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TSH increased
My tsh was 2.1 in sep while on 20 mcg for a year t3 t4 were in range too but because of some issues at home n stress i missed doses from dec on and off till feb then by march i forgot taking meds because i was rushing every morning now in april i checked it is 6.1 tsh and my GP gave me 100mcg for 3 months
Plus my folic acid was 2.66 low and D3 was 17 equally low. My calcium level is 8.77 I have started taking folvite mb as my b12 is 357 in range but not upto mark Uprise D3 once weekly
Do i need calcium supplement too? Or food can help with that its borderline.
Answers (22)
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There was a sudden increase in dose of thyroxine. In my personal opinion the dose escalation should have been more gradual. Tsh 6 is within the normal limit of <10. ( Yes within 5 is good , but within 10 too is okay, and neednot much dosage adjustment)
Even if the dose has been increased , repeat the TSH after 2 months or anytime inbetween if you feel anything.
And there is no need of measuring t3 and t4, they are not required to titrate doses in a case of hypothyroidism.
You continue taking folate and vit d supplements. You calcium is also on the lower side , so you can take some kind of supplements for 1 month ( eg calcimax/ shelcal)
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• Your current picture suggests mild hypothyroidism due to missed doses of thyroid medication → Hypothyroidism
• Labs:
– TSH 6.1 → mildly elevated
– Vitamin D 17 → deficient
– Folic acid low
– Calcium 8.77 → borderline but still acceptable
Next Steps
Thyroid:
• Continue medication but ideally:
Health Tips
• Diet for calcium:
– Milk, curd, paneer
– Ragi, sesame seeds
– Green leafy vegetables
• Important:
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Continue thyronorm 100mcg, vit d3, polite. Take shelcal 300mg one morning and one evening for 4 weeks as you have calcium on lower side of normal.
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TSH increased mainly due to missed doses.
100 mcg ok, take regularly empty stomach.
Calcium 8.7 borderline → food usually enough + D3 will improve it.
Advice:
• Continue thyroxine daily same time
• Continue D3 weekly
• Add milk/curd, nuts
Repeat TSH after 6–8 weeks.
You can consult me, I guide dose properly.
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It is common for TSH levels to fluctuate when doses are missed, but we can definitely get this back on track. Here is a simplified way to look at your current situation:
Thyroid Medication
Going from 20 mcg to 100 mcg is a very large jump for a TSH of 6.1. Usually, we aim for a smaller adjustment to avoid making the thyroid overactive. You should double-check this dose with your doctor or consider starting at a lower increment (like 25 mcg or 37.5 mcg) and re-testing in 6 weeks to see how your body responds.
Calcium and Vitamin D
Your Vitamin D is low at 17, which often causes borderline calcium levels like yours (8.77) because the body needs Vitamin D to absorb calcium.
Do you need a supplement? Since you are already taking Uprise D3 once weekly, your calcium levels will likely improve on their own as your Vitamin D levels rise.
Food first: For now, you can focus on calcium-rich foods like milk, curd (yogurt), paneer, and ragi. You likely don’t need a separate calcium pill unless your levels drop further or you experience muscle cramps.
Consistency is Key
The most important thing for your TSH is taking your medication at the same time every morning on an empty stomach, at least 30-60 minutes before tea or breakfast. This will help stabilize your levels much faster than a high dose will.
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Hi!
First of all I would suggest to make sure to stick to the schedule with the Thyroid medicines and definitely check after 3 months because the dosage will require adjustment then as well. As for the values, it depends on lab reference ranges to comment on how severe is the deficiency.
Next Steps
Continue with your supplements and yes you can add a calcium supplement as well for 1 month. Once your vitamin D is back in level, the calcium levels will also get moderated as they are interlinked.
Health Tips
Do not miss the thyroid medicines, if forgotten take when remembered in the first half of the day.
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Continue all medicine regularly.
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Medicine take regularly. No problem then.
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Hello..!
Your elevated TSH (6.1) is most likely due to irregular intake of Levothyroxine over the past few months. The dose adjustment to 100 mcg is appropriate. Kindly ensure strict compliance—take the medication daily on an empty stomach, at least 30–45 minutes before breakfast. A repeat thyroid profile is advised after 6–8 weeks.
Regarding your other parameters:
• Your Vitamin D level (17 ng/mL) is low; continue Uprise D3 as prescribed.
• Folic acid is low; continue Folvite.
• Vitamin B12 (357 pg/mL) is within acceptable range at present.
• Serum calcium (8.77 mg/dL) is borderline low.
At this stage, calcium supplementation is not mandatory if you maintain an adequate dietary intake
Milk, curd, paneer
• Ragi, sesame seeds (til)
• Green leafy vegetables
• Almonds
especially since Vitamin D correction will improve calcium absorption.check for repeat calcium 3 months later..
Calcium supplements may be considered if dietary intake is insufficient or if levels remain low on follow-up .
Hope you find this helpful
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Aapka TSH increase hona mainly medicines miss karne ki wajah se hua hai, isliye ab jo dose doctor ne diya hai usko regularly lena bahut important hai. 6–8 weeks baad TSH repeat karna.
Folic acid aur vitamin D dono low hain, unka supplement lena sahi hai aur continue karo.
Calcium 8.77 borderline low hai, lekin abhi direct calcium supplement lena zaroori nahi hai. Vitamin D correct hote hi calcium level bhi improve ho jata hai.
Aap diet se easily manage kar sakte ho:
Milk, curd, paneer regularly lo
Green leafy vegetables aur nuts include karo
Thodi sunlight exposure bhi lo daily
Agar future me calcium aur kam aata hai ya symptoms (bone pain, weakness) aate hain tab supplement consider kar sakte hain.
Abhi main focus hona chahiye:
Thyroid medicine regularly lena (empty stomach, same time daily)
Vitamin D aur folic acid continue karna
Aur 2–3 mahine baad repeat tests karna
Regularity maintain karoge to sab values gradually normal ho jayengi
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"Regarding your question about calcium, a level of 8.77 mg/dL is technically within the normal laboratory range but is on the lower borderline. Since you are already taking Weekly Vitamin D3 (60,000 IU), your body's ability to absorb calcium from your diet will naturally improve, as Vitamin D is essential for calcium absorption. At this stage, instead of adding another pill to your routine, you can effectively manage and improve these levels through targeted dietary changes, provided you remain consistent with your Vitamin D and Thyroid medication."
Next Steps
Yes, food can definitely help bridge this borderline gap. I suggest incorporating the following into your daily diet:
Dairy & Alternatives: 1 glass of milk or a bowl of curd (yogurt) daily.
Seeds & Nuts: A tablespoon of sesame seeds (Til) or a few almonds are excellent plant-based calcium sources.
Green Leafy Veggies: Increase your intake of spinach or broccoli.
Sunlight: Try to get 15 minutes of early morning sunlight to assist your Vitamin D supplements."
Health Tips
"You do not need an immediate calcium supplement pill. However, because you are managing Hypothyroidism and low Vitamin D/Folic acid, bone health is a priority. I recommend re-checking your Serum Calcium along with your TSH after 8 weeks. If the level drops below 8.5 or if you experience muscle cramps/numbness, only then would we consider starting a dedicated Calcium + Magnesium supplement."
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Donât worry, your calcium is borderline but still within acceptable range, so supplements are usually not needed immediately.
You can manage it with diet Milk curd paneer Ragi sesame seeds Green leafy vegetables Since your Vitamin D is low, correcting that will also help improve calcium levels.
Focus on taking thyroid medication regularly and continue your current supplements.
If youâd like, I can help you plan a simple routine and diet to normalize all your levels smoothly book a consultation with me
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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. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Kindly do connect and consult
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Dr. Moin Ahmad Siddiqui
Trichologist
7 yrs exp
Lucknow
Dose correct
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Uprise d3 capsule 60k
Once a week for 12 weeks
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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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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