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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18443
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I just had a test. It came back normal. But my TSH IS GH.

Customer Question

I just had a test for Cushings. It came back normal. But my TSH IS HIGH. WHAT DO I do next?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.


It will help if you could provide some further information.

Do you know the actual numeric value of the elevated TSH?

Was a T4 level also checked?

What symptoms are you having?

Expert:  Dr. D. Love replied 1 year ago.

I had asked for some further information and have not heard back, but this information would guide decision making.

An elevated TSH is indicative of hypothyroidism, since this is a sign that the brain and pituitary is trying to get the thyroid to release more thyroid hormone.

If the TSH is severely elevated or the T4 level is low, then there is clear evidence that thyroid hormone replacement is the proper step. However, if the TSH is only mildly elevated and the T4 is normal, then the evidence is not as clear. In this latter situation, the symptoms would usually guide decision making. If the symptoms are typical for hypothyroidism and are symptoms that would resolve relatively quickly, then the usual approach would be to start thyroid replacement and adjust the dose until the TSH is normal, and then reassess whether this has improved the symptoms. When the only symptoms are more vague or slower to respond, then it is a more difficult situation, but your doctor may still consider a trial of thyroid hormone replacement.

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