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Thyroid Level 167??

I have been having issues for the last year or so... by themselves I just thought they were because I was getting older... Until the weight gain... 30lbs in 3 months... I have had muscles loss, muscle and joint pain (at times severe), Depression, lack of sex drive, moodiness, inattentiveness, something i call "brain fog" and there are others including a chronic cough and difficulty swallowing... I went to the doctor and apparently my thyroid level (TSH) is a 167.  My doctor has started me on a dosage of Levothroxine of 150 mcg. daily. They have also ordered an ultrasound of my thyroid because of my difficulty swallowing and of course the visible enlargement of the thyroid itself.  I am concerned and really dont know what to make of the numbers, medication etc... any information or guidance would be greatly appreciated.        
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Avatar universal
First off.  You are Hypothyroid. Which means that you have low (Hypo) thyroid hormone in your blood.

ALL the symptoms you report are ALL consistent with being Hypo.

TSH is a screening test and really shouldn't be used for monitoring and adjusting medication dosage.  For that you REALLY must DEMAND to be tested each and every time to also include the Free T4 and Free T3 hormones.  These are the ACTUAL hormones that your body uses.  TSH on the other hand is a pituitary hormone that simply tells your thyroid gland to produce more or less thyroid hormone.

Normal range for TSH is usually something like (0.3 to 3.0)  Yours being 167 means that your pituitary gland is SCREAMING for your thyroid gland to produce thyroid hormone. But for whatever reason your thyroid gland cannot produce it.  

So adding thyroid hormone medication is clearly the correct thing.

HOWEVER!  a starting dose of 150 mcg is HUGE.  Absolutely huge and many people's body's cannot adjust from going from almost no hormone to this massive dosage! Some people can and maybe you are one of them. But the more common starting dosage is 25 mcg to 50 mcg.  And then slowly increase the dosage over time.

The medication prescribed is a T4 hormone.  This hormone is a "storage" hormone and is NOT used directly.  Your body must first convert it into the usable T3 hormone.  For this reason, it takes about  SIX WEEKS to stabilize in your blood.  So you probably will not notice any dramatic changes for awhile UNLESS it is due to the HUGE initial starting dosage you are taking.

Standard protocol is to start out with no more than about 50 mcg a day then retest your blood after 4 to  weeks when the T4 has stabilized, then make an additional adjustment, and wait and be tested again in 6 weeks. and keep d oing that process until you feel well.

I would strongly encourage you to talk to your Dr about lowering your starting dosage or to at least take the 150 mcg every other day or to cut it in half and take daily. This would result in an average of 75 mcg a day which is still over the more common starting dosage of 50 mcg.  You could do this for a couple weeks at least and then start taking the full dose or some other way to ease yourself onto the addition of thyroid into your body.

Also it is quite common for people to actually feel WORSE and have MORE symptoms when first starting to take hormone replacement.  THis is because your body is not used to having hormone and has to rebalance and adjust to this fact.  This is why starting low and slow is the common route to take.

Just wanted to give you a few thoughts to consider and discuss with your Dr.
Avatar universal
I went to to ultrasound today... I had a "chatty" but well meaning Ultrasound Tech. She explained that she had never seen anything like mine.. That it varied in density in many areas and that it almost looked "nutty" and even went as far to say that if this were her thyroid and she had the symptoms I had she would have hers removed (no I did not ask.. She volunteered this info) then for the next near hour she took images of the front right side of my neck where I have at times severe pain and a mass or something that is about 3in long and about 3/4 inch wide. She felt it, she found it on ultrasound and said NOTHiNG more. So now I'm slightly (at best) freaked out until the ACtual Radiologist finally calls my doctor tomorrow... Any thoughts?
Avatar universal
I got results and apparently I have a 12 mm solid nodule on the left lobe and a 6 mm nodule on the right. I have an appointment with.a surgeon on Tuesday and I am very nervous.
649848 tn?1534633700
COMMUNITY LEADER
Do you have written copy of the ultrasound report?  If so, check to see if there is an impression at the bottom.  That's where the radiologist add his opinion of follow up recommendations.

Many of us have nodules on our thyroid and they are nothing to worry about.  
Avatar universal
I do not but I'm going to get it. I met wth the surgeon and he wants a biopsy done of  the larger nodule and if it proves questionable they want to remove the entire thyroid however if it comes back "normal" they will only remove that one side.  I am now starting my third week of Levothroxine and my symptoms are worse than ever I'm 45 and getting out of bed is a struggle... One I win but when I do get up I feel it in every joint of my body.  My weight continues to creep up... I suppose I'm just very dissappointed that I feel NO different yet.  Just really looking forward to feeling normal again.  :/
Avatar universal
I do not but I'm going to get it. I met wth the surgeon and he wants a biopsy done of  the larger nodule and if it proves questionable they want to remove the entire thyroid however if it comes back "normal" they will only remove that one side.  I am now starting my third week of Levothroxine and my symptoms are worse than ever I'm 45 and getting out of bed is a struggle... One I win but when I do get up I feel it in every joint of my body.  My weight continues to creep up... I suppose I'm just very dissappointed that I feel NO different yet.  Just really looking forward to feeling normal again.  :/
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