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High Tsh (level is 20)
I went through a full body checkup in Jan 2026 and my cholesterol levels were high with tsh as 11 with normal t3 and t4 and low vitamin d with borderline b12.
Other kidney and liver profile were in range.
In cbc , platelets were low which always comes low for me.
After one month again I tested only for only tsh which came out to be 20 with normal t3 and t4.
I used to do gym but used to do less cardio.
Post that, I started running in morning continuously for a month and took vitamin d and b complex along with omega capsules.
I tested today, my all cholesterol parameters are normal , all vitamin are normal along with vitamin d and vitamin b12 and b9.
Iron levels is also normal.
But my tsh is still 20 with normal t3 and t4 .As usual platelets are around 1.35 lakh.
Also free t3 and t4 are normal.
What could be reason for elevated tsh always?
Is anything I can do for it?
Any lifestyle changes?
I don't smoke or drink and mostly eat balanced diet.
Answers (23)
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Repeated high TSH so it's clear hypothyroidism.Dont ignore it ,you need to start medication for this.
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Do video consultation here in practo or see your local physicians
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You have hypothyroidism. Please consult an endocrinologist physically for clinical evaluation and further management accordingly.
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Hi dear,
According to these reports of elevated TSH and normal/borderline T3 & T4 levels, this suggests pre-clinical hypothyroidism which might have an autoimmune etiology. Your borderline low platelet levels also suggest a possible chronic autoimmune platelet destruction disorder.
Next Steps
kindly refer to an endocrinolgist as well as a rheumatologist both to rule to auto-immune disorders. progress of which may be delayed with timely intervention.
Health Tips
monitor for excessive daytime sleepiness/lethargy, cold intolerance, blood pressure disturbances, pin-point skin rashes (petechiae) etc.
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Consult an Endocrinologist.
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TO KNOW REASON CONSULT SUPERSPECIALIST LIKE ENDOCRINOLOGIST.
CHANGE LIFE STYLE N DIET PLAN DRASTICALLY FIRST.
ADD YOGA WITH GYM IN BALANCE. ADD WALK EVEN 3 TO 5 DAYS.
DEFINITELY NEED THYROXINE.
DOSE 125 MCG ONE BEFORE BREAKFAST. THYROXINE IS CALCIUM DEPLETING AGENT SO BONES BECOME WEAK SO NEED TO ADD CALCIUM.
SHALCAL XT ONE AT NIGHT.
BOTH TWO MONTHS. NOT TO STOP. U NEED FOLLOW UP.
OK
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Do consult
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Avoid food that contains goiterogens like cauliflower cabbage coffee etc..
Do lifestyle modification include diet ..
Try do activity which increase ur bmr
Next Steps
do thyroid function test n consult endocrinologist..
persistently high tsh may require medicine support
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Hi! Let's begin with the good job done in starting the exercise routine and taking supplements. The normal reports of vitamin and lipid levels must be reassuring. Now to the part that is bothering you. Elevated TSH. I feel that what you've achieved to correct your lifestyle is out of strong will power. Because a Normal T3,T4 but a TSH of 20 is more likely to give you a fatigued, moody feeling with weight only going up or remaining stagnant.
In my practise I have seen many patients develop Thyroid issues after COVID too.
Next Steps
1. keep up the exercise.
2.Thyroid friendly dirt opinion( please feel free to use AI to list out food best avoided in high TSH).
3.I feel, you will be better if you know- Is this condition here to stay. So get an Anti TPO antibody test done .
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You seem to prefer a lifestyle fix over medication , so with all the above ,Yoga has done very well for a lot of my patients. definitely worth trying.
If the glitch is here to stay, then Medication ( Thyroxine) will be very effective and the result will be felt in a week or so.
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You probably have a condition called subclinical hypothyroidism where TSH levels rise initially but T3 and T4 doesn't.Hoping the values you are stating are from fasting Thyroid function tests.
Please elaborate on your symptoms.
Next Steps
You should get yourself checked with Anti TPO antibodies as in that case you might need to be started on thyroid medications.
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You get your anti tpo test done and for further evalution consult endocrinologist
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Hello, I’m Dr. Praveen Moses
Thank you for reaching out. Please describe your symptoms or concerns in detail, including duration and any medications you are taking. This will help me guide you more effectively.
How is your dietary salt intake?
How is your stomach?
Any complaints of bloating, constipation?
Do you feel heaviness
Next Steps
try taking food which are rich in iodine and you might have to start levothyroxin based on your weight dosing
Health Tips
i suggest you to have an appointment with endocrinologist for better work up...
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TSH 20 with normal T3/T4 = subclinical hypothyroidism, most commonly due to early thyroid (often autoimmune).
At this level (TSH >10), usually thyroxine treatment is needed, lifestyle alone won’t correct it. Continue healthy diet, exercise, and check anti-TPO antibodies once.
Consult an endocrinologist to start proper dose and follow-up.
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TSH being high is not a normal thing to be. All the time when you for your thyroid functions, you got tested T3T4 , instead please get tested Free T3/Free T4 which indicates the unbound thyroid hormone in your body. Even if that comes normal, you should get further tested for anti thyroid antibodies. You should start taking iodine in the form of iodised salt, liquid iodine with water which has enhance the production of thyroid hormone in you. And with this thyroid profile, you should be having symptoms of hypothyroidism like lethargy, constipation, excessive sleep, occasionally high systolic BP etc etc. At your age, it can also cause extra stress, depression etc.
Do not neglect this at all. Get your tests done and get a review here at Practo
Do
Next Steps
Get tests repeated as Free T3/ Free T4/ TSH from a reputed lab
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Yes you are good going but sometimes it’s some genetic factors also so don’t worry if u hv any problems with high tsh then start medication otherwise please continue as u r doing
Next Steps
Or you can also do jag of neck
Health Tips
Visit to nearby endocrinologist
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You need to consult a metabolic physician.
If Tsh is consultantly high , means you need medical attention. Later in life it affect fertility , and make your metabolism slow. If there is thyroid hormone deficiency in the body no amount workout can fix that. Think of it like a vitamin deficiency. You took the supplements for the vit b 12 and d deficiency. Similarly , if your body is making less thyroid hormone than its requirement , you will need to medicat.
Next Steps
FT3 , FT4 TSH .
Health Tips
Continue following a healthy lifestyle.
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Marini Vanitha
General Physician
12 yrs exp
Kakinada
Need medication.
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Dr. Annpurna Pai
General Physician
31 yrs exp
Mumbai
You have to go for detailed thyroid profile test : free T3 , Free T4 and ultra sensitive TSH and anti TPO antibody test to rule out autoimmune thyroiditis like Hashimotos (after overnight fasting ). Get these tests done and consult an endocrinologist.
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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