An elevation in the thyroid-stimulating hormone (TSH) level indicates that the thyroid gland
An elevation in the thyroid-stimulating hormone (TSH) level indicates that the thyroid gland is not functioning properly. The TSH hormone controls the level of T3 and T4 hormones in the body, which in turn carry out various cell functions.
A high TSH level is often found in conditions where T3 and T4 levels go down, and the brain (pituitary gland) compensates by increasing the serum TSH levels. This condition is called hypothyroidism.
The symptoms may include:
- Weight gain
- Decreased heart rate with abnormal rhythm
- Decreased body temperature (feeling unusually cold)
- Reduced sweating
- Feeling irritable
- Feeling of lethargy, tiredness, or weakness
- Mood swings
- Constipation
- Puffiness around the eyes
- Osteoporosis (bone loss)
- Interrupted menstrual cycles
- Infertility
The standard reference range for the TSH level is anywhere between 0.30 and 5.0 uIU/mL. If your TSH level is higher than 5.0 uIU/mL, then the lab will flag you as “high,” and you may experience the symptoms listed above 5.0 uIU/mL. Values of the TSH level more than 10.0 uIU/mL need long-term thyroid supplements.
Subclinical hypothyroidism is seen where TSH levels are between 5.0 and 10.0 uIU/mL but T4 levels are normal. This may need to be treated with supplements if it causes symptoms or if the woman is at present pregnant. Often subclinical hypothyroidism settles on its own with lifestyle changes, diet, and stress management.
Causes for a high TSH level:
- Hashimoto's thyroiditis: It is a condition where your body begins to attack its own thyroid gland, through an autoimmune process, which results in long-term and potentially permanent damage to your thyroid gland over time.
- Iodine deficiency: Iodine is required for the production of the thyroid hormone in your body. Low iodine content in the diet will result in low circulating thyroid hormone in the serum. This may trigger a feedback loop that will result in an increase in the TSH level from your pituitary.
- Obesity and metabolic damage: Obesity, weight gain, and metabolic damage may all potentially increase your TSH level and lead to hypothyroidism. Women with polycystic ovarian disease are at special risk.
- Stress and increased cortisol: A high TSH level may also be due to stress and an increased cortisol level. A high cortisol level is positively correlated with TSH levels in the serum. Cortisol is considered our stress hormone that is released to help our body tolerate excessively stressful situations.
- Thyroidectomy (partial or complete): Damage to or removal of your thyroid gland may increase TSH levels.
- Drugs: Lithium, metformin, and other drugs are known to cause thyroid dysfunction.
Treatment for hypothyroidism or high TSH levels:
- Using thyroid hormone T4 supplements will help reduce your TSH level due to the feedback loop that exists in your body.
- Treating the cause. Some causes such as iodine deficiency and drugs can completely be reversed if you treat them appropriately by adding sufficient iodine in your daily diet.
- In case of stress, you may be able to improve your TSH level by completely reversing the stress from your body or by attempting to lower your cortisol level by yoga and other activities such as painting and dancing.
- The use of supplements that contain both zinc and selenium improves thyroid function in those who have deficiencies.
What are the complications of hypothyroidism if left untreated?
If hypothyroidism is left untreated or not treated properly, a life-threatening complication called myxedema can occur. Myxedema is considered a medical emergency that can also be triggered by a trauma, an infection, a surgery, uncontrolled diabetes, pregnancy or labor, or going off thyroid medications. Symptoms may include:
