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Causes Of High TSH


Whenever there is decreased thyroid hormone secretion from thyroid gland leads to rise in TSH (Thyroid Stimulating Hormone) this condition ic called Hypothyroidism.  There can be many reasons why the cells in the thyroid gland canít make enough thyroid hormone. Here are the major causes, from the most to the least common:

Hypothyroidism due to iodine deficiency
Hypothyroidism due to Subacute thyroiditis 
Hypothyroidism due to goitrogens

Autoimmune disease. In some peopleís bodies, the immune system that protects the body from invading infections can mistake thyroid gland cells and their enzymes for invaders and can attack them. Then there arenít enough thyroid cells and enzymes left to make enough thyroid hormone. This is more common in women than men. Autoimmune thyroiditis can begin suddenly or it can develop slowly over years. The most common forms are Hashimotoís thyroiditis and atrophic thyroiditis.

         Surgical removal of part or all of the thyroid gland. Some people with thyroid nodules, thyroid cancer, or Gravesí disease need to have part or all of their thyroid removed. If the whole thyroid is removed, people will definitely become hypothyroid. If part of the gland is left, it may be able to make enough thyroid hormone to keep blood levels normal.

         Radiation treatment. Some people with Gravesí disease, nodular goiter, or thyroid cancer are treated with radioactive iodine (I-131) for the purpose of destroying their thyroid gland. Patients with Hodgkinís disease, lymphoma, or cancers of the head or neck are treated with radiation. All these patients can lose part or all of their thyroid function.

         Congenital hypothyroidism (hypothyroidism that a baby is born with). A few babies are born without a thyroid or with only a partly formed one. A few have part or all of their thyroid in the wrong place (ectopic thyroid). In some babies, the thyroid cells or their enzymes donít work right.

         Thyroiditis. Thyroiditis is an inflammation of the thyroid gland, usually caused by an autoimmune attack or by a viral infection. Thyroiditis can make the thyroid dump its whole supply of stored thyroid hormone into the blood at once, causing brief hyperthyroidism (too much thyroid activity); then the thyroid becomes underactive.

         Medicines. Medicines such as amiodarone, lithium, interferon alpha, and interleukin-2 can prevent the thyroid gland from being able to make hormone normally. These drugs are most likely to trigger hypothyroidism in patients who have a genetic tendency to autoimmune thyroid disease.

         Too much or too little iodine. The thyroid gland must have iodine to make thyroid hormone. Iodine comes into the body in food and travels through the blood to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in too much iodine can cause or worsen hypothyroidism. See ATA Iodine information pages: Iodine Deficiency and Low Iodine Diet.

         Sometimes overproduction TSH from pituitary may also lead to high TSH.


First  of all proper diagnosis for cause of high  TSH need to made by investigation and correct diagnosis. Treatment is provided in the form of

Investigations & Diagnostic Tests:  Some of the following tests are required for correct diagnosis of severity of hypothyroidism, what its cause is & whether it is temporary or permanent. After below mentioned test we may decide what dose to be given & how long to continue it.

1) Free T3, Free T4 & TSH / or T3, T 4 & TSH ( In hypothyroidism there is low free T3 or T3 & free T4 & T4 & high TSH.

Other below mentioned tests required to know the cause of hypothyroidism & also in deciding whether this thyroid disorder is temporary i.e. permanent or temporary.

2) Thyroid microsomal antibody (also known as anti-peroxidase antibody or anti-                 microsomalantibody

3) Anti-thyroglobulin antibody

4) Thyroid scan

5) Urinary iodine

6) ESR

7) Fine needle aspiration cytology

8) Sonography Thyroid

9) Thyroglobulin

11) Other relevant tests.


Treatment: Before starting the treatment we decide the severity of illness, its cause & whether it is temporary or permanent. Normally in cases of temporary hypothyroidism we need to give small doses just for three to six months. Thus before staring the treatment asks your doctor whether your thyroid is temporary or permanent & whether it can be cured or not. In cases of permanent hypothyroidism full dose for that particular patient is decided. After diagnosis proper treatment in form of Thyroxine hormone (Eltroxin, Thyrox, and Thyronorm) is prescribed. 

Cure of hypothyroidism:  Because many cases of Hypothyroid are temporary still doctor keep giving lifelong medication wrongly. Thus before staring the treatment asks your doctor whether your thyroid is temporary or permanent & whether it can be cured or not. If proper diagnosis of etiology of thyroid disorder is diagnosed then many times it can be cured permanently..  




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