Hello Sir! My sister in law and she has hypothyroidism from unknown time period. Her TSH level is somewhere around 400. Her weight is Round 32-35 kg. Loss of appetite and tiredness present. She took thyroxine 50 mg for three months and her TSH level dropped to 9. Then she stopped taking medicine and her TSH level again raised to 400. We contacted many physicians but not satisfied with their consultation. Everybody give thyroxine just to drop TSH level. No body try to rule out underlying cause. I am an orthopaedic physiotherapist by profession. I hope for your proper guidance and help. Thanks

Dr. Prabhakar Laxman JatharEndocrinologist47yrs exp

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Hello, Thanks for the query. Madam please understand the reason why TSh levels jump when thyroxine tablets are stopped. There is a negative feed back mechanism operating between thyroid gland, pituitary and hypothalamus. If there less or no thyroxine secreted from thyroid gland, then a signal goes to hypothalamus through the blood, then it produces a hormone called Thyroid Releasing Hormone, this stimulates pituitary, whichthen produces TSH (Thyroid Stimulating Hormone). Since thyroid gland is not able to produce thyroxine (in hypothyroidism) there is excess secretion of TSh by pituitary. In such a situation the treatment is to give adequate amount of Levothyroxine as supplement from outside. This will bring down TSh. Ideally TSh should be maintained around 3 to 4 mU/L, to be free from all the symptoms of hypothyroidism. Therefore, I hope you understand the ONLY TREATMRNT is to take adequate dose of thyroxine. TSH should be brought down to 3 to 4 mU/L Treatment is for lifetime. There is no other way. Please do not stop the treatment on your own. I hope you understand. If you have any doubt please come back. Thanks. 

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