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Hypothyroidism
I’m a patient hoping to get some insights from doctors, especially endocrinologists, psychiatrists, or other healthcare professionals, about a recent health concern. I’m trying to better understand my situation and learn more about what might be going on, as I feel a bit lost after a recent doctor’s visit.
I’ve been on quetiapine (an antipsychotic medication) for a psychiatric condition for a while. Recently, I had routine blood tests that showed an elevated TSH level to 42 , and my doctor diagnosed me with hypothyroidism. They prescribed Levothyroxine (Eltroxin, 100 mcg daily) and asked me to follow up in 2 months with another TSH test. However, I don’t have a history of thyroid problems, and I’m worried that the elevated TSH might be a side effect of quetiapine rather than true hypothyroidism. I mentioned this to my doctor, but I felt like my concerns weren’t fully addressed, and I’m now unsure if I really need this new medication.
Answers (17)
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Your concerns are valid, and I appreciate you reaching out for clarification. Let me address your situation step by step:
Understanding Your TSH Level (42)**
- A TSH of **42** is significantly elevated, indicating **primary hypothyroidism**. While medications like quetiapine can sometimes affect thyroid function, such a high TSH typically suggests true thyroid dysfunction rather than just drug-induced changes.
Key Points to Consider:**
1. **Quetiapine and Thyroid Function:**
- While quetiapine is not commonly known to cause hypothyroidism, some antipsychotics can mildly affect hormone levels. However, a TSH of 42 is unlikely to be caused by medication alone.
2. **Need for Levothyroxine:**
- With your TSH level, **levothyroxine (100 mcg) is appropriate** to restore normal thyroid function. Untreated hypothyroidism can worsen fatigue, mood, and metabolism.
3. Next Steps:**
- Continue levothyroxine as prescribed.
- Recheck TSH in **4-6 weeks** (instead of 2 months) to assess response.
- Monitor symptoms: energy levels, weight changes, mood, and cold intolerance.
When to Seek Further Evaluation:**
- If you experience **palpitations, excessive sweating, or anxiety** (signs of over-treatment).
- If fatigue or depression persists despite normalizing TSH.
Your Concerns Matter**
If you still have doubts, a **second opinion from an endocrinologist** would be helpful to rule out other causes (e.g., autoimmune thyroiditis).
For a detailed discussion, you can reach me on WhatsApp at **Eight Zero Zero Nine Eight Two One Three Three Two**.
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I m a known case of hypothyroidism since the age of 36, I m on quitipin50 from 1.5 years I have insomnia my masi is psychiatrist in Huston, basically it's for sleep, no any relation with thyroid.
Thyroid is totally different secret from pituitary but control by thyroid gland. You level is quite high.
Please add calcium as eltroxin is calcium depleting agent you bone become weak. Tab calcijoint xt one at night till u r with eltroxin.
OK.
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TSH level of 42 is high , indicates that you have hypothyroidism.Its better to repeat the TSH and free T4 levels in a accredited Lab in your area to compare with the present results.If the TSH level remains high ,do follow your doctor's treatment.Interactions with medicines will not cause such a high level.
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Hello,
Quetiapine has been associated with mild increases in TSH levels, but a TSH of 42 is significantly elevated and suggests primary hypothyroidism rather than just a medication-related fluctuation.
Since you have no prior thyroid history, it’s reasonable to consider whether Quetiapine contributed. However, true hypothyroidism needs to be ruled out. Here’s what you can do:
Confirm Diagnosis: A full thyroid panel (Free T3, Free T4, anti-TPO, and anti-TG antibodies) can help differentiate between transient and primary hypothyroidism.
Continue Thyroxine: Since your TSH is significantly high, continuing levothyroxine 100 mcg as prescribed is advisable while monitoring response.
Re-evaluate in 2 Months: If TSH normalizes, it suggests primary hypothyroidism. If it remains high, further assessment may be needed.
Discuss with Your Doctor: If Quetiapine is suspected as the cause, your prescribing doctor may consider dose adjustment or an alternative medication.
Next Steps
Follow up as planned with repeat TSH testing.
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Consult online
Continue thyroid medication
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It is unlikely to be likely that.
Continue medication for thyroid.
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