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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Endocrinology
Satisfied Customers: 18661
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have a TSH level of 3.360 and am currently on treatment

Customer Question

hi. i have a TSH level of 3.360 and am currently on treatment for thyroid issues for the past 7 years. i have always had symptoms of both hyper and hypothyroidism and lately have been having lots of anxiety attacks and neck pain racing heart.. bowel issues and doctor is writing it off as anxiety..
Submitted: 1 year ago.
Category: Endocrinology
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

Many of the symptoms of hypothyroidism and hyperthyroidism are non-specific, so can occur in a variety of other conditions. There is also some degree of overlap, since it is obviously impossible for someone to be hypothyroid and hyperthyroid at the same time.

You do not say which thyroid treatment you are taking, but the most common would be thyroid replacement, such as with levothyroxine. If there are persistent symptoms in someone on thyroid replacement, the first goal is to achieve a TSH that is within the normal range. There is some evidence that certain people on thyroid replacement may do better if the TSH is lower in the normal range. So, if symptoms persist when the TSH is in the upper portion of the normal range, further adjustment of the dose to achieve a TSH around 1.0 may do better.

However, there is some risk to this. And particularly, if there are anxiety symptoms, slight increases in thyroid replacement doses may exacerbate the anxiety.

If your doctor is not willing to consider adjusting the dose of thyroid replacement, then it would be an option to consult a different doctor, possible a specialist in thyroid disease.

If I can provide any additional information, please let me know.

Customer: replied 1 year ago.
i am taking synthroid and am on 1 and a half pills of 25 mcg. so would you say that based on my symptoms and tsh level that my tsh is too high?
Expert:  Dr. D. Love replied 1 year ago.

Only in the context of what I said above.

Large studies only show that it is helpful to achieve a TSH in the normal range. The literature that suggests that some people do better with a lower TSH is not solid, so it is also an area in which you can find experts that espouse both perspectives. National guidelines only address recommendations for which the evidence is solid, and the national guidelines only recommends achieving a TSH in the normal range. And from that perspective, your TSH is perfect.

With time and further study, then this issue will be clarified, but until that clarification is done, there are some thyroid experts that advocate for achieving a TSH closer to 1.0, if symptoms are still present. Since this is a controversial area, seeing a thyroid specialist would be reasonable.