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Subacute Thyroiditis
In December my TSH was very low and kept on getting lower till February. From Feb end till now the TSH has now spiked severely. T4 is borderline low right now and TSH is 16. Two weeks ago it was 8. Doctor had diagnosed subacute thyroiditis. But is this spiking of TSH is two weeks normal? Should I test for Hashimoto's? Currently not on medication. Should I consult for medication?
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Consult an Endocrinologist.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Hello, what you are experiencing is the classic triphasic course of Subacute Thyroiditis.
1. Is this TSH spike normal?
Yes, it is common. After the initial 'hyper' phase (low TSH) where the gland leaks stored hormone, the thyroid becomes temporarily 'exhausted' or depleted. This leads to a transient hypothyroid phase, where TSH rises significantly (in your case, to 16) while T4 levels drop. This phase typically occurs 2–4 months after the initial onset.
2. Should you test for Hashimoto's?
While Subacute Thyroiditis is usually triggered by a virus, it can occasionally unmask or overlap with Hashimoto’s. Given that your TSH doubled in just two weeks (from 8 to 16), it is reasonable to check your Anti-TPO and Anti-Tg antibody levels. If these are highly positive, it suggests an autoimmune component (Hashimoto's) rather than just a temporary post-viral inflammation.
3. Should you start medication?
With a TSH of 16 and borderline low T4, you have Overt Hypothyroidism.
If you are experiencing symptoms like extreme fatigue, cold intolerance, or brain fog, low-dose Levothyroxine is usually started to support you while the gland heals.
If you have no symptoms, some doctors prefer to wait and retest in 4 weeks, as this phase is often self-limiting.
Recommendation:
I suggest checking your Anti-TPO antibodies and repeating the TSH/Free T4 in 2–4 weeks. If you are feeling symptomatic now, please consult for a starting dose of thyroid supplementation. Most patients recover full function within 6–12 months, though about 10–15% may require long-term support.
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Start Thyronorm 25mcg once a day and continue.
Rpt blood test including TSH, TPO antibodies
All the best.
www.jgsr-health-education.in
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It Will be batter to take Consultation.
Next Steps
You Can Go Anti TPO Test.
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Repeat t3t4tsh.
Anti two antibody test to rule out hasimotoes disease.
Consult superspecialist like endocrinologist
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Radioactive Iodine Uptake (RAIU) test is one of the best functional test to differentiate Subacute thyroiditis and Hashimotos. Im subacute thyroiditis RAIU is characteristically low, whereas it is normal or elevated in Hashimotos
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Do consult
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This pattern—initial low TSH followed by a rapid rise (now TSH 16 with borderline low T4)—is typical of Subacute Thyroiditis.
The condition usually follows phases:
• Hyperthyroid phase (low TSH)
• Then hypothyroid phase (high TSH)
• Then gradual recovery
Next Steps
• Check symptoms: fatigue, weight gain, cold intolerance → if significant, treatment may be needed
• Repeat Thyroid Function Test (TSH, Free T4) in 4–6 weeks
• Consider Anti-TPO Antibody Test to rule out Hashimoto’s Thyroiditis, especially if:
– TSH remains persistently high
– No recovery over 2–3 months
• Medication:
– If TSH >10 with low/low-normal T4 or symptoms → doctor may start **Levothyroxine temporarily
Health Tips
• This phase is often self-limiting, so don’t panic
• Avoid unnecessary frequent testing (give 4–6 weeks gap)
• Maintain balanced diet and adequate iodine intake (normal salt is enough)
• Monitor symptoms rather than just numbers
⚠️ Red flags:
• Severe fatigue, swelling, very low energy → need earlier review
⸻
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Yes u should be tested for hashimoto , plz consult an endocrinologist
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Please consult with endocrinologist physically because you need evaluate properly first .
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Do you feel pain in your throat ?
I think you should consult for medication.
Health Tips
Avoud assuming consult for medication and examination.
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Dr. Shaikh Huzaif
General Physician
20 yrs exp
Mumbai
Please consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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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. Rachna Pande
Internal Medicine
42 yrs exp
Bhopal
Please consult an endocrinologist physically for clinical evaluation and suitable line of management.
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Check free t3,t4
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Yes
Get anti tpo antibodies done
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