M taking thyronorm 25 mcg regular, and last week do report tsh come 15.53 empty stomach only tea and water taken and second day report after 1 hours lunch tsh 3.5 why this type, also some day in a week feeling fatigue and moodless, t3& t4 normal, what to do sir, any advice.

Dr. Pramod Kumar SharmaEndocrinologist42yrs exp

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Repeat tsh one more time.  

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Dr. Prabhakar Laxman JatharEndocrinologist51yrs exp

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Hello, Thanks for the query. TSH does not change in such a manner. It takes a minimum of 4 to 6 weeks for TSH to change. Ideally on correct treatment (correct dosage of Levothyroxine) TSH is maintained around 3 to 4mU/L at which all the symptoms are in check. So my suggestion please check TSH on empty stomach before 8.30 am. That will give a correct value. Then we can look at the dosage and decide if an increase is needed. Thanks. 

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Dr. M S SeshadriEndocrinologist49yrs exp

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Dear lybrate-user, in someone with hypothyroidism on reguar treatment, a tsh elevation is usually due to missing out tablets for 2 or more days in a month. If this is happening then you take an extra dose the day after you miss a dose and the values will remain normal  

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