were likely still under dosed. DO you have any labs with ranges during that period in time?

I highly syggest you not take your Levothyroxine before your lab, rather wait and take after. DOsing by TSH is not going to get you where you need to be as TSH can lag up to 5 weeks and is more of a thyroid disease screen test.


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## Ellina (Dec 31, 2016)

I would expect my ft3 and ft4 to be lower now (last lab was from December 22, where TSH was so high), will find out tomorrow.

I would actually hope so because then I'd have an explanation why I feel so bad now. And why I have felt increasingly bad over the last few months.

My labs when I started the Cytomel (first 5, then increased to 10) in 2010:

TSH 0,15
FT 3 2,9 (2,3 - 4,2)
FT4 1,4 (0,5 - 1,8)

> this was after ca 5 weeks of taking the Cytomel. First lab right when I started showed a total drop in ft3 and ft4, and this was when they got back to normal, but still low range.

Next lab 3 months into Cytomel:

TSH < 0,03
FT3 4,1 (2,3 - 4,2) 94,74%
FT4 1,3 (0,5 - 1,8) 61,45%

> BUT I took both tablets right before the blood test so these must be "fake high".

I didn't feel any better. I wrorte about it in a German forum and I said that I still feel cold etc.

I took 125 LT at the time.

But like I said, beginning of 2011 I started feeling worse and by summer, I was really nervous, depressed and I thought I might have been overdosed. My lab then confirmed (although I don't know if I took the tablets before as well).

That said, I can never tell a difference whether I could be hypo or hyper. I had times when my TSH was suddenly very low and I felt just as moody, sad and on edge than now, that my TSH is high.

Maybe these symptoms are just general "something not ideal with dose/thyroid" symptoms?


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## Lovlkn (Dec 20, 2009)

> Next lab 3 months into Cytomel:
> 
> TSH < 0,03
> FT3 4,1 (2,3 - 4,2) 94,74%
> ...


Totally inaccurate if you took both your levo and cytomel prior to the lab.

Have you ever had an ultrasound of your thyroid? You may want to ask for one as it is sounding like your issue may be nodules since you had a sudden and unexplained spike in TSH.


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## Ellina (Dec 31, 2016)

I have regular ultrasounds. No nodules so far.

The reason for the high TSH now could most likely be that the dose of 100 LT just isn't near enough anyway and my own fault for mistaking 75 LT tablets as 125, and breaking off a quarter to make it "100".

I only discovered this when I looked at the empty blister pack. I don't know how many of these I took, because I also had another blister pack of real 125.

All in all, I didn't pay attention to an exact dose, so this must be at least part of the reason.

And since I have had these consistent hypo symptoms I mentioned for years, I suspect now that even the dose of 125 (which I took for the longest time) might not be enough and maybe I should try to increase in little steps.

The reduction from 125 to 100 was at the beginning of 2016, because I had a drop in the TSH - but ft3 and ft3 weren't tested...so I am really learning my lesson now that adjusting a dose simply based on TSH isn't a safe bet for me.

Unfortunately, my doctor is one of those who thinks it is.


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## Ellina (Dec 31, 2016)

I got the rest of the lab results back:

ft3: 2,47 (1,70 - 4,20)
ft4: 11,8 (9,4 - 18.0)

I think this must be too low for me and I have increased the dose (to my usual 125) again.

I hope this is an explanation why I feel bad right now.

What puzzles me though is that I had similar ft3 and ft4 before, and a TSH of 1,38 to go with it!

And I remember feeling ok back then. At least not depressed or anything.


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## joplin1975 (Jul 21, 2011)

Some times, the higher your TSH, the more antibodies. So it might be less about free hormones and more about antibodies.

By the way, you are still trending hypo with those results.


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## Ellina (Dec 31, 2016)

I definitely want to start doing my own adjusting now and taking my symptoms (cold intolerance, being tired in the morning, bloated stomach no matter what I eat or don't eat etc) seriously and as indicators the dose isn't good yet. So far, when I felt ok mentally, I just accepted the rest of the symptoms.

At least now I can safely say that a big part of why I feel so bad right now is due to being borderline hypo (I also took the tablet an hour before the test, so ft3 and ft4 might be even lower actually because they were taken during the peak).

Which should be good news because I can hope to get better once the new dose kicks in and my goal now is to really get rid of the underlying symptoms mentioned above as well.

The bloated stomach has been annoying me for a long time now, and I took a ton of tests, tried gluten free, dairy free etc, but never noticed a difference,

So could this really be due to not enough hormones and go away with better LT dose?


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## graves84 (Oct 7, 2013)

My TSH also just jumped from .99 to a 3.91 (4.0 is top of the range) AND I am on NDT which is supposed to suppress TSH if it is working so that is even scarier.


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