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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 2.99 low and D3 was 17 equally low .
I have started taking folvite mb as my b12 is 357 in range but not upto mark
Uprise D3 once weekly
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• Your rise in TSH (2.1 → 6.1) is very likely due to missed doses, not disease progression → Hypothyroidism (under-replacement)
• Current issues:
– TSH 6.1 → mild elevation
– Vitamin D 17 → deficiency
– Folic acid low
– B12 borderline
Next Steps
Thyroid
• Continue medication but monitor closely
Health Tips
• Take thyroid tablet:
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Continue these supplements. Take thyronorm 100mcg till 12 weeks, then repeat thyroid profile.
Better to take calcium supplements as calcium is on lower side of normal.
Take shelcal 300mg one morning and one evening for 4 weeks.
Take more of fresh, green vegetables, curd, cheese, nuts freshfruits, in your diet.
Repeat tests after 4 weeks.
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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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Better consult for thyroid issues
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It is quite common for TSH levels to fluctuate significantly when thyroid medication is missed for an extended period, as in your case from December to March. While your current TSH of 6.1 mIU/L indicates mild Hypothyroidism, the jump from 20 mcg to 100 mcg is indeed a significant increase. Usually, clinicians prefer a gradual titration (e.g., moving to 37.5 mcg or 50 mcg) to avoid symptoms of 'Hyperthyroidism' like palpitations or anxiety. However, your doctor might have chosen a higher dose to quickly stabilize your levels given the non-compliance history."
Next Steps
Your Vitamin D3 (17 ng/mL) and Folic Acid (2.99 ng/mL) levels are indeed low and require supplementation, as these deficiencies can often mimic or worsen symptoms of hypothyroidism like fatigue and brain fog. Continuing the prescribed Vitamin D3 (weekly) and Folvite MB is a correct step. However, for your thyroid dosage, it is crucial to monitor for symptoms of Hyperthyroidism (like palpitations, anxiety, or excessive sweating) since the 100mcg dose might be high for a TSH of 6.1."
Doctor's Advice:
"I recommend following the current 100mcg dose but getting a repeat TSH, Free T3, and Free T4 test after 6 weeks of consistent intake. This will confirm if 100mcg is your maintenance dose or if it needs to be scaled back. Ensure you take your thyroid medication on an empty stomach, at least 30–60 minutes before tea or breakfast, for maximum absorption. Consistency is the key to stabilizing your levels."
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Hello. I have reviewed your laboratory results and your recent history regarding your thyroid and vitamin levels.
It is very common for stress and a change in routine to lead to missed medication doses. However, your current TSH of 6.1 indicates that your thyroid is struggling to keep up, and your low Vitamin D and Folic Acid levels are likely contributing to any fatigue or "brain fog" you may be feeling.
1. Thyroid Management (TSH 6.1)
Dose Increase: Your GP has increased your dose from 20 mcg to 100 mcg. This is a significant jump. While necessary to bring your TSH back into the normal range (usually 0.4–4.0 mIU/L), you should monitor for symptoms of "hyperthyroidism" such as heart palpitations, excessive sweating, or tremors.
Consistency is Key: Thyroid medication must be taken on an empty stomach, at least 30–60 minutes before breakfast, with water only. Coffee or food can interfere with absorption.
2. Addressing Vitamin Deficiencies
Vitamin D3 (17 ng/mL): Your level is quite low (deficiency is typically defined as below 20 ng/mL). Starting Uprise D3 (60,000 IU) once weekly for 8–12 weeks is the standard protocol to replenish these stores.
Folic Acid (2.99 ng/mL): This is also below the optimal range. Folvite MB will help resolve this deficiency, which is important for red blood cell production and nerve health.
Vitamin B12 (357 pg/mL): While technically "in range," many physicians prefer to see this level above 400 or 500 pg/mL for optimal energy and neurological function.
3. Next Steps
Follow-up Testing: You should re-check your TSH, Free T4, and Vitamin D3 levels in 6 to 8 weeks. It takes about two months for your body to stabilize on a new dose of thyroid hormone.
Stress Management: Since stress caused the initial missed doses, try to link your pill-taking to a fixed morning habit (like placing the bottle next to your alarm or phone) to ensure consistency during busy times.
Summary Advice:
Continue the 100 mcg dose and your supplements as prescribed. Your TSH of 6.1 is not dangerously high, but it does require correction. You should start feeling an improvement in your energy levels within 2–3 weeks as your vitamin levels rise and your thyroid hormone stabilizes.
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Get it tested after 1 month and dose is accordingly adjusted .
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Dr. Manisha Mallavarapu
Consult Now
Endocrinology, Metabolism And Diabetes Specialist
7 yrs exp
Rajahmundry
50mcg could be a perfect dose for you. Or even 25 mcg works.
100 is definitely higher dose.
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Take your thyroid medications as prescribed... nd repeat test after 3 weeks (TSH) females usually have decreased d3 levels so no need to worry about take cholecalciferol capsule 60k for 8 week nd repeat test after that .... stay in sunlight for few duration this will increase your d3 level
I would also recommend you to do serum calcium level test nd kindly mention the reports ... as of now continue folic acid as prescribed....
Do mention the calcium level reports... then after getting rest test after 1.5 months do mention that reports ... we will futher suggest you accordingly...
Take care nothing to worry
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Your TSH rise (2.1 → 6.1) is most likely due to missed doses, not a new problem. Levothyroxine works only when taken regularly and missing doses for weeks/months leads to TSH rises again.
About the new dose (100 mcg):
It may be slightly higher than your previous need (20 mcg)
But sometimes doctors give a higher dose to correct levels faster
Important: Do TSH repeat after 6–8 weeks and adjust accordingly
Regarding your other deficiencies:
Low Vitamin D (17) - continue Uprise D3 60k weekly
Low Folic acid - continue supplements
B12 borderline - current treatment is appropriate
Next Steps
Take thyroid medicine correctly:
Take Levothyroxine early morning, empty stomach
Wait 30–45 mins before food/tea
Do not skip doses
Health Tips
Watch for overdose symptoms like-
Palpitations
Anxiety
Weight loss
Excess sweating
If these occur then see your physician.
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Its reversible, continue your medicine, dont skip.
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Donât worry, this rise in TSH is most likely due to missed doses, which is common and reversible., increasing directly from 20 mcg to 100 mcg may be a bit high in some cases, so itâs important to monitor how you feel and repeat TSH after 8 weeks.
Try to take thyroid medication regularly on empty stomach at the same time daily. Your Vitamin D and folic acid are low good that you started supplements, that will help with energy and overall health
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Kindly consult with me on 94 two six eight six 78 nine six.
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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. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Uprise d3 capsule once a week for 12 weeks at 6am
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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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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Kindly do connect and consult
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Plz use regularly
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