Hi, I am 32 years old. I have a case history of increased TSH level since the last five years. I used to take 100 mcg Eltroxin as advised by the doctor, but till now I have not seen any improvement in the TSH levels. Although, the level has declined from 32 (five years before) to 18.4 (recent report). Secondly, for the first time, I have noticed the fall in my Hb content which ranged from 14-16 g% previously but recently it was reported to be 10.5, which was startling for me. I need your help to understand that why my TSH levels are not coming back to normal although I am a non-drinker and non-smoker?

Dr. Prabhakar Laxman JatharEndocrinologist47yrs exp

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Mr. lybrate-user, Thanks for the query. TSH level has declined from 32 mU/L to 18 mU/L. So there is a reduction, however, desired level is not reached mainly due to inadequate dosage of Levothyroxine. The dosage has to be increased to 125 mcg per day, then check TSH after 6 weeks. If still the desired level is not achieved (3 to 4 mU/L), then dose has to be further increased to 150 mcg per day, and again check TSH after 6 weeks. You will have to continue doing this exercise till the desired level is reached and and stabilised. As regards reduction in Hemoglobin level, that has no relation to taking Levothyroxine. That is dependent on iron intake from food and or presence of some reason where there is some iron loss. Dietary correction and iron supplement will take care of that. There is nothing to alarmed about it. If you have any questions please do come back. Sometimes we may have to give up to 200 mcg of levothyroxine per day. This is because there is absolutely no secretion coming from your own gland. Thanks.  

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