“My daughter has increased TSH levels and is on thyronorm 25mg. Will it be a lifelong medication for her?”

The thyroid medication should be increased until the TSH is at a good range. 0.5 to 1.5 range is ideal. Once a change in medication is made, check the TSH level in 6-8 weeks to see if the TSH level is optimal. Some thyroid conditions improve and don't need treatment as time goes by. And some will continue lifelong. Only time will tell. But for sure, many will improve and need no medication. Only regular monitoring and medication adjustments will determine. If a patient stays at a lower dose for a long time with stable thyroid hormone levels, then weaning him/her from the medication is reasonable. If the Wrangler is tolerated, then stopping the medication and monitoring is reasonable.
Thanks.

The answer to your question depends on the diagnosis. TSH can be elevated for many reasons, not only hypothyroidism. If it is due to autoimmune disease then it is more likely to be a permanent condition. If it's associated with being overweight or obese, then weight loss might help lower the result if the highest the TSH ever got was 9 or less.

"Thynorm" sounds like a generic form of levothyroxine. It's crap. Use brand only Synthroid. Also 25 micrograms is less than a newborn baby would get. Not nearly enough as evidenced by TSH elevation. See a board certified Ped or Adult Endocrinologist if you want real healthcare.

Depends on the reason why the medication was prescribed. The most common reason worldwide is Hypothyroidism secondary to iodine deficiency, but in the USA, the most common reason is Hashimoto's disease (autoimmune chronic inflammation of the thyroid gland). I recommend to clarify with your doctor the reason behind the elevation of her TSH and then you may be able to get a better answer for your question.

I assume you mean 25 mcg (micrograms) and not mg (milligrams). This is a very small dose of thyroid hormone for a full grown 17-year-old. Whether or not it is permanent depends on why it was prescribed. It is not necessarily permanent. You can always ask your daughters doctor at the next appointment if they think it is really necessary.

Kathleen Bethin, MD, PhD

I assume that thyronorm is levothyroxine and that you really meant 25 micrograms (ugm) not mg. That would be a very low dose, but sometimes only a small dose of thyroid hormone is needed for very mild hypothyroidism (or in an infant). Most cases of hypothyroidism are caused by an inflammation called Hashimoto's thyroiditis. Detected usually by blood testing of thyroglobulin or thyroid microsomal antibodies. Sometimes the thyroiditis can also be seen on ultrasound exam of the thyroid gland as well. Not very common to do actual thyroid biopsies any longer, but if thyroid tissue were available, then this, too, could lead to a diagnosis of Hashimoto's thyroiditis. Thyroid functions are checked by blood work, usually total and free T4 levels and TSH (thyroid stimulating hormone)levels. TSH from the pituitary acts like a thermostat to regulate thyroid functioning. If T4 is low and TSH high, that would be classical hypothyroidism. The more abnormal the symptoms and the more abnormal the blood work, the higher the dose of thyroid hormone replacement. If this is Hashimoto's thyroiditis,usually this is a life-long need for thyroid hormone replacement, but some variability. Follow up TSH and free T4/total T4 levels as well as periodic thyroid physical examinations and history would allow decision to be made for dose adjustments based on these findings. Goal is to completely normalize the total T4, free T4, total T3 and TSH levels and sustain such normality with appropriate dose adjustments.

Stuart Brink, MD