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Please interpret my thyroid report and advise on medication.

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am on Synthroid 75 mcg. My family doctor referred me to an endocrinologist and he had ordered some tests.

The results are:

  1. TSH - 3.45 (gone down from 5.45).
  2. T4, T3 tests canceled as per the guidelines.
  3. TPO is 48 and normal range is under 35.
  4. Thyroperoxidase Ab - 48.

I am currently on Lithium 750 mcg and Synthroid 75 mcg.

Please guide.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome to icliniq.com.

Your TSH is in the normal range. Your TPO, as you mentioned, is high, indicating an autoimmune condition. So right now, you should continue with the same dose of Levothyroxine because it is maintaining your TSH (thyroid-stimulating hormone) in normal range. Check your TSH again after six to eight weeks. No need to check TPO at least for a few months. You can check it after six months. I hope your symptoms have improved.

I hope this helps you.

Thank you.

Patient's Query

Thank you doctor,

I will surely do this. Is this a cause of concern that my TPO is high? I guess it is good that I caught it in time and have started on Levothyroxine. Is 75 mcg enough or do I need a higher dose? What precautions should I take, since I have an autoimmune condition? Is this a cause of concern?

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

Right now, the dose is good, so continue with the same dose. Repeat your TSH after six or eight weeks, and the dose may need to be titrated according to your TSH level. Your target TSH level should be 0.4 to 4.5. I hope your TPO comes down after treatment, but it cannot be predicted. So you need to recheck it after six months.

When someone has an autoimmune disease, there are chances he may have other autoimmune diseases too. The common ones are diabetes mellitus, Addison’s disease, pernicious anemia, thyroid, etc. For diabetes, you can check HbA1c (glycated hemoglobin) once in a while and fasting blood sugar. Without symptoms, usually, we do not ask for screening for other diseases.

You can check your vitamin B12 levels for pernicious anemia because it is easy to do. For Addison's disease, a morning cortisol level test is enough.

1. Have a hygienic lifestyle. Quit smoking.

2. Consume alcohol less than the recommended level.

3. Take a good seven to eight hours of sleep.

4. Drink plenty of water, and a daily walk is what we recommend to everyone.

I hope this helps.

Thank you.

Patient's Query

Hi doctor,

My thyroid-stimulating hormone (TSH) is well under control. Today the level is 2.5 mlU/mL, which is far better than 5.65 mlU/mL a month and a half ago. I have started with weight loss measures too. Endocrinologist did a few more tests and below are the results; a) FSH - 1.3 mlU/mL b) LH - 1.7 mlU/mL c) Prolactin - 8.8 ng/mL d) Testosterone - 11.6 ng/dL. I do have extremely low sexual urge and low libido. Are these values in range? Is my low sexual desire due to variation in these values? Tomorrow I will do my cortisol test in the morning and will let you know.

Kindly help.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I suggest you not repeat tests so often. I hope you already did this test two weeks back. Usually, it should be repeated after six to eight weeks and TPO (thyroid peroxidase) after six months. As per the reports, TSH (thyroid-stimulating hormone) is fine. The other hormonal tests are in the normal range. I suggest the sexual issue is more related to your psychological problems. I recommend getting good psychological counseling. Let me know the cortisol levels once the results come.

I hope this helps you.

Thank you.

Patient's Query

Hi doctor,

I am currently on Lithium for bipolar disorder, GABA, tablet Synthroid for hypothyroidism, tablet Tamsulosin for bladder disorder. I am doing well with these medicines. But all this stress and pain caused me a lot of depression, and my social worker asked me to get a companion dog which would ease my life quite a lot. I own my unit, and the building manager wants a letter stating my disability and why a dog and not a cat would help. The letter has no legal value to it; it is simply for internal building purposes only. I am attaching the document that states my disabilities which is bipolar disorder, radial plexus injury, and anxiety disorder. Kindly help.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I am sorry. I cannot attach any document here; I can only write it here.

Answered byDr. Zulfiqar Ahmed

Medically reviewed byDr. Hemalatha

Published At September 30, 2020
Reviewed AtJune 2, 2026

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed

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