Hello doctor I had checked my thyroid on august 7th it showed 5.63 t3 and t4 are normal. I was given thyronorm 50 mcg yesterday when I tested again it showed 6.3 but t3 and t4 are normal. What is wrong here sir? First time when I gave blood for test it was in the morning yesterday when I gave it was in the evening does that make any difference? It's urgent please guide me.
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Hello, thanks for the query. Variation in tsh values can occur based on when the blood samples are given. The values are in very small units so these variations are expected. Ideally tsh is to be checked before 8.30 am preferably on empty stomach. Treatment is usually advocated when tsh is > 10 mu/l. Between 6 to 9.9 mu/l is considered as subclinical condition and no treatment is usually advocated. However, in patients who have subclinical levels of tsh but also have troublesome symptoms of hypothyroidism present then treatment is initiated. Another important aspect in many cases tsh may be as above, but increased number of anti tpo antibodies can lead to hypothyroidism. That condition is known as hashimoto's thyroiditis (ht). So please get your ht test also done. Thanks.
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Dear lybrate-user, I note that you are overweight by about 10-12 kg and may be this is why thyroid function was tested in the first place. Your initial tsh was just above normal range and your t4 and t3 were normal at the time of diagnosis. This is called subclinical hypothyroidism. This may remain like this for several months to years before progressing to overt hypothyroidism. Treatment is required only when overt hypothyroidism occurs, and at that time t4 or free t4 will be low and tsh usually > 10 uiu/ml. This is the time to start thyroxine. At present I feel you can stop thyronorm and monitor free t4 and tsh after 6 months. At that time check tpo antibodies also and get back to us on an online appointment for your weight issue I suggest the following reduce the quantity of carbohydrate (rice, wheat, rava, maida) in each meal and increase the quantity of protein (dhal, soya, egg white, fish or chicken). Take lot of green leafy vegetables walk 5 km per day and gradually reduce weight by 1 kg per month to ideal body weight (height in cm minus 100 will roughly be your ideal body weight in kg) about 60-63 kg.
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Thyroid tests should be repeated after at least one month of intake of thyroid supplements. Tests are to be done early in the morning on empty stomach. Repeat thyroid tests are important to asses the exact dose of thyroid tablets required.
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