High TSH & High T4

Douglas Ek

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Joined
Feb 8, 2017
Messages
642
Hi!

My sister has been diagnosed with autoimmune hypothyroidism. Shes currently om synthetic T4 to lower her tsh. It has gone down from being 30+ to 8 now. The doctors upped her dose from 25, 50 and now 75 but the last bit if TSH doesnt want to come down. She has now started experiencing severe overdose symptoms as rapid heart beats, tremors, nausea, pain in chest etc. She had to go to the emergency yesterday and I feel so bad for her since shes quite scared. T3 is in normal range. Im thinking shes having a bit of problem converting the T4 to T3 thus not lowering TSH as effective? At the emergency the only things elevated was T4 was 24 and blood glucos was over the reference range. Obviously the high glucose comes from elevated cortisol and adrenaline from the overdosing and stress the T4 puts on her body. Anyone been in a similair situation and had success?
 

marsaday

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Joined
Mar 8, 2015
Messages
481
Can she monitor her blood pressure? This is a helpful indicator if taking to much thyroid medication as the BP will go up to much if on to much. Low thyroid also gives a higher BP, but once you establish a base line level you can them use the pressure to help guide you while increasing the T4

Starting on 25, then 50, then 75 is the way to go, but it wants to be done slowly and not condensed into a few weeks.

However a TSH of 30 is high, so i would have started on 50mcg anyway.

If the T4 at 24 is elevated, by how much ? What is the range. A normal range in nmol is 10-22 (used to be 24). So if using this range she is at the top, but not excessively over.

Women are often low in iron or ferritin storage and so this can cause palpitations while using thyroid meds. The iron is part of the equation in transporting the thyroid. So check her iron status. This will need to be increased if she is low and the thyroid meds will not work that well if low.

Don't be frightened to back down on the T4 if experiencing hyper symptoms. Going back down to 50mcg should be tried and if she stabilises, hold for a bit and get blood tested again. Don't rely on the TSH though. The FT4 and 3 and more important indicators on how the thyroid is doing.
 

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