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What could be the cause of sudden drop in TSH levels?

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Patient's Query

Hi doctor,

I am a 53-year-old peri-menopausal woman. My weight is 160 lbs. I had a thyroidectomy ten years before. Since then, I have been taking Levothyroxine 112 mcg daily and was maintaining a TSH level around 3.5 to 5 mU/L. (last good test was four months back with TSH- 4.0 mU/L). However, three months back, I had to change to a different Levothyroxine brand and used it for two months, then the next month woke up with a fast heartbeat in the morning and realized that my TSH level was suddenly down to 0.5 mU/L (also had a sudden drop in blood count of 8 g/dL). So I stopped taking it for three days and continued with the original brand. Every ten days or so, my TSH would go up by 1.0 point. So after ten days, it was 1.5 mU/L, then 20 days later, it was 2.5 mU/L (blood levels also rose to 9 g/dL). However, after another ten days (a full 30 days) from the initial problem, my heart again started to beat fast in the morning while waking up. The TSH levels had dropped again to 1 mU/L (blood levels still getting better- 10.4 g/dL, except for some exceptionally high white blood cells). So it is confusing because we thought the cause could be the switch in medicine, but now we cannot figure out what is causing these drops suddenly. Any thoughts on what could cause these drops in TSH value and cause hyperthyroid and fast heartbeats in the mornings?

Answered by Dr. Penchilaprasad Kandikattu

Education:

MBBS

Professional Bio:

Dr. Penchilaprasad Kandikattu is a General Practitioner with 15 years of clinical experience. He pursued his MBBS from Dr. NTR University of Health Sciences, Andhra Pradesh, and MD in General Medicine from Rajiv Gandhi University of Health Sciences, Karnataka. He is specialized in treating acute and chronic illnesses and provides preventive care and health education to patients. Currently, he is working at Sri Sai Hospital, Mancherial, Telangana.

This doctor is not available for online consultations on the platform anymore.

Hi,

Welcome to icliniq.com.

Sudden drop of TSH (thyroid-stimulating hormone) level may be due to thyroiditis, inflammation, or leak of thyroid hormones. Other possibilities are mistakenly taken excessive levothyroxine dose, or the previous dose may not have absorbed well with immediate food intake. In the case of thyroiditis, you have to reduce the intake of Levothyroxine to 75 mcg. Infection, stress, certain drugs like radioactive iodine, etc., can cause thyroid storm. So repeat your thyroid profile after one month. If your heartbeat is still not under control, you can take a tablet of Propranolol 10 mg once daily for five days. Avoid caffeine drinks and alcohol. Review with reports or consult with your physician to examine and treat you accordingly. Take care.

Medically reviewed by Dr. Sneha Kannan
Published At August 25, 2020
Reviewed At August 10, 2024

Education:

MBBS

Professional Bio:

Dr. Penchilaprasad Kandikattu is a General Practitioner with 15 years of clinical experience. He pursued his MBBS from Dr. NTR University of Health Sciences, Andhra Pradesh, and MD in General Medicine from Rajiv Gandhi University of Health Sciences, Karnataka. He is specialized in treating acute and chronic illnesses and provides preventive care and health education to patients. Currently, he is working at Sri Sai Hospital, Mancherial, Telangana.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Sneha Kannan is a skilled Dental Surgeon with expertise in providing general dental care, including scaling, fillings, and preventive treatments. She does oral surgery procedures such as extractions and minor surgical interventions. She does procedures in restorative dentistry, including crowns, bridges, and dentures. She is an expert in doing endodontic treatments such as root canal therapy. She is well-versed in doing procedures in cosmetic dentistry, including teeth whitening and smile correction. She can provide pediatric dental care for children’s oral health and preventive treatments. She promotes oral hygiene awareness and preventive dental practices.  

This doctor is not available for online consultations on the platform anymore.

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

Education:

MBBS

Professional Bio:

Dr. Penchilaprasad Kandikattu is a General Practitioner with 15 years of clinical experience. He pursued his MBBS from Dr. NTR University of Health Sciences, Andhra Pradesh, and MD in General Medicine from Rajiv Gandhi University of Health Sciences, Karnataka. He is specialized in treating acute and chronic illnesses and provides preventive care and health education to patients. Currently, he is working at Sri Sai Hospital, Mancherial, Telangana.

This doctor is not available for online consultations on the platform anymore.

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