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Old 04-24-2006, 08:44 PM   #1
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Question What else can cause elevated TSH?

Hi everyone- it's been a long time since I have posted. My daughter had an elevated TSH (4.8) about 2 years ago and the doctor agreed to try her on some medication. We tried Levoxyl first then Armour and then a mixture of the two. Her levels finally looked pretty good but there still wasn't any improvements (no weight loss, still very irritable, headaches...) We have finally taken her off all medication. Her blood work was taken again after being off of meds for about a month and her TSH was back up to 4.4. She has had her cortisol levels checked (pretty low but bearly in range) and her glucose checked (also low - out of range). Does anyone have any ideas what else we can look at? I really feel something isn't right but obviously it isn't her thyroid since meds didn't work... what else could be causing her symptoms and her TSH to be elevated? Any thought are appreciated!

 
Old 04-25-2006, 06:39 PM   #2
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Re: What else can cause elevated TSH?

Is 4.4 normal or should I being trying to find the reason for the elevated number?

 
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Old 04-25-2006, 07:44 PM   #3
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Re: What else can cause elevated TSH?

4.4 can be very normal, alot of people don't think it's normal, but i do. Maybe there's something else going on.

 
Old 04-26-2006, 04:56 AM   #4
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Re: What else can cause elevated TSH?

I'm sorry to disagree but 4.4 is definitely NOT normal.

She needs treatment and you need to find out what her Free T4 and Free T3 numbers are. Especially once treatment begins, you cannot go by TSH.

And the low blood sugar goes along with that too.

 
Old 04-26-2006, 05:18 AM   #5
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Re: What else can cause elevated TSH?

Her Free T3 and Free T4 #'s were not checked with this last round of bloodwork, but they were checked when she was on meds. At one point her TSH was .3 and her Free levels were close to the top of the range. Because we still didn't see any results we decided to wean her off the meds. How does the low blood sugar correlate with the thyroid levels? Thanks for your response.

 
Old 04-26-2006, 08:19 AM   #6
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Re: What else can cause elevated TSH?

from what I read in "The Thyroid Solution" and from my own doctor's experience hypoglycemia (blood sugar) is a symptom of hypothyroidism.

When I went for my initial diagnosis, my TSH was normal at 1.82, but I had low blood sugar, high triglycerides, and high cholesterol which my doctor said were 3 very good indicators of low thyroid.

 
Old 04-27-2006, 08:22 AM   #7
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Re: What else can cause elevated TSH?

It is possible that she has adrenal problems along with thyroid problems. You mentioned that her cortisol was low as well as her blood sugar (both signs of adrenal fatigue or even more serious Addison's disease). If her adrenal glands are not able to keep up, then she will be tired, moody, etc. even if her thyroid levels are good. There is something called polyglandular syndrome (Schmidt's disease if it involves adrenals and thyroid). Post all her tests, the results, and the reference ranges here and we can look at them to get a better idea what may be going on. You might want to ask for more specific tests for cortisol such as an ACTH stim test to see whether or not she has enough reserves for stressful situations (thyroid hormones can even be a stressor to adrenals); possibly a saliva test to show her cortisol rhythm throughout the day (take 4 or more samples at different times in the day); and there are other tests. The Addison's board might help with any questions you may have about cortisol.

Anyway, I do believe she is hypothyroid for sure (4.4 is too high, especially with the presence of symptoms), but she most likely has something else compounding the problem. I would look into adrenal issues. Has she been checked for her iron levels and ferritin? Those might cause problems, too. I have read that cells need adequate cortisol and ferritin levels in order to even get thyroid hormones into the cells; otherwise it just circulates in the blood unused.

Good luck.

 
Old 04-28-2006, 04:57 AM   #8
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Re: What else can cause elevated TSH?

I went back and found her old saliva test for cortisol and here are the results:
Reference range:
7am-9am
.27-2.06 her level= .47

11am-1pm
.03-.77 her level= .05

3pm-5pm
.03-.56 her level= .18

10pm-12am
.03-.50 her level= .03

This test was done almost 2 years ago; she hasn't had any more testing for this. For her last thyroid test they only looked at her TSH. I know that her Free T4 and T3 needs to be looked at, but I didn't push for it just because her levels were optimized at one time and it didn't help. Any other ideas?
Thanks!!

 
Old 04-28-2006, 10:08 PM   #9
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Re: What else can cause elevated TSH?

Quote:
Originally Posted by KBT's mom
I went back and found her old saliva test for cortisol and here are the results:
Reference range:
7am-9am
.27-2.06 her level= .47

11am-1pm
.03-.77 her level= .05

3pm-5pm
.03-.56 her level= .18

10pm-12am
.03-.50 her level= .03

This test was done almost 2 years ago; she hasn't had any more testing for this. For her last thyroid test they only looked at her TSH. I know that her Free T4 and T3 needs to be looked at, but I didn't push for it just because her levels were optimized at one time and it didn't help. Any other ideas?
Thanks!!

First don't mess with the medication right now. Go back and have a full thyroid panel done, including antibodies, free t4, FREE T3 WITHOUT FAIL!!!,
also take her temperature in the moring before she gets up, without moving, just barely awake. Chart this for a couple weeks...if you can search (broda barnes body temperature and thyroid). She probably needs to have her hormone levels checked also. Also remember normal does not always mean optimal.

 
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